There are still not enough women in high level leadership positions in healthcare to cement change which improves the health inequalities for women. Two contradictions hold back many women who try. These are encompassed in what I call reticence. The qualities of nurturing and maintaining harmony keep women feeling comfortable in the thinking of middle management; which is mainly about maintaining organizational harmony. So, even when we are given the opportunity, we avoid the activities known to be associated with the male persona, such as embracing competitive situations at work and displaying raw ambition.

Many of our successful entrepreneurial women leaders in health care exhibit high level robustness.

Entrepreneurial women do not think that their past work will be recognized without them having to promote themselves. Neither do they think opportunities will come their way without asking.

Another counterproductive force at work is our resilience. Entrepreneurial women do not accept their fate. Nor do they subscribe to a female propensity for resiling from difficult situations. They choose a stronger way forward. I call it robustness. It is about looking forward and the realization of where we should be heading not where we have been. We can energize our future, not just euthanize our past. It is well recognized in the entrepreneurial sectors of the health care industry but less so in academe, the public health care sector and research.

Next month I will be a keynote speaker and presenting a workshop at the Harvard Leadership program for women in the health professions. This is a sold-out event, mainly because of the hard work of an academic entrepreneur Dr. Julie Silver and her team. I have been involved for several years and every year I have found the robustness of the audience increasing. It is a good sign for the future but we cannot be too complacent.