Just because a physician excels in the operating room or in treating patients in the clinic doesn’t mean that he or she will settle comfortably into a seat at the board table, according to governance experts.
Thus, the challenge: how to identify someone who complements other board expertise, without dominating discussions or in other ways scrambling team dynamics.
Physicians, after all, frequently possess a lot of innate skills, including leadership abilities, intelligence and the well-honed capacity to process stacks of information quickly. On the other hand, “physicians are trained to be autonomous decision-makers,” says David Nash, M.D., dean of the Jefferson School of Population Health in Philadelphia. “That is not necessarily predictive of good board behavior. Good boards are definitely good teams.”
To locate that physician trustee in the rough, Nash and others advise delving beyond a doctor’s resume and patient caseload to gain a better sense of their emotional resilience, ability to handle conflict and work within team settings. Once they join the board, physicians also might need some prepping and guidance to adjust to more than just the hefty workload. They may have to navigate the transition from an all-clinician environment to interacting with attorneys, auto dealers and other board members with diverse backgrounds and perspectives. At the same time, they must strive to protect their own autonomy, both within and without the boardroom.
No single physician can represent all physicians, and that should be relayed to fellow members, says Matt Lambert, M.D., who is based in Chicago but also serves as vice chair of the board at Sisters of Charity of Leavenworth Health System, a multistate nonprofit health system. A surgeon by training, Lambert points out that his clinical perspective might differ from that of a primary care doctor. “Rather than be representatives of the profession per se, we really are trying to bring in the physician sensibility to some of the issues,” he says.
At the same time, doctors on the board must learn to erect a strict confidentiality perimeter around board discussions, says Susan Douglass, whose Colorado Springs, Colo.-based consulting firm focuses on the management of workforce and physician talent. “It’s a lot like patient confidentiality,” she says. “You don’t discuss a patient in the cafeteria.”
Identifying and recruiting a good physician trustee is far easier if they’re already taking care of patients at that particular hospital or a nearby facility, Douglass says. That provides a front-seat view of how they work with others.
“You want someone who treats other people with courtesy and respect,” she says. “You don’t want someone who is always fighting with the nurses. That’s a telltale sign that that’s a physician who feels a lot of autonomy and control.”
Look for an ability to listen, even in circumstances in which the physician doesn’t agree with the answer, Douglass says. “In general, I think any person who can handle contrary opinions is someone who has a very strong sense of self,” she says. “They are flexible. And they are patient.”
Nash ticks off other promising signs: demonstrated leadership skills both within a medical setting and also, perhaps, within a community social or religious group. Find a doctor who already has demonstrated a commitment to the hospital system’s larger goals, says Nash, who has lengthy board experience, including his current board position at Main Line Health, a nonprofit hospital system in suburban Philadelphia. “For example, a doctor who practices in underserved areas in a system that’s committed to care of the poor,” he says.
Good board candidates also demonstrate a hunger for learning and new ideas, one that extends beyond fulfilling continuing medical education credits, Lambert says. The doctor may be pursuing an additional certification or involved with an educational initiative through the Institute for Healthcare Improvement or another organization, he says.
But don’t make any snap judgments based on a physician’s specialty, Lambert says. Some people, he quips, would assume that a surgeon like himself couldn’t serve a board well. “We do have a reputation of being somewhat impulsive and direct and quick to come to decisions.”
Doctors are not the only newbie board members who might benefit from some coaching on working collaboratively, says Barry S. Bader, who runs a governance consulting firm based in Scottsdale, Ariz., and is a senior consultant to the American Hospital Association Center for Healthcare Governance. “The same challenge exists when a board recruits an entrepreneur who has brought along a company from a startup and is used to calling all of the shots,” he says.
Given a physician’s stature in society, though, nonclinical board members who don’t have a strong sense of self could be influenced by a grandstanding physician trustee, Douglass says. If that occurs, it’s crucial that the board chair step in to steer the conversation and if the problem persists, ultimately, to mentor the doctor involved.
The good news is that, as medical treatment moves toward a team-based model, new physicians will hit the workplace with more of a team mindset, Douglass says. In that regard, physicians at least 10 years out of residency might be good candidates for board recruiting, she says. But don’t overlook seasoned, senior physicians, as long as they demonstrate a willingness to learn and grow into the trustee role. “Because frankly, they know a lot about the market, they know a lot about the patients and they know a lot about where the bodies are buried,” she says.
Joining a board is a significant commitment, one that time-pressed doctors underestimate at their peril, says Nash, who previously served on the board of Catholic Healthcare Partners in Cincinnati. “Speaking personally, I was very surprised by how much work it takes to be a really good board member. It was twice as much work as I had anticipated.”
The written briefing material alone is “voluminous,” Lambert says. Still, wrapping up his board service at Leavenworth Health System, which ends this year, is going to leave a “big hole” in the surgeon’s life.
“I consider myself extraordinarily fortunate to have been selected to do this,” Lambert says. “I love learning and I love the interaction with the people we have. The issues are difficult, the dialogue is intense, but it’s very informed. It’s very energizing.”
Charlotte Huff is a freelance medical writer in Fort Worth, Texas. For more about physicians on the board, please see “The Physician Trustee,” April 2012.