michael million consulting

Synopsis

Medical association boards present unique challenges for Executive Directors and CEOs. Success requires balancing respect for medical expertise, clear communication, strategic vision, and consensus-building among diverse stakeholders. Aligning the board on a long-term strategy is essential for serving the association's mission while ensuring smooth operations and effective decision-making. When boards are aligned, they gain momentum, strengthening both the association and its brand. However, misalignment can lead to inefficiencies, resource issues, and even leadership turnover.

Many organizations bring in external facilitators for strategic planning. Choosing the right facilitator is key—they must advance the agenda and establish credibility for the CEO. Leaders should seek professionals with the right expertise and traits to support this process.

 

Managing medical association Boards carry a unique set of challenges 

Unlike Boards at corporations or even other non-profit organizations, those at medical associations, societies, and academies have unique characteristics which can be particularly challenging and should be considered, including:

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• Lack of business experience: While more clinicians are earning business degrees, few board members have real organizational leadership experience. This can lead to board members overstepping into operational matters, making it harder for a non-physician CEO to establish authority and explain business decisions to those with a clinical focus.

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• Financial health challenges: Medical associations often rely on membership dues and educational programs like CME credits, requiring CEOs to continually sharper the member value proposition, innovate revenue streams, control costs, and manage board members' expectations—many of whom may not fully grasp the financial realities of nonprofit programs.

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• Composition diversity: Medical association boards often include a diverse mix of specialties and practice types, from primary care physicians to specialists, academics, and private practitioners. While this diversity brings valuable perspectives, it can also create competing priorities and factions. With members from multiple generations, boards may also struggle to address varying needs, viewpoints, and levels of technological familiarity across age groups.

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• Volunteer leadership: Unlike corporate boards, many association board members are volunteers, balancing their duties with full-time medical careers. This can result in varying levels of engagement, limited time commitment, less accountability in decision-making, and challenges in organizing meetings and reaching consensus.

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