Even though most practicing pediatricians in the U.S. are women, that hasn’t mean the end of the gender gap, especially when it comes to leadership in this medical specialty.

In a new article published in this month’s edition of the journal Pediatrics, several pediatricians from leading U.S. medical institutions take on three of the main excuses given for this disparity. The first, that there aren’t enough women in the field to promote, is easily refuted, given women’s dominance of pediatrics, the authors note.

According to a 2017 report, over 72% of active pediatricians and more than 63% of pediatric residents and fellows are female. Across all specialties, 35% of active physicians and nearly 46% of residents and fellows are women.

The other two excuses are more subjective, that women lack the skills required for higher level positions and that many women do not seek out leadership positions because of family and lifestyle reasons.

Lead author Nancy D. Spector, an associate dean and pediatrics professor with the Drexel University College of Medicine, spoke with us about the myths behind the gender imbalance in pediatrics leadership. She’s especially knowledgeable on the subject, given that she directs the university’s Executive Leadership in Academic Medicine program.

What are some of the main reasons you say these excuses are actually myths?

First, research shows that family and lifestyle choices do not adequately account for the gaps in representation of women in leadership positions. And second, the pipeline is bursting with qualified women who are seeking leadership opportunities. The problem is not with women — the problem is with the process that elevates people into leadership positions. There is a lack of intentional effort to recruit and hire women for these positions, and then provide the appropriate support to ensure they will be successful.

You and your colleagues call for using a scientific approach to address these inequities. Can you explain?

Institutions and organizations use scientific principles to effectively tackle all kinds of hard problems. But gender-equity initiatives in medicine have traditionally been driven from a grassroots level by women. This method has not resulted in enough progress. By shifting our approach to utilizing scientific methods and incorporating data analysis, institutions won’t be able rely on anecdotal stories of success. They will have to show metrics and outcomes and commit to prioritization and funding.

Why do you believe these inequities and obstacles have persisted?

Women face challenges for many reasons including implicit bias, gender stereotypes, discrimination, and psychological associations. Men are associated with qualities which convey assertion and control, while women are associated with communal qualities, which convey a concern for compassionate treatment of others. Organizational systems must be fixed by implementing specific strategies such as ensuring a critical mass of women leaders and giving employees with family responsibilities more time for promotion.

How significant is the wage gap between male and female pediatricians?

Research shows a 20% to 25% pay gap for women in pediatrics. And that’s just based on compensation. The impact of pay disparities go beyond one’s take-home salary. They affect women’s futures by reducing retirement savings and slowing down educational debt repayment.

Research suggests women experience more burnout than their male colleagues. What could addressing gender equity do to address this problem?

Ensuring that work environments are free from sexual discrimination and harassment will have an enormous impact on the burnout women physicians experience. When you couple the day-to-day stresses of being a physician, the long hours and the enormous responsibilities, with the fact that 30% of women on medical faculties report experiencing sexual harassment, you have a recipe for burnout. Eliminating sexual harassment will go a long way in ameliorating burnout rates.

How could addressing the gender equality gap benefit patients and their families?

Women physicians potentially have better clinical outcomes compared with those of male colleagues. A study published in JAMA Internal Medicine showed that patients treated by female physicians had lower odds of death and readmission compared with patients cared for by male physicians. Studies show that organizations with diverse workforces perform better financially, and that benefits everyone’s health care. Also, the physician workforce and leadership in medicine should mirror the diversity of the population in the country for best health outcomes.