Impatiently Waiting: Women Managers, Professionalism, Psychological Costs, and the Reduction of ER Wait Times

Abstract

Administrative burden has emerged as a key theoretical framework for understanding onerous, burdensome, and slow citizen-state interactions. While most work to-date focuses on how the political process generates burdens, how citizens experience burdens, and how burdens affect street-level bureaucrats, this manuscript focuses on the understudied link between management and administrative burden. This link is essential to understanding administrative burden because burdens are often reflected in bureaucratic logics, standard operating procedures, and other administrative tools—all facets of an organization which management possesses some power over. This manuscript develops an argument which links the literature on gendered management, representative bureaucracy, and sex-based selection with reduction in wait times (a dimension ripe with psychological costs) since women in management positions tend to be more relational, transformational, and process-oriented than men, all behavioral characteristics which may link onto administrative burdens in predictable ways. An empirical test linking women managers to a reduction of wait times in Florida emergency departments reveals that hospitals managed by women observe lower wait times, on average, across four out of six interrelated processes. Supplemental analyses examine the link between professionalism and gender and find that women with a health background are effective in reducing some of the most complex dimensions of waiting.