Opening the Door
Regina Herzlinger charted the course for HBS's tenured female faculty
For her innovative research and outspoken advocacy of US health-care reform, Professor Regina Herzlinger is known in some media circles as "the godmother of consumer-driven health care." At HBS, she holds the distinction of being the first woman to become a tenured faculty member, which happened in 1981.
The School's Nancy R. McPherson Professor of Business Administration, Herzlinger is the author of seven best-selling books, including her landmark volume Market-Driven Health Care (1997), which analyzed the revolutionary impact of consumer awareness, cost consciousness, and innovative technologies on the health-care industry. A highly rated teacher, she is also an acclaimed public speaker, board member, and policy adviser whose expertise on health-care management has influenced private- and public-sector decision-makers in the United States and abroad.
Herzlinger was born in Israel and immigrated to the United States with her family when she was eight. She earned a degree in economics from MIT, spent time in Washington as an economist, and worked as a consultant before pursuing her doctorate at HBS in 1968. Since her appointment to the faculty in 1971, she has been a driving force in recruiting women for prominent roles at HBS and has inspired legions of MBAs to pursue careers as health-care entrepreneurs and managers.
As a pioneer in opening new options for women in academia and business, Herzlinger has led by example. Married for 47 years and the mother of two Harvard College graduates, she has maintained a steadfast focus on research, course development, teaching, and advocacy. Although her early days as a faculty member presented significant challenges—and on occasion, she has written about the status of women in academia and business—Herzlinger notes, "I am not someone who studies women. I believe you gain strength by being who you are and by being good at what you do."
You became involved in research on health-care management well before it was on most people's radar screen as a pressing issue. What sparked your interest?
Originally I came to the DBA Program to study finance, but I switched to control, primarily because of the pathbreaking work that Bob Anthony was doing on control in nonprofits. Bob was working with Massachusetts General Hospital on a neighborhood-based health plan for the city of Charlestown, and I became involved in building a system of benchmarks for the various services that were being offered—everything from dental care to drug and alcohol abuse counseling. I spent three years developing the system and meeting with health professionals every month, reviewing the numbers. I learned a lot about medicine that way.
Wasn't your husband also in the health-care industry at the time?
Yes. Under a push for funding from President Nixon, there had started to be more research and interest in biomechanics, biochemistry, and building artificial organs. My husband, an MIT physicist, started a company that developed technology intended to keep a diseased heart beating while the patient was awaiting a transplant. Working with him on that start-up was a fascinating experience that gave me even more insights into the intersection of business and health care. That period was the start of a revolution in health care.
What aspects of that revolution reverberated the loudest in the business world?
The technology was truly thrilling. It was a wave of scientific genius that included work on transplants, new treatments for diseases, and the beginnings of the genomic research industry and all the companies that grew —and are still growing —from that. It was also the time when the concept of diagnostic related groups [DRGs] was introduced. DRGs essentially redefined health-care services as products that could be priced and reimbursed by insurers at certain set levels. That changed everyone's mindset. At about that time, I started a new course on innovating health care because I believed MBAs who were interested in pricing, productivity, and efficiency could be essential as that industry evolved. Today, we graduate about a hundred students each year who are interested in careers in health care. Our HBS Healthcare Club is one of the largest on campus, and the HBS Health Industry Alumni Association is huge. So I guess I was onto something back then!
We've talked about the early development of your career interests, but not about the experience of being the first woman to receive tenure at HBS. What was it like to break that barrier?
The day I won tenure in 1981 I was teaching in the Program for Management Development, and that morning my students brought roses and gave me a standing ovation. I was very touched, of course, and hopeful that my accomplishment would open the way for other women here. But getting to that point wasn't always easy. When I started my career, some of my colleagues thought that it was OK for women to do research here, but teaching was off-limits. Since this is a teaching school, I believed it was absurd to be on the faculty—on a tenure track—and not in the classroom. I won that argument, but it was a tough introduction. The students who voted me the best teacher in 1997 had no idea what it meant in my case.
Did you feel extra pressure to succeed because you were breaking new ground for women?
I felt two things. First, I believed my male counterparts were well-intentioned but unfamiliar with women as colleagues. In those early days, they were comfortable commenting on my hairstyle—some of them actually gave me fashion advice!—but few of them knew how to interact with an ambitious, aggressive, outspoken woman, which is who I am. So I felt it was important to serve as a role model of women who are driven to succeed in the same way that men are. It was quite a burden. In those early days, for example, I returned to teaching two weeks after my first child was born so that no one would say that women leave work for their children. Second, I believed it was essential to actively recruit and help tenure other bright, motivated women scholars and teachers for the HBS faculty.
Where did you find the inner resources to persevere in an era when there were so few women role models?
First of all, my husband has always supported my ambitions. Also, my parents were Holocaust survivors, and we lived in Palestine until I was eight. There were constant blackouts, and we were often running for cover. On one occasion, a bullet passed behind me and grooved into the stucco wall of our house. What doesn't kill you makes you stronger.
US consumer-driven health-care reform has been a focus of your teaching, research, writing, and advocacy. Does President Obama's Affordable Care Act move us any closer to that approach?
