Avoid Bogging Down

Medical group governing Boards often get mired down while addressing important group issues or trying to make decisions. They also have a tendency to micro-manage rather than govern. Following are some ways to overcome these challenges.

Send It To Committee

We will discuss committees and how to make them effective in more detail in a future article.

We have found that the best medical group Boards use their committees to process information prior to the Board addressing an item. When an item is raised at the Board level, the first step is often to send it to a committee to:

• Define the scope of the issue.
• Gather needed data.
• Analyze the data.
• Recommend a solution.

Once the committee has developed a solution or recommendation, this information should be presented to the Board. However, the Board must be extremely careful to not redo the work of the committee. If the Board feels the committee has not completed the assignment, it should be sent back to the committee for further work.

In addition, the Board should make every effort to accept the committee’s recommendation. Why? If the Board always rejects the committees’ recommendations or re-does the work, the committees will reach the conclusion that their thoughts are not being considered and stop doing the work.

Avoid Micromanagement through Setting Policy

As a Board tries to do its work, it’s often tempted to move from “governance/oversight” to micromanagement of the organization. The best way to way to avoid this is to focus the Board on setting “policy” than on decisions.

A “policy” is a statement which guides and constrains the subsequent decision making. In setting policy you try to specify the ends rather than the means.

In setting policy, the Board should identify what is to be accomplished and a range of acceptable and unacceptable means for achieving the objectives. This could include a set of directives for how the group will operate in the future, or instructions to management to implement.

To help the Board avoid micromanagement, it’s often helpful to remind them that they don’t have to (and shouldn’t) make each and every decision. The Board has options, which include:

• Request proposals and recommendations from Management prior to making a decision. Example: “we need avoid problem X. Management – develop a set of alternative methods to achieve this end.”
• Delegating decision-making authority with constraints. Example: “We need avoid problem X. Management – develop a set of alternative methods to achieve this end, but it must cost less than $50,000.”
• Delegating decisions with an exceptions. Example: “We need avoid problem X. Management – develop a set of alternative methods to achieve this end, but it must be a process solution rather than a technology solution.”
• Retain authority and make decisions itself.

The best Boards always think – “is this something that Management should decide once we’ve provided guidelines?” The best Boards spend most of their time setting policy.

 

Please contact me if you’d like to discuss this post.

Will Latham
wlatham@lathamconsulting.com