Women leading change: perspectives on the Saskatchewan experience
A sea change is happening in Saskatchewan. Health regions have consolidated into a single authority, and the entire health system is undergoing a complete redesign informed by the people who provide care and the patients who receive it.
I had the privilege of sitting down with these health care leaders as they shared their experiences in rising to the top, discussed what contributed to their success, what they still struggle with, what excites them, and what they’ve learned.
Maria: In this province, we have a particularly strong complement of women leaders. How do you think that compares to what you’ve seen in other sectors and other parts of the country?
Dr. Joanne Sivertson: Honestly, for me it’s never been about gender. It is far less important to me whether I am male or female — and I was raised in that vein — it just matters if you’re competent and interested and passionate and you do what you do.
Dr. Karen Shaw: I would echo what Joanne says. I never thought much about gender per se. I’ve always looked at the individual for the competencies they have and the passion that they’ve had to go forward. But, I think that we’re doing well; for example, there are six male and 12 female presidents and six male and 20 female registrars of the organizations that make up the Network of Inter-Professional Regulatory Organizations.
Maria: It sounds like there’s been a shift. What do you think has contributed to that?
Dr. Janet Tootoosis: Things have become much more competitive in the sense that companies and organizations need to have the best person in the position; so, it really became about skill set and having the best person for the job. Gender, belief systems, your abilities, and your skill set have had to come to the forefront because it’s a big market out there.
Dr. Susan Hayton: We’re finally getting a chance to see women and their strengths. I also think women sometimes tend to be more collaborative. We have often played multiple roles over the centuries so maybe we have that opportunity to see ourselves and imagine ourselves in different roles and play supporting roles, collegial roles, maybe more so than men have been able to do.
Maria: Has the environment in Saskatchewan been supportive for women or do we still have a long way to go?
Dr. Susan Shaw: It’s been crazy, crazy supportive. I’m not sure that it is different in Saskatchewan, but it feels like it is. We’re small, we’re relationship-based, and we have a history of supporting each other. We still have egos and all these other things, but I think we’re able to find common ground — to get into a room together, have a meal together, solve a problem together, allow strengths to rise and give people opportunities. But I know that isn’t everyone’s experience.
Dr. Susan Hayton: Yes, it was quite different for me. I was the first woman general surgeon practising in Saskatoon, and at times it was difficult. I finished medicine in ’85 and I did my residency in Calgary, and at that time no women could wear “greens.” You had to wear a dress. If you wanted to wear scrubs, which some women were trying to do, you had to go around to the men’s change room on the other side of the OR. That didn’t change until a woman walked into the change room and a man was standing there: a 65-year-old in his underwear. All of a sudden, that same day, greens appeared in the women’s change room.
Now, it’s much better than it was, but I think it’s still harder for women. Things have changed a lot because men have changed, thank goodness. My spouse has been extremely supportive: we’re equal partners and if I’m not there, he makes dinner, cleans up, and gets the kids organized.
Dr. Susan Shaw: I think about this all the time. Who here has not felt guilt about whether you’re in the right place at the right time? If you’re at work, you’re not at home, and if you’re home, then you’re not at work. If you love both — and it’s ok to love both — then there’s a conflict.
Dr. Karen Shaw: One of the biggest challenges for me, and most women in medicine, is getting that work–life harmony. I don’t truly believe there’s a balance, and if that’s your goal, you’re kidding yourself. But you have to be able to get a harmony that fits so that you don’t feel like you’re in the wrong place at the wrong time as Susan alluded to.
Dr. Janet Tootoosis: That reminds me of a discussion I had with Bonnie at the CMA General Council around disruptive innovation. Maybe disruptive innovation means changing the way we do things. For example, how do you meet your responsibilities as a leader? I’m talking about changing the way in which we do that so that it’s amenable to someone who wants a family, to a woman who wants to have it all. Changing the process. Changing the travel. Changing the paradigm. There are ways that we can run companies, there are ways that we can see patients, and make an impact, and do all kinds of things without following the traditional paths in what was, before us, a male-dominated profession.
Maria: What are some of the other challenges you have faced?
Dr. Janet Tootoosis: I think I was the biggest challenge: wrapping my head around who I was, what I was going to do, where I wanted to go, and whether I could match that in real life. I would sometimes feel like somebody was faking my grades. Then I’d get a really bad grade and say, “Oh it’s all good!” Whether you want to call it imposter syndrome or just building confidence — to be who you truly are, to be unapologetic, and to pursue your truth — and silence all those negative ideas or thoughts, the self-doubt, and things that take you down rather than build you up. Top
Bonnie Brossart: I found that compounded when I took on my role as CEO at the Saskatchewan Medical Association, because now I was arrogant enough to think that I could lead an organization of one of the highest calling professions. When I thought of the community of physicians and their ability and their contributions to society, I wondered, ‘What can I, as a non-physician, possibly give to this esteemed group of people?’
Maria: I’m seeing a lot of nods around the table. Yet, in defiance of self-doubt, you’ve each risen in your careers. What do you think contributed to your success?
Dr. Susan Hayton: It helps to have people support you. My dad did everything with me that he did with my brother. It was always assumed that there was no distinction between us. I think that’s a great thing as a parent to let your child know that you back them. And later with your partner in life.
Dr. Karen Shaw: If you have a good, well-rounded upbringing — and I had exactly the same experience as Susan — I never doubted that I could do anything. If you have a sense that it’s okay to experiment and try things, you get a lot of practice before you get into a real leadership position. By then you’ve had failures and you’ve had successes, and you’ve coped; the value of these things can’t be underestimated.
Maria: You need to be strong to tackle the challenges that come with your roles. Are there any other challenges that come to mind?
