Author: Kurt Greenbaum


About Kurt Greenbaum

As communications director for the Olin Business School, my job is to find and share great stories about our students, faculty, staff, and alumni. I'm also on the U College faculty in the journalism sequence. My background includes a stint at the Consortium for Graduate Study in Management and as a journalist for the St. Louis Post-Dispatch, Sun-Sentinel in South Florida and the Chicago Tribune.

If you’re having a heart attack and you’re a woman, hope a female doctor greets you in the emergency room.

A review of nearly 582,000 heart attack cases over 19 years showed female patients had a significantly higher survival rate when a woman treated them in the ER, according to Olin’s Seth Carnahan, part of a three-member research team on the project.

In fact, in the researchers’ sample, 1,500 fewer women would have died—women who were treated by male doctors—if their survival rate was the same as women treated by female physicians.

Seth Carnahan

Seth Carnahan

Researchers also found that women had a better survival rate with male doctors who have a lot of female colleagues in the ER—though they’d still be better off with a female physician. The results parallel similar studies of gender differences in medical outcomes, but the difference here, Carnahan said, is the stakes.

“You have highly trained experts with life or death on the line and yet the gender match between the physician and the patient seems to matter a great deal,” said Carnahan, associate professor of strategy at Olin.

The conclusions are central to a paper in the Proceedings of the National Academy of Sciences entitled “Patient-Physician Gender Concordance and Increased Mortality Among Female Heart Attack Patients,” coauthored with Brad Greenwood at the University of Minnesota-Twin Cities and Harvard University’s Laura Huang.

The business connection: Gender differences at work

Though the topic focuses on medical outcomes in a healthcare setting, Carnahan said the conclusions are relevant to business because the big picture is about gender differences in the workplace. It’s a subject that’s interested him for a long time, particularly after hearing how his sister’s experiences in male-dominated workplaces differed from his own.

“Interpersonal interactions, whether they are between a doctor and patient or a manager and a subordinate, create the core of an organization,” he said. “I’m very interested in how these interactions determine a firm’s performance and influence the lives of its managers, employees, and customers.”

The team reviewed a trove of anonymous medical data from Florida hospitals from 1991 to 2010.  These data allowed the team to measure important factors like the age, race, and medical history of patients, hospital quality, and more. Even accounting for these factors, the team found female patients were less likely to survive heart attacks than male patients and that gender differences in survival rates were the highest under male physicians.

For patients treated by female physicians, the gender disparity in survival rates was about 0.2 percent. In other words, 11.8 percent of men died, versus about 12 percent of women.

However, for patients treated by male physicians, the gender gap in survival more than tripled to 0.7 percent. In that case, 12.6 percent of men died compared to 13.3 percent of women.

“Our work corroborates prior research showing that female doctors tend to produce better patient outcomes than male doctors,” Carnahan said. “The novel part of what we are doing is showing that the benefit of having a female doctor is particularly stark for a female patient.”

Does anything improve outcomes with male docs?

In reviewing the conditions that most favored female patients, the team found that female survival rates rose as the percentage of female doctors in the ER rose—particularly if the treating physician was male. The “male bias” effect also declined the more the male doctors had treated female patients.

Those mitigating factors “suggest that having training programs that are more gender neutral, or showing how men and women might present symptoms differently, could improve outcomes for female patients,” Carnahan said.

The research is similar to another Carnahan-Greenwood collaboration documenting how female lawyers were less likely to advance in their firms with promotions and plum assignments when they worked for politically conservative male law partners. That project grabbed the attention of The Washington Post, The Guardian, and Politico when Carnahan was on the faculty at the University of Michigan-Ann Arbor.

The current paper, however, moves outside the employer-employee arena, where gender bias is well documented in certain circumstances.

“Employee-customer relationships don’t have as much research in this area and you can think of a physician and a patient being a customer relationship,” Carnahan said. “I think organizations that get this right can outperform other firms and produce better outcomes for all of their stakeholders.”

An incoming Olin freshman has already been recognized with a $36,000 award for creating a business that provides “upcycled” used clothing for homeless youth in the LGBTQ community near his home.

Dillon Eisman, who starts at Olin in the fall, was one of 15 high school students from around the country to receive the Diller Teen Tikkun Olam Award, first bestowed in 2007 to recognize leadership and social outreach among Jewish teens. The Hebrew phrase “tikkun olam” means “repairing the world.”

Eisman, from Malibu, Calif., founded Sew Swag to update used clothing and provide it to older teens and younger adults living in shelters — work he began at age 14 and work that required him to teach himself to sew.

According to a story about Eisman in The Orange County Register, the idea grew from a tour he took of a nearby shelter for LGBTQ after he founded the gay-straight alliance at his high school.

“The fact that these kids don’t have that simple pleasure upset me,” he told the Register. “One of them said they hadn’t had a jacket in like six months. It’s not something you think about, someone my own age who is freezing at night because they don’t have a jacket. It was heartbreaking.”

Eisman told the Register that because he has a full tuition merit scholarship at WashU, he’ll apply his Diller award toward supporting Sew Swag.

