BOARD OF GOVERNORSHow to be a more effective medical board memberExpanded from the print edition
When doctors get together they complain, a lot. This could be a good description of most hospital medical boards, even yours. However, better hospitals have built a different doctor relationship, which makes the medical board an instrument of change, a launching pad for new programs, and a forum for constructive dialogue.
By David R. Edelstein, MD, Manhattan Otolaryngology-Head and Neck Surgery, Chair-elect, Board of Governors
When doctors get together they complain, a lot. This could be a good description of most hospital medical boards, even yours. However, better hospitals have built a different doctor relationship, which makes the medical board an instrument of change, a launching pad for new programs, and a forum for constructive dialogue. Former IBM CEO Louis Gerstner once stated: “Don’t tell me about the flood, build me an ark.”
In their book Chaos and Organization in Health Care Thomas H. Lee and James J. Morgan describe modern medicine as having a problem—chaos, with a solution—organization, and a motivating question—how do we get there. No one in medicine knows what the long-term outcome of healthcare reform will be, but hospitals need to have a plan to implement the changes, interpret new rules, use new technologies, and make strategic choices. This makes the medical board essential to overcoming chaos, since we spend our lives taking care of patients and using the hospital.
The problem with most medical boards is that physicians are often unwilling to speak up and are not prepared for the meetings. Physicians get elected for one- to two- year terms and spend too much time getting acclimated. I have known physicians to go an entire term without speaking for fear that they would offend someone or show ignorance. Some physicians are too willing to accept information from administration, which may be contrary to their medical knowledge. Most medical boards have a majority of members who are chairpersons, who may believe incorrectly that it is in their best interest to agree with administration. For a medical board to be effective, physicians need to be vocal and equal partners with administrators in organizing patient care solutions.
10 points for an effective medical board member
- Understand the medical board bylaws.
- Get the monthly minutes and agenda in advance and read them carefully.
- Ask questions often, speak up frequently.
- Help in the development of new business and strategic plans.
- Keep board documents for future reference.
- Assume nothing; you may have the most knowledge on a subject.
- Do not vote on proposals that you do not fully understand and have not had time to evaluate.
- Remember, the goal is improved patient care and safety.
- Differentiate between hospital goals and patient care—this will help you keep your “medical compass.”
- The medical board is where reality meets hospital decision-making. You are the reality.