It is nearly impossible to ignore the need for clear thinking, confident and “in control” leaders. And whether in Congress or in a physician’s office, medical school department or hospital administrative suite, women leaders are notably absent. And while recent research tells us that women aspire to be leaders, the barriers to achieving this nebulous goal are enormous.

So whose fault is it anyway?   I say both the women and the institutions are at fault.  And the main reason? Devaluation.  Women are devalued by the treatment we get and the treatment we accept.

Let’s first blame the women who plead, “I have no time.” “I am given dead-end assignments.” “I don’t like to tell people what to do.” “People don’t do what I ask of them and then all the work falls on my shoulders.”  “I won’t get any credit for this.”

Now let’s blame the institutions where, through both subliminal and open communication send these messages: “Women don’t make good leaders.” “Women don’t want to be leaders because it interferes with ‘life.’” “Women don’t have the training or experience to lead effectively.”  “Women don’t communicate well.”

Both sets of observations are entirely true, and really for the same reason.  Women are devalued.  They are devalued in what they say, for how they behave and for what they think.  They are devalued because the benchmark, created from a male perspective, does not and should not apply.  And in trying to succeed in gaining leadership positions, women have not yet set the new benchmark which will measure them differently and allow them to become effective and successful leaders with their own styles and on their own terms.  We need to expect more support from a system that is inherently oblivious to what a woman leader-to-be needs.

So let’s get down to business, lay it all out, and walk them through this.

First, we have to stop discounting women’s words and women’s ideas.  There is no one reading this post who hasn’t experienced her voice ignored or drowned out in conversation with male colleagues, particularly in meetings where the “coin” of the leadership realm are ideas.  When we speak, we have to inform those present that we are making a statement that is worthy of their attention.  And then repeat again and again until it is clear what is being said and who is saying it.    At a group meeting, the first time you put forth an idea, you might say, “I would like to say for the record (in your most charming voice with that lovely smile on your face, batting your eyelashes), that my thoughts (those two words with emphasis) are that in order to have women leaders … “we need to do an institutional study of who is leading what initiative and how are they accomplishing their goals.  Let’s look at appointment process, previous experience, committee charge, resources and gender mix as some of the variables.”

By the way, this example of a statement is exactly what every institution/organization needs to do if they want to create a class of women physician leaders.

Now back to our meeting.  As soon as you hear your ideas being usurped, you immediately ask the recording secretary to refer to the minutes which noted your suggestion and that you want the minutes to reflect that the suggestion did indeed come from you.  Yes, that means we have to be assertive and own our ideas.  That is where we show we are entitled to be leaders–by having confidence to stand up for our ideas. And the institutional responsibility here is that whomever is in charge of these meetings, will be held accountable to make sure that this voice is not drowned out.

Oh, but what about assertive women coming across as “pushy.”  Gender stereotyping of women has to be called onto the carpet for what it is–a way to keep our voices from being heard.  Learn the words that counter the stereotype. You are not pushy, you are assertive (again with that great smile).

Finally, women have to take control.  If an assignment comes up, we must insist on the resources to do the job in a way we can accomplish that job.  This means flexibility in scheduling when and where meetings occur.  We must insist on clear expectations and firm commitments for resources.  And most importantly, we have to learn to ignore critique of our style and insist on being judged by the outcomes expected and the outcomes delivered.

As physicians, we are all leaders.  We positively exert constructive influence on the lives of patients everyday.  We muster the help of our clinical team, be it big or small.  We make things happen and we are constantly advocating for change.  Accepting that we all have this potential to lead, we have to be ever more vigilant to create an environment where women and their institutions bring forward their vision and nurture their talents and skills to create a more dynamic medical workplace for the benefit of the advancement of the health of our society.

Linda Brodsky is a pediatric surgeon who blogs at The Brodsky Blog.  She is founder of Women MD Resources.