Read more of Eisman’s story on The Orange County Register or see his profile on the International Diller Teen Fellows website.

Emily Gallagher

Emily Gallagher

Emily Gallagher, an Olin postdoctoral research associate, has won a $35,000 research grant that will help underwrite her research into the relationship between healthcare costs, Medicaid availability, and Obamacare subsidies on housing security.

The research highlights the ways access to healthcare yields indirect financial benefits to households and society that go beyond physical well-being.

The grant comes from the Russell Sage Foundation, which is dedicated to underwriting social science research. The announcement of the grant came as Gallagher, who holds a joint appointment with the Brown School, was wrapping up a trio of research papers around questions of household savings, housing security, and earnings stability.

All three research papers lean heavily on a trove of data Brown attained through a partnership with a major tax preparation platform (which has asked to remain anonymous). Researchers have sliced and diced anonymized data from thousands of consenting tax filers and have posed survey questions through the tax platform. Gallagher’s research is part of a broader range of joint projects between faculty at Brown’s Center for Social Development and Olin.

Tying healthcare with housing security

Gallagher’s first paper looked at the effect of healthcare subsidies through the Affordable Care Act on rent and mortgage delinquency rates among low-income households. She found a 26 percent decline in home delinquency rates as households qualified for subsidies through the ACA. This is significant, she said, because the cost of foreclosures and evictions to society—costs borne by tenants, homeowners, landlords, neighboring homes, lien holders, banks—is substantial.

“You wouldn’t think giving people health insurance would reduce foreclosures and evictions, but it does,” Gallagher said. In the study, the average ACA subsidy was about $4,300. Under plausible assumptions, Gallagher said, 33 to 53 percent of that subsidy cost might be offset by the social savings associated with fewer evictions and foreclosures.

In the second paper, Gallagher looked at the Medicaid eligibility of 67,000 tax filers and their propensity to save a portion of their expected tax refunds for a rainy day. Researchers surveyed taxpayers just before receiving their tax refund, asking how much of the refund they intended to keep, use to pay down debt, or consume within the next six months.

“When you look at households that are right on the verge of having to declare bankruptcy, they intend to save more when they gain access to Medicaid,” she said. In fact, the taxpayers say they intend to increase their savings by about 4.4 percent of the tax refund amount, or $93 on average. The savings, “modest in absolute magnitude, are substantial when compared to the impact of interventions explicitly designed to encourage saving among low-income and financially constrained households,” she wrote in the paper.

“It’s hard to nudge low-income households into saving more, but as it turns out, Medicaid is a successful way of doing that for households in the most trouble.” For households that are doing better, Medicaid appears to have no effect on their savings behavior.

Stabilizing income through better healthcare access

Preliminary results from Gallagher’s third paper, still in draft form, show a taxpayer’s access to a healthcare subsidy — and, as a result, health insurance — increases the person’s income stability. When people get treatment for chronic conditions, reliably take their medication, or address mental health issues, they’re more reliable workers and maintain jobs longer — leading to a steadier income.

“People are experiencing fewer unexpected variations in their income by being on the subsidy,” Gallagher said. Health conditions can cause “unexpected labor shocks” that destabilize income. To the extent that health conditions are exacerbated by a lack of health insurance, households with insurance tend to report fewer unexpected income shocks. In contrast, “when a person reports they have variable income because of expected factors, such as due to seasonal jobs, there’s no effect there.”

Gallagher led the research under the counsel of Olin’s Radhakrishnan Gopalan, professor of finance, and Michal Grinstein-Weiss, a professor and associate dean for policy initiatives at the Brown School.

The first paper, “The Effect of Health Insurance on Home Payment Delinquency: Evidence from ACA Marketplace Subsidies,” is under second review for publication. The second, “Medicaid and Household Savings Behavior: New Evidence from Tax Refunds,” is in the submission process. Gallagher is drafting the third paper “The Effect of Health Insurance on Earnings Stability: Evidence from the ACA Marketplace.”

“The broad thing we’re looking at is that we massively expanded our social safety net” by passing the Affordable Care Act, Gallagher said. “People think of it as just improving people’s health and, maybe, reducing medical bills. We’re looking at indirect financial outcomes that you wouldn’t expect health insurance to affect.”

Left, Skae and Hammack at their reception at the Missouri Athletic Club. Right, Gauthier and Triplett on graduation day.

Conventional wisdom says students in the Professional MBA program—while committed to advancing their careers—are also at the right age to invest in their future, if you know what we mean.

Maybe Madeline Triplett can explain it a little better.

“Everyone is trying to push ahead in their careers, but we’re young,” she said. “You’re trying to have some semblance of a social life while you’re working and going to school.”

Things are bound to happen. Introductions. Networking. A little “due diligence.” Then, bang! A merger. For PMBA Class 38, things happened. Twice.

Triplett met John Gauthier. About a year into the program, they started dating, hit it off, and are headed to Graham Chapel on Dec. 15 for their wedding. Meanwhile, two of their PMBA 38 classmates, Alexandra Hammack and John Skae, beat them to the altar with their own wedding on March 11, 2017.