Dr. Joanne Sivertson: I’m going to put something out there: I think a challenge is working with other women. I was a subtle leader early in my career, and my department, which was made up of women and one man, were happy to have me take that role. But once I became SMA president, there was certainly a lot more friction and more discontent.
Dr. Karen Shaw: There is the sign in the gym downstairs that says “Girls compete, women empower.” There is that competition sometimes, for whatever reason, and you have to develop a thick skin early on. You have to feel confident in wanting to do something for the right reasons and not get distracted. You receive criticism sometimes, but if you learn to manage that criticism and look at it as feedback to try to improve things, oftentimes you can break down those barriers.
Dr. Janet Tootoosis: When you put yourself out there, you put yourself in a position for criticism, for people to lash out, perhaps unjustifiably. That risk is part of the leadership package. You need a thick skin and you need to understand that humans are humans. I think this happens to both genders. But I fully agree — when you put yourself out there, be ready to dodge!
Maria: Janet, you’re a physician of Indigenous heritage. Are there any additional challenges you would like to speak to?
Dr. Janet Tootoosis: As we’ve already discussed, we don’t put a lot of thought into being women, and so the idea of being a group of women leaders stings a little bit. Why does there have to be that distinction? In my case, I never get introduced as a physician; I’m introduced as an Indigenous physician. And there’s a lot of weight with that. That “label” is a big challenge because the expectation that I’m going to somehow contribute in a much bigger way for a large population that I have no real authority over, or even knowledge of for that matter, is unrealistic. I have my circle, my knowledge, my upbringing, my tribe, my spirituality, but why is that always on the table?
Maria: This isn’t the first time we’ve talked about labels, whether it’s being labeled a woman leader instead of a leader or, taking it a step further, an Indigenous woman leader. It sounds like this issue has been a challenge for many of you.
Dr. Joanne Sivertson: My speech at the end of my presidency was about coming to terms with the fact that, even though I don’t identify as a “female leader,” people see me as that, and some people need to see me as that. They need women in these roles to feel like they can aspire to them. So, if I have to wear a mantle of “female-ship,” I can do that. If you don’t see me as a woman, but just as a competent leader, that’s fantastic. But if you need to see me as a woman, then I’m the “president in heels,” as the medical students named me. Top
Dr. Susan Hayton: For my kids, and probably for anybody who has daughters, seeing you in that role makes a difference. Maybe they already think, “Of course I could do that.” But when they see a woman like you in that role, it helps. That’s why we want people of different ethnicities and races in these leadership roles, because people tend to think, “That could be me.”
Maria: You’re each an inspiration — you have accomplished so much and are making real change for the people of Saskatchewan. What are some of the things you’re working on now that excite you?
Dr. Susan Shaw: Well this health authority is pretty exciting! That’s what I am spending most of my waking and thinking, and, actually, dreaming time on. How many people get to be part of redesigning a health care system? We have a long history, all around the world, of tweaking and testing but here we — everyone around this table — have been given the opportunity to make a difference in how patients have a voice and how physicians and patients partner together.
Dr. Janet Tootoosis: My focus has shifted to how I can support improvements in Indigenous health. From this privileged vantage point — in my work with the board and with all of you — and as a physician, I understand that the contribution health care makes to our overall health is maybe 20%. Your family physician and your access to acute care makes up that 20%, and there’s all this other space that isreally in your decisions, in your opportunities. How do we move thisunderstanding upstream so that our Indigenous communities aren’t overusing the system, so that the majority are not even in the system because they don’t need it?
Maria: The potential for positive change in Saskatchewan is staggering. Is there anything you’ve learned that you would like to share with the next generation of leaders? Top
Dr. Karen Shaw: Often, when you first start out, you doubt yourself because you don’t have all of the competencies and you’re trying desperately to gain them and become an expert in everything. So the lesson is, try your very best to gain all the competencies that you can, but the better solution is to surround yourself with good people. The more diverse the better.
Dr. Joanne Sivertson: I used to think that being a leader meant telling people what to do — you got out there and had your idea, so if you didn’t have an idea then you shouldn’t be a leader. I’ve learned that leadership has nothing to do with that at all. You don’t need the answers. You need the right questions and to be able to amplify the voices of the people who have good suggestions. It’s truly a huge privilege when people let you be their voice.
Maria: How can we foster more leaders like you?
Dr. Susan Hayton: One thing we have to do is not just encourage but reach out and try and pull people in.
Bonnie Brossart: We need more intentionality. All of us came from supportive families that said, “I believe in you.” There were also moments in our careers where somebody said, “Hey, have you thought about this? I think you’d be good at it.” That’s what I think we have to do for others.
Maria: Any parting words for the leaders who will come after you?
Joanne Sivertson: Don’t wait until you’re ready. You’ll never be ready. Just do it.
Dr. Karen Shaw: Prepare for what the changing role will be for physicians. The advent of artificial intelligence and all these technologies that are coming at us are going to require a different role for physicians and a different leadership role. Get prepared to take on some of the things that women aren’t usually involved in. The IT world is male-dominated, and yet that’s where we will be getting a lot of the things that are going to change how we do medicine.
Dr. Susan Shaw: Work to your strengths. A strengths-based approach is so much better than any other way. Work to your strengths and learn where you need to grow. I think I was lucky to have had the opportunity early on to be able to do that.
When people give you a tap or a push, listen to them. Believe in them more than you would believe in yourself, because they can’t all be wrong. If you’re getting a message that you should give something a try, do it. Don’t wait until you feel ready. You’ll never be ready. If other people are giving you that message, maybe you should go, because who knows where you’ll end up. Top