In 1992, a joint study by the American College of Healthcare Executives (ACHE) an international society of 30,000 healthcare executives and the National Association of Health Services Executives (NAHSE), the society for black healthcare executives. compared, for the first time, the career attainments of a group of black and white healthcare executives. The study had three objectives (1) to describe and compare the career attainments of the two racial groups; (2) to suggest what factors might account for any differences in their attainments and (3) to elicit opinions on public policy initiatives that might bring about greater equity of opportunity in the field of healthcare management.

The findings showed that fewer blacks held CEO positions or positions reporting to the CEO; fewer blacks worked in hospitals and financial remuneration for blacks was 13 percent lower than for whites. Blacks expressed less satisfaction than whites in pay and fringe benefits, job security and the respect they received from their supervisors. Nevertheless, blacks and whites had achieved comparable levels of formal education and blacks had accrued one year less experience compared to whites.

When the results of the 1992 study were published, the leadership of the two sponsoring organizations published a set of eight recommendations. These were intended to redress what appeared to be unfair discrimination against black healthcare executives. They included such positive actions such as urging executives: to recruit and promote black managers with requisite preparation at all levels, to deploy black executives in the role of recruiter for various positions in their organizations, and to endorse equal employment opportunities.

Several suggestions were directed to black executives: that they seek first positions in organizations in which they hope to build their careers as first job was strongly related to current position held. The study sponsors also urged blacks to interact with colleagues in professional associations. Financial aid for black students in healthcare management was encouraged and executive search consultants were to be apprised of the study findings. Finally, the sponsors suggested that a follow-up study be conducted in three to five years. The current study responds to that last recommendation.

Between the time of the publication of the original study and 1997, our society and our field has experienced considerable change. Diversity initiatives have become popular in all kinds of organizations. Indeed, the field of healthcare management—led by the American Hospital Association the ACHE and NAHSE sponsored the initiation of an Institute for Diversity in Health Management. Its goals are to recruit talented minorities to the field, provide internships for a group of selected future leaders, enhance the career mobility of minority executives through a centralized job bank and referral network among other positive actions.

When the time came to conduct a follow-up study, leaders of ACHE and NAHSE saw fit to broaden the study objectives to focus on two other racial/ethnic minority groups: Hispanics and Asians. Toward that end, they enlisted the support of the Association of Hispanic Healthcare Executives (AHHE) and the Institute for Diversity in Health Management. These organizations assisted in identifying leaders in the field who were Hispanic and Asian. Thus, the current study consists of both a cross-sectional and an extension of the original 1992 research.