For Jan Snow, director of graduate programs student affairs, two couples in one class is unusual. But it turns out that the PMBA program is something of an an incubator for relationships. Snow says the students are just at the right age when they might be looking for a relationship.

“We had one pair that I put in a team together,” Snow said. “They ended up getting married.” They were from Class 33. In fact, Snow came up with the names of three other married PMBA couples without breaking a sweat.

Love at First Case

It didn’t take long for Gauthier to notice his future fiancee. Soon after they started attending classes together, “I always noticed her responses in class were similar,” he said. “We found similar takeaways.” But, alas, he and Triplett ran in different friend groups among the fellow PMBAs.

For Skae, his future mate caught his eye during orientation weekend for the class. He and Hammack soon realized they had a lot in common—beginning with the overlapping network of friends they had in St. Louis. “Everywhere we turned, we we found we had these connections,” Skae said.

“We started hanging out outside of class in October,” he said. “We knew pretty quickly this was something serious.” The couple “came out” to their classmates during a class trip aboard a “pirate ship” arranged by a classmate with connections to the boating industry — and a Missouri River cruise.

The stress of the crisis communications project helped them see the durability of their relationship, Hammack said. “We decided if we could get through this weekend, we could get through anything,” she said. “It was very stressful.”

Gauthier and Triplett finally found the spark after he moved to Clayton’s DeMun neighborhood and noticed her out for a run. The pair got engaged a year ago on Memorial Day weekend in Michigan, on a boat trip where Triplett had spent her summers growing up.

“She’ll say that it was a surprise and that she was hopeful it was coming,” he said. “I was playing it very cool. She actually packed my bag, and because she did that, she didn’t think I had a ring.”

Family Traditions

With one pair hitched and the other fast approaching the aisle, they both reflect on the history that drove their plans. Triplett’s parents, for example, are both WashU alums. That, along with their meeting on campus, persuaded them to nab Graham Chapel for their upcoming nuptials.

Skae finished his final class in March the weekend before the wedding at Central Presbyterian Church in Clayton with a reception at the Missouri Athletic Club in St. Louis – just as Hammack’s parents had done 30 years earlier, also in March.

Today, Hammack works at Square as small- and medium-sized business sales manager, while Skae is an investment analyst for NorthMarq Capital. Meanwhile, Triplett is marketing manager at Hunter Engineering Company, chaired by another WashU alum, Steve Brauer. Gauthier is mergers and acquisitions manager for Lanter Delivery Systems.

“Going into WashU, I knew from people who had been in the program that people are at the same stage of life as I am,” Gauthier said. “I expected I would meet a lot of cool people—friends—not a potential bride.”

Pictured above: Left, Skae and Hammack at their reception at the Missouri Athletic Club. Right, Gauthier and Triplett on graduation day.

Early in his new book, The Samurai Listener, Cash Nickerson recounts the shock he received from a poor performance review in his first year as a corporate attorney for Union Pacific Railroad.

“At the young age of 26, what held me back were skills I had not learned in college, law school, or business school,” writes Nickerson, JD ’85, MBA ’93. “My behaviors in the office and the perception of those behaviors by my boss’ assistant and everyone else in the office who had an opinion had derailed me—possibly even threatened my career.”

Nickerson recalls that he hadn’t learned to listen. He hadn’t learned to watch people around him for signals about how they were feeling about the situation—and how he should respond. He hadn’t learned to “read situations” or identify and navigate power structures—like the influence his boss’ assistant could wield—in the organization effectively and respect.

His latest book (Nickerson has five other published volumes to his credit) puts listening skills in the context of martial arts practices such as politeness, self-control, and honesty. Great listeners, he says, use these practices to guard against “subtle attacks we often face from colleagues, clients, and others competing for control, eager to succeed at our expense.”

“I’ve seen a list of as many as 70 ‘soft skills’ in my research,” Nickerson said told the Olin Blog. “Listening is one that is heavily talked about. There’s also teamwork, which probably gets the most attention in business school, but gets zero attention in law school. In business school, that’s recognized as a critical success factor.”

The Way of the Samurai

Listening was key, he said, serving as an umbrella category for a host of other soft skills—how to read others, how to broaden your perception of what’s happening around you, how to read situations, and how to navigate politics.

He tells a story of a class on negotiation he gave recently for students at the WashU law school. He passed out a playing card to two class members for a quick game of “high/low.” Which student, he asked the rest of the class, had the higher card? The class stared at the students trying to discern a signal. None got it right the first time. A few people guessed correctly on the second round.

Before he tried a third time, he chided the class: “You guys are just staring at their faces. You have to get a broader view.”

And that third time, he passed out two cards and asked again: Who has the higher card? Finally, a student gave the correct answer: They have the same card. “I saw the look on your face,” she said, “and you seemed to be smirking a little bit.”

“Don’t just watch someone talk. Step back,” he said. “See how everyone else is reacting.”

Olin Business School Blog Olin Business School Blog