Allied health professionals (AHPs), who make up a substantial portion of the healthcare workforce, are so rarely seen in leadership roles. Despite their critical skills in communication, decision-making, and patient advocacy, structural and cultural barriers keep them from ascending to the C-suite. As we consider the future of healthcare, how can we overcome these barriers and fully leverage the unique expertise of AHPs to revolutionize leadership and improve patient care?
This blog is part of a series of profiles of different clinical health professions written by Health Professions Network members. These profiles are intended to give students and those looking at prospective careers in health care an accurate, professional perspective on different health care fields, specialties and careers. This blog was written by Zach McElgunn, VP, Education & Development.
Back towards the beginning of April, HPN published a blog by HPN Board Member, Nanci Burchell, which highlighted an anomaly regarding leadership across the U.S. healthcare sector. Nanci pointed out that despite the fact that professionals across the 80+ distinct allied health professions make up roughly 60% of the total healthcare workforce, very few of these professionals are represented in leadership roles within healthcare organizations. Exploring this imbalance in allied health professional (AHP) representation, Nanci considered two insightful questions – What are factors that have led to allied healthcare professionals being underrepresented in the C-suite? and How do we remedy this inequity? This blog is being written in response to these same two questions, and to expand on some of Nanci’s suggestions about how allied health professionals might be more effectively prepared to fill leadership positions in the broader healthcare environment. The Factors at Play Regarding the first question – What are factors that have led to allied healthcare professionals being underrepresented in the C-suite? – Nanci contends that AHPs often spend time delivering direct patient care without the benefit of mentorship, structured support, or developmental supervision. As a result, AHPs remain “hidden” at the bedside, creating a significant blind spot for current healthcare leaders and decision-makers (i.e. people with outsize influence and control over which professionals are identified for advancement). This insight is a good one, but we can dig even deeper into why this lack of observation and recognition of AHPs is detrimental to the healthcare leadership infrastructure generally. First, the lack of observation of AHPs is grounded in cultural and structural realities in healthcare which inhibit effective collaboration and communication across groups of professionals. In the doctor-centric healthcare model that typifies most healthcare provision in the United States, strict hierarchies dominate the professional space with physicians placed comfortably at the top of the pyramid. This structure can reinforce cultural biases that call the value of AHPs and their contributions into question. Simply speaking, doctors (who have a great deal of power and influence in the current system) do not know what they cannot observe. On top of the lack of perception of AHPs in the current healthcare system, professional silos prevent AHPs from natural career progression that expands skill sets, increases professional responsibilities in the work environment, and provides collaborative opportunities between professionals. A culture of specialization, as opposed to collaboration, is prevalent across the healthcare landscape. The firm boundaries thus enacted between providers and departments limits AHPs’ ability to demonstrate their expertise alongside decision makers, making it difficult for them to gain the trust required to ascend to leadership positions. This lack of opportunity for leadership consideration is especially detrimental to healthcare’s leadership infrastructure (not to mention ironic) if we consider the skills and perspectives that AHPs are able to develop while tucked away in the crevices of organizations delivering direct patient care. The Consequences of Neglect Working closely with patients, families, and other healthcare providers, AHPs must tailor their communications to specific audiences. Their verbal and nonverbal communication skills are honed constantly as they strive to explain complex medical information clearly to both co-providers and patients, as they actively and empathetically listen to patients' concerns and mitigate any distress, and as they continually negotiate their specific roles and responsibilities within the care team. In the context of direct patient care, AHPs are familiar with situations that can change on a dime. They routinely make decisions about patient care within established protocols, weighing risks and benefits, and acting with sound judgment. The value this provides for AHP’s ability to analyze situations, think critically, and make effective decisions under pressure can not and should not be understated. Additionally, AHPs often act as patient advocates, working to ensure their needs and voices are heard by the rest of the care team. They educate patients on their conditions, treatment plans, and self-care strategies. In short, AHPs must inspire and motivate patients throughout their healthcare journey, while maintaining the confidence to accurately represent their interests to other healthcare professionals. To do so effectively requires no small amount of measured empathy, a leadership quality that maintains perpetual relevance for professionals who are thrust into complex changes beyond their control (i.e. in the healthcare environment). Finally, AHPs are experts when it comes to quickly developing sustainable trust between patients and providers. Their ability to effectively and efficiently develop trust is the fulcrum upon which the quality of their service delivery pivots. To inspire