MGMA e-Source, April 13, 2010
Working with the board of directors: There's no fun in dysfunction
By Erin Landeck, MS, CPA, freelance writer
As a CEO or administrator, you must create and maintain a harmonious relationship with the organization's board of directors in order to keep it running smoothly. Because board members have disparate personalities, differing political interests and varying levels of experience, this can be a difficult task.
According to Frederick Wenzel, MBA, FACMPE, MGMA member and consultant, and assistant professor in the MBA program in Healthcare in the College of Business, University of St. Thomas, Minneapolis, Minn., the trick is to employ the necessary leadership skills – and develop new ones as needed – to manage the board even when its members manage you.
"It comes down to the quality of the decisions of the board," Wenzel says. "If the board is not driving the strategic planning process, it is not adding value." To ensure that the board is as effective and efficient as possible, work in concert with the board chair. Together, you can create healthy processes and help each board member understand his or her role and the role of the board as a whole.
Here are five ways you can help create a highly functional board of directors:
- Stick to strategy.
Create an agenda that focuses on strategy rather than operational details. Though it's easy to get bogged down in discussions about physician compensation, keep the board from going down that path by sticking to top-level issues. If they continue to micromanage, take time in one or two meetings to clarify the roles of the CEO and the board.
- Be a teacher.
Take responsibility for educating the board about your organization and trends in the health-care environment. Wenzel suggested dedicating 15 to 30 minutes of each board meeting to a guest speaker or a current issue. You may also give the board a few simple questions each member can answer and then discuss them as a group. For example: What is the practice's 2010 revenue budget? How many patients did we serve last year?
- Communicate and appreciate.
Continuously work on creating a partnership between you and the board of directors, and avoid perpetuating an "us vs. them" atmosphere. Great leaders demonstrate respect by always keeping the board apprised of major developments in a timely fashion and recommending alternate courses of action.
- Institute a picture-perfect process.
Be the model of efficiency and consistency when it comes to process. Create a timed agenda and send it out at least two weeks ahead of the meeting. Document all decisions and action plans and the follow-through that happened as a result. Start and end meetings on time. Orient each new board member to the organization and the board's processes before his or her first board meeting.
- Decide how to decide.
Does your board of directors have difficulty coming to consensus? Add a decision-making process to the agenda. Each group has to set its own norms, but you can push them forward by allowing them the space to make those rules.
"Without a work plan and a decision-making process, the board tends to get caught up in counting paper clips and rubber bands," Wenzel explained. By taking a strong leadership role with the board of directors, you will help the board govern well, stay focused on strategy and push your organization forward.
This article was adapted from a concurrent session at the MGMA 2009 Annual Conference in Denver. Find out about the MGMA 2010 Annual Conference in New Orleans.