MarieAnn North

No one ever said the path to the top is easy. Why do some folks make it and others fail?

Two years ago, I decided to complete my Fellowship with the American College of Medical Practice Executives. I had intended to do so for many years and had completed all but the final requirement-write an original research paper. The paper sat on the back burner for several years. It's not that I hadn't started to write the paper. I had actually begun many papers, but the ideas became stale, and I lost interest. Finding a topic that captured my attention finally generated the energy and enthusiasm to see this endeavor through to completion.

I stumbled on my topic quite by accident. I was asked to present a "brown bag lunch" with the faculty at one of my client sites on why so few women fill the top roles in academic medicine. Data supported the perception that diversity statistics were not improving noticeably, even with women making up half of medical school enrollments and filling most middle-management positions in health care. My research and interviews resulted in a list of what it takes for women to make it to those top academic medical center or medical school roles.a

Although this paper was written from a female perspective, my male colleagues thought the list applied to them as well and was not limited to the academic environment.

For those aspiring to make it to the top, success can be attained if you are willing to do the following.

Work very, very hard. Forever! There are no shortcuts. The top echelon female executives interviewed work hard and put in long hours. They are driven, focused, organized, results-oriented, and high achievers. They have good analytical skills and pay attention to detail while not losing the big picture. They are not only intelligent, but also knowledgeable and emotionally mature. Interestingly, these women were not necessarily at the top of their class in college, but more likely one layer down, where they learned to compete.

Make tough decisions about what you are willing to sacrifice so there are no regrets. When asked about the sacrifices they made to succeed in their careers, not one of these female executives could say she had not made serious sacrifices, especially those involving relationships. These women recognized early on that success came at a price and that they could not "have it all." Yet in spite of this, they had no regrets. When asked if, given the chance, they would make different career decisions, the answer was a unanimous "no." These women are satisfied with their lives. The common theme was, "I wouldn't change a thing. The journey has been an extraordinary adventure."

Find a mentor. Or preferably two-a male and a female. Both male and female executives interviewed stated the single most important advice given to someone striving to make it to the top is to find a mentor. You need two people in your professional life at each stage of your career. First, you need a respected peer to share your successes, disappointments, and ideas. Second, you need a mentor who represents in some way what you aspire to be-someone who will take the time to develop others and help others find their niche. Someone who will hold you accountable. Who will push you to excel when you would rather play it safe. Working with a mentor requires a formal relationship, an investment of time, and a game plan.

Be true to yourself; never compromise your integrity or ethics to get ahead. It is critically important not to compromise one's principles along the way and to stay grounded in a strong, ethical value system. Leaders' attitudes and ethics permeate their organizations, and the environments they create directly affect organizational performance. If an employment situation does not support one's personal value system, it's time to change jobs.

Take risks; embrace change, challenge, and creative chaos. The most important trait mentioned by successful female executives is the ability to take risks. There is a unique ego strength that makes these women willing to function outside their "safety zone." They are comfortable with taking charge. They have courage.

Surround yourself with a loyal, talented, high-performing team and develop strong bonds with team members. Genuinely like, care for, and nurture your inner circle. Team building is another important characteristic. These successful women know how to pick good people for their teams and work in a way that brings the entire team to a higher level. They know how to get people to buy into their vision while maintaining (and freely expressing) their individuality and differing points of view. These women have superior communication and delegation skills. They understand leadership is not a popularity contest and are willing to make the tough decisions that stick. There is no ambiguity in their team environments.

Never stop learning. Always find new and better ways of doing everything. Possess wisdom. These women believe in their unlimited capacity to grow at every age and every stage. They have sought out highly visible assignments, and approached them with creativity. They focus on expanding their skill set rather than just focusing on the job at hand. They stay adaptable and flex their styles to get results. They allow people to make mistakes. They recognize what they didn't do well, and don't waste their time and energy in those areas. Instead they have found roles and responsibilities that play to their strengths. They have considerable common sense.

Pick your battles; don't use political capital on the small stuff. Keep your eye on the big picture. Women who made it to the top have learned corporate politics and pick their battles carefully. They know the difference between the small stuff and when to "fall on their sword." They understand who has the real power (i.e., controls the money) in organizations and build relationships with key decision makers. However, they also have perceived when there wasn't a fit with an organization or with a particular boss, and made the decision to move on to another job. In these situations, they took control of their destinies, rather than focus on external obstacles.

Have fun along the way. A sense of humor is critical. In discussing lessons learned, some women mentioned that they would not have taken themselves so seriously and would have had a little more fun along the way. Successful leaders have a sense of humor. Teams that play together and laugh together are energized and creative. A work environment in which people have fun leads to lower stress and less burnout (i.e., better retention of talented people).

Have a real passion for what you do. If you love the work itself, success is a byproduct and not a goal. Don't waste your time on what you don't want to be doing, and don't take a job just because it's a promotion. A paycheck of any size is not enough to result in a satisfying and fulfilling career. There needs to be a sense of accomplishment and a commitment to the work itself to stay the course, particularly when the path is difficult, as it so often is. Enjoy what you do, or even more so, really love what you do. Work isn't just work when you feel passionate about it.

MarieAnn North, FACMPE, is a director, Navigant Consulting, Inc., Tampa, Fla. (


a. Portions of this article were originally part of a professional paper submitted to the American College of Medical Practice Executives in partial fulfillment of requirements to achieve the Fellow certification. ACMPE, the standard-setting and certification body for the Medical Group Management Association, manages highly respected programs of certification, self-assessment, and professional development for medical practice professionals.

Publication Date: Sunday, October 01, 2006

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