Earlier this year, many of the tech giants came clean about their remarkably low numbers of female employees, which are highlighted in the lack of female leadership in the tech industry.  While we are seeing dramatic improvements in the number of women training in surgery, we continue to struggle in academia, and particularly in areas of surgical leadership.  The October HBR includes an article discussing tech’s diversity problem, particularly with regard to gender diversity, and introduced me to the interesting concept of the bias interrupter.  To summarize, a bias interrupter is an intervention designed not just to demonstrate patterns of gender bias, but to break those patterns.

Williams includes a citation of this work published in 2013 as a bias interrupter for salary inequity at time of hire.  Apparently if women understand that there is an expectation to negotiate, we do so, and we might even do so better than our male colleagues.  Women may also derive equality (or non-inferiority) from negotiations that are not conducted face-to-face, something confirmed in Leibbrandt and List’s work and demonstrated previously in other venues.  To me, the most important feature of this work is that it took an area in which there is a known issue (women generally fail to negotiate starting salaries as well as men) and addressed it without explicitly bringing up culture or gender.  While I wrote in September about leadership perceptions and the gender gap, with an eye to performance evaluation and promotion of women in surgery, I will admit that I would prefer to address this challenge for our profession without having lengthy discussions on sociology.  I want data to clearly define the problem, I want a way to measure the problem, and then I want to start experimenting.

When Williams discusses the four basic patterns of bias, multiple opportunities jumped out at me. “Prove it again” comes up in evaluation for hiring and promotion, as well as in performance evaluations.  Reading about “Tightrope” made me wonder- are the women who leave academics leaving because they do more “housekeeping” tasks, as opposed to getting the glamour work, and are therefore dissatsified? Do glamour roles for women encourage their satisfaction and, in turn, encourage retention in academia?  What is the role of the “maternal wall” in hiring and promotion in academic surgery?  And last, but not least, why can’t we stop playing “tug of war” with each other- we really shouldn’t be our own worst enemies?

Obviously these are all just musings as I worked my way through Williams’ article, and all of her thoughts on tech diversity may not be perfectly applicable in academic surgery.  To my eye, performance evaluation of trainees seems an easy enough place to start, as does the promotion and tenure process; if we have clear objective metrics for these activities, and we spend time training people to improve their documentation and evaluation skills in a neutral manner, the accountability alone should mitigate bias and raise the playing field for everyone- not just women, and not just minorities.  I’ve found that driving change by showing how everyone benefits is far less scary for people than focusing on equity issues.