I agree that the individual mandate is essential. But with Obamacare, agents who don't know our individual needs are selecting plans on our behalf, and that's not consumer-driven health care. Obamacare establishes health-care exchanges, or markets, but a consumer-driven system would require transparency in health-care quality and costs. Can you imagine shopping in a supermarket where you don't know products' prices or ingredients? In the 1930s, President Roosevelt created the SEC to oversee the capital markets, and today we have the lowest cost of capital in the world. It's time we had some kind of a health-care/SEC equivalent. There are some encouraging trends in the private sector. For example, Sears Holdings Corporation and Darden Restaurants are now giving employees cash allowances and assistance in shopping for insurance providers. The "affordability" of the Affordable Care Act is questionable, but some aspects of the initiative are pushing companies in the right direction. I'm glad I've stuck around long enough to see it.
Perspectives on Progress
Four distinguished women faculty share their views
In the 30-plus years since HBS professor Regina Herzlinger received tenure, the current number of women scholars and teachers at the School has grown to 56. With that increase, women have moved into leadership roles in all areas of the School. Bearing that in mind, the Bulletin asked four long-term women faculty—Lynda Applegate, Carliss Baldwin, Linda Hill, and Cynthia Montgomery—to share their views.
When you talk about the role of women in business with older MBA alumnae or with your own colleagues, do you talk more about the progress that's been made or the barriers that still exist?
I'd have to say we talk more about the barriers. Women and men are surprised and frustrated that efforts to increase the presence of women in senior roles haven't yielded the kind of parity we'd all like to see. You can't get around the fact that women still have more responsibility for raising children and taking care of elderly parents than men. Women are eager to find a way to integrate their personal and professional lives. Electing to leave the corporate world and pursue entrepreneurial careers can make it even harder for women to fulfill their personal responsibilities. And let's face it, women still have more difficulty getting access to start-up capital. When you have to meet a payroll, the issue of fulfilling both personal and professional responsibilities still looms large.
I recently talked about the School's celebration of the 50th anniversary of women in the two-year MBA Program with a woman who is a fellow mutual fund board member. It was the first time we'd spoken about gender, although we've worked together closely for over five years. That's not to say that all the challenges have gone away; it's an indication, though, that some important degree of progress has been made and that women serving in such roles has, in many ways, been somewhat normalized.
I talk more about successes, because I believe those stories inspire others to succeed. Recently I gave a talk to the HBS Women's Association of New England on women entrepreneurs who are changing the world. I shared the story of a doctor in Jordan who started a school for developmentally disabled children that was so successful she was able to franchise the concept throughout the country. I also talked about an MBA who had left a high-powered career to be home with her children and later launched a car-sharing service that is now a publicly traded, global business. Women are great entrepreneurs, and it takes an entrepreneurial mindset to transform an organization, an industry, and a society.
Do you think today's women MBA students have different expectations for their careers or different definitions of success than they did when you first came to HBS?
Yes, interestingly, today's women MBA students are both more ambitious and more realistic about the world, especially career/life/family trade-offs. Women in my generation did not accept these facts. I know I didn't. We were idealists and revolutionaries. We thought we could have it all.
Has the increased presence of women faculty in HBS classrooms had an impact on case-method teaching over the years?
Discriminatory, offensive expressions and stereotyping are no longer acceptable in HBS classrooms or in the general culture. In other dimensions, case-method teaching has the same power as when I was a student at HBS in the 1970s—each professor develops it in his or her own way, making each classroom unique.
When I started at HBS in the mid-1980s, there was what I would call a "paternalistic" culture here that didn't fit well with my style. I was very committed to teaching but really couldn't pull off the strong, formal control that my male colleagues—especially senior male colleagues—had in the classroom. Instead, I earned respect because I really knew the material and cared deeply that the students learned. I also had a big personality and could engage the students in learning. Today, we have faculty from many backgrounds, and there isn't one strong, dominant culture. In a way, it might be more difficult to teach here now, because students haven't bought in to a universal classroom culture or standards. But what hasn't changed is that case-method teaching requires mastery of the subject, the ability to engage students as partners in creating a positive learning environment, and a deep, personal investment in each student's success.
Has your own definition of career success evolved over the years?
Throughout my adult life—and the early years of raising children—I've believed that with careful choices, one could have a balanced work and family life. With the advent of technologies that enable 24/7 access to work from anywhere, the boundaries between the two are blurring in a way that concerns me. Along with many others, I'm pondering: What is balance? What is success? Or better, what is a successful life? I feel the need now to move from automatic choices to more deliberate ownership of how I'm spending my time, or as poet Mary Oliver asked, what am I doing with my "one wild and precious life?"
When I was younger, I simply wanted to have a job and support myself. I came from a traditional family, and independence was a paramount goal for me. Since then, I've come to believe that each person has a life's work—the contributions to knowledge and human welfare that come from each individual's unique combination of training, talent, and point of view. Success is first developing and then being true to that vision.
What advice would you give to a scholar-teacher who is just beginning her career in higher education? Is that the same advice you would give to a male?
I'm always wary of giving career advice, but based on my own experience, I would say that it's important to pay attention to one's values and passions. As a woman and a minority, when I came to HBS almost 30 years ago, I was cautioned by friends and mentors that I wouldn't fit in. But I loved the way people here were dedicated to doing work that had impact. So my advice would be to seek organizations whose mission you can embrace, and to work with individuals you can respect and learn from. Maybe they don't look like you, but if they share your values, it can work. Women and minorities often have additional complexities to deal with, but you can get through them if you are working with people who share your passions.
Know your talents and deficiencies, then seek a place where you can do your best work. Being truly original takes lots of time—there will be many blind paths and mistakes. Day-to-day responsibilities both at work and at home can be all-consuming, so defend the time you need to be creative. But also cherish your students and make them your colleagues. I would give that advice to any young scholar and teacher.