behavior change, and help support someone to maintain those changes is no easy feat – AHPs have skills that result in this complex, negotiated process time and time again. When taken individually, each of these skills is a valuable asset to anyone in a leadership role. Taken as a bundle of competencies, however – the ability to tailor communications to specific audiences, active listening skills, flexible solution-oriented thinking, collaborative decision-making, advocacy and community education and engagement, trust development and relationship building – these skills represent a near-comprehensive framework for leadership skills and behavior. Potential Remedies Considering what tools are at our disposal to address the dearth of AHPs in healthcare leadership positions, Nanci outlines a number of suggestions ranging from providing more opportunities for AHPs to present their perspectives publicly (i.e. conference presentations and involvement in research), to developing mentorship programs and leadership pathways that facilitate upward mobility for these professionals. As Nanci points out, this is not only a matter of equity and representation in the broad sense of “healthcare occupations” being brought to the table, but also in material, societal terms as allied health professionals represent an outsize number of low-wage, frontline jobs, which are often held by women and minorities. A solution bringing AHPs into leadership roles puts women and individuals with other minority identities in positions to address long standing inequities that pervade broad societal systems, not just the healthcare sector. Nanci’s suggestions of “next steps” to address the lack of AHP representation in leadership roles are good ones, which can be implemented with relatively little effort from those who currently hold positions of power in the healthcare system. Certainly, anyone working closely with allied health professionals should actively seek out opportunities for these professionals to shine. Their perspectives, creativity, and energy are incredibly valuable assets in the organizations where they work. Beyond what Nanci suggests, though, in order for these solutions to “stick” and for AHPs to consistently be given equitable opportunities for advancement, there needs to be a cultural shift across the healthcare sector. As the healthcare landscape continues to evolve, the demand for innovative solutions and a diverse range of expertise will only grow. While physicians traditionally occupy leadership positions, it's time to acknowledge the immense value AHPs bring to the table. From patient care to system-wide decision-making, AHPs offer a unique perspective that can revolutionize healthcare leadership. By leveraging AHP’s broad understanding of the healthcare space – from the bedside to the C-suite – healthcare professionals need to coordinate their efforts to create an environment where interdisciplinary collaboration is the expectation, not the exception. The silos that currently define the healthcare space will only become calcified if they are not challenged, and AHPs are in a unique position to challenge them, but they need support from those professionals who hold the power and influence in the current healthcare system. Indeed, those who currently have a majority of the social capital in healthcare should be excited about the opportunity to incorporate AHP perspectives into their work with greater intention. AHPs understand the intricacies of specific conditions, rehabilitation needs, and the emotional challenges patients face. This deep understanding translates into leadership skills that prioritize holistic care, ensuring decisions are made with the patient's full well-being in mind. AHPs are masters in their specialized fields, and their in-depth knowledge of specific treatments and rehabilitation processes allows them to identify bottlenecks and inefficiencies within the system. This expertise is crucial for developing evidence-based protocols and optimizing care delivery for patients. AHPs work seamlessly within interdisciplinary teams, and their expertise naturally fosters a culture of communication, ensuring all voices are heard and decisions are made through a collaborative lens. This collaborative approach breaks down silos within the healthcare system, leading to a more unified and efficient approach to patient care. AHPs are constantly pushing boundaries and developing innovative approaches to patient care. Their daily work involves navigating complex clinical situations and finding creative solutions. This problem-solving mindset translates perfectly into leadership roles, where innovative thinking is crucial for tackling challenges and improving healthcare systems. AHPs being in leadership positions facilitates the development of a more diverse healthcare system that reflects the demographics of the population served. This diversity of perspectives ensures leadership decisions are inclusive and take into account the needs of a wider range of patients. The above list represents a fraction of the potential impact that AHP healthcare leadership is poised to deliver. By integrating AHPs into leadership positions, we can unlock a wealth of expertise, foster collaboration, and drive innovation within the healthcare system. It's time to break down barriers and recognize allied health professionals as the future leaders who can revolutionize patient care and build a more efficient, patient-centered healthcare system. Doing so is not only the “right” thing to do, but it is necessary if we (all healthcare professionals) are going to remain adaptable and effective in a landscape that changes on a near-daily basis. Thank you to Zach McElgunn, VP, Education & Development, without whose contribution this necessary conversation would be much slower to progress. Your vision, leadership, and generosity are an asset to HPN and the incredible Allied Health Professionals we develop and serve.