Self-described firebrand Mandi Bishop on inequity in the health IT workplace

'Early in my career, I simply seethed, and sought other opportunities.'
inequity health IT workplace

Mandi Bishop is co-founder, CEO and chief evangelist of Aloha Health, a fledgling company she started with Bill Bunting in August of 2016. Their goal is to tailor care to the individual. Bishop is also a board member of the Society for Participatory Medicine.

Before Aloha Health, she worked at Dell as Global Healthcare Anaalytics Solutions and Consulting Practice Lead.

She’s a well-known social media diva, “disrupting healthcare 140 characters at a time,” as she puts it.

In this Q and A, she talks about male-female disparities in the healthcare technology industry and how she’s addressed them over her own career.

Q. In your work, have you experienced being paid less than a male colleague doing the same work? How did you handle it?

A: Yes, I have. Early in my career, I simply seethed, and sought other opportunities. Looking back now, I know that I frequently had not been as effective a negotiator as I could have been in accepting job offers; it is challenging to "make up" the wage gap once you've established it on entry. The most recent time that I discovered the discrepancy, I gathered all the hard data I could about my peers (salary, bonus structure, performance awards, etc.) - as well as the gender composition of the organization - and I took the details to human resources to review and discuss ways to address the processes that created and then perpetuated the gap.

Q: Are you a good negotiator when it comes to salary, benefits, the position, workload?

A: I am getting much better, and I am taking "lessons" from my mentors in self-valuation and appropriate acceptance (or decline) of opportunities. I consider it my highest priority personal development objective. I am becoming increasingly more aware of the ways in which I, and by extension we, ourselves, sabotage our efforts to negotiate boundaries effectively, which in turn establish an environment that fosters equality. I have been making a concerted effort lately to identify times I marginalize myself, or at least allow room for marginalization by others, through passive speech, body language in meetings, even automatic apologies uttered as greetings or as preface to a dissenting opinion. I feel like I’m entering a 12-step program, and the first step is admitting I have a problem. “I’m Mandi Bishop, and I’m an apology addict.”

Q: What is your best negotiating tip?

A: First, I've begun asking my mentors, male and female, for a valuation sanity-check before moving forward with opportunities. As a data geek, taking a personalized data-driven approach to negotiation allows me to take control of the conversation, and it also helps mentally establish acceptable thresholds before any conversation takes place. If the opportunity fits the parameters I've established after my research, great! If not, let it go. That's the second tip – letting go of opportunities that don't align to your goals and objectives, financial or otherwise.

Q: Do you think the healthcare/health IT industries are more prone to disparity between women and men than other industries/sectors – and why?

A: I actually researched this recently, and I'm saddened to report that, indeed, data shows that there is a higher rate of wage disparity in healthcare and health IT than many other industries. According to Glassdoor's 2016 study, which compared apples-to-apples same-company/same-title gender salary discrepancies, female computer programmers, who factor heavily into the core of the health IT workforce, fared the worst of all the industries surveyed – making only 72 cents for each dollar of their male counterparts.

[Also: Glassdoor's 2016 study]

Female dentists are paid 73 cents per dollar of their male peers. Female psychologists are paid 72 cents on the male dollar. And the list goes on. The reasons why are varied, stemming from an undervaluing of female education (although we are statistically achieving higher education levels than our male peers) to the "mommy tax" paid on mid-career maternity. There's unfortunately not an easy answer, and the challenge is very real.

Q: Have you had a mentor(s) in your career, and how has that benefited you?

A: Although I've only had one formal mentor assigned in my career, I've recently realized that I have an entire "personal advisory board" of informal mentors who enrich my professional development every day. My mentors challenge me to push through my fears and discomfort to grow in ways I never expected – such as speaking and writing about my experiences as a woman, executive, and entrepreneur. Also, I cannot overstate the importance of the sponsorship my mentors have provided, opening their networks with key introductions and helping create opportunity for me to thrive in each new avenue I've pursued over the years.

Q: Are you yourself a mentor, and what’s the best advice you give?

A: I am an informal mentor as well as an advisory board member to women-led organizations, and I generally feel it benefits me as much, if not more, than it benefits the mentee. I'm brutally honest about my own experiences and pitfalls, and try to use hindsight to help inform my responses to their questions and concerns. I'm not sure I have a specific nugget of wisdom that's always an "a-ha", but I do know that my story evaluating opportunities based on the prospect's reaction to my (medically necessary) sneakers seems to resonate clearly.

Q: What do you most want to change about your work – and why?

A: "Healthcare" and "insurance" became synonymous somewhere in the days since the advent of Medicare, and the resulting Medical Industrial Complex continues to move the "health" further from the "care". I want my work to reflect a transformative effort to bring health back to healthcare, rather than simply focusing on optimizing payment and reimbursement under whatever the latest risk-stratified model dictates. ROI is critical. We must be fiscally responsible. But we, as an industry, can do the right thing while remaining financially viable, even growing through alternative sources of revenue. It is the only way that we can return to a focus on health attainment and develop a sustainable healthcare system.

Q: What has been your greatest challenge and how did you overcome it?

A: Honestly? I once worked for a predatory executive who hired single mothers in order to exploit their resulting financial dependence upon him. The harassment was such an ingrained part of the corporate culture that the executive would not even close the door to his office when propositioning, and then threatening to "spank", his female employees - even with his wife's office next door, and the HR director's office across the hall. As a single mother, myself, it was degrading, terrifying - and, ultimately, years after leaving that environment, empowering. That experience gave me renewed faith in my strength, tenacity, and professional worth - as some of my mentor team helped me navigate the uncharted waters of my first entrepreneurial venture.

Q: What is the best advice you've been given?

A: Say no early and often. I am still working on following that advice!

Q: What is it like to be the only woman in the room?

A: I've grown so used to being the only woman, or one of very few, in the room that I don't know what it's like, from a professional standpoint, to have a balanced room to consider for comparison.

My entire career has been in IT and health IT. The thing I notice most often is that inappropriate chatter quickly dissipates if I refuse to engage yet make firm eye contact with participants, reminding them that I am present - and listening. To overcome "mansplaining" events that may arise, if possible, I have a "buddy" in the room who watches for interruptions and helps keep the conversation on-track and the voices evenly distributed. I position myself across the table from the person with whom I expect (or hope) to engage in extended dialogue, so that I can establish and maintain eye contact. And I am working on not apologizing for interjecting dissenting opinions, which I'm wont to do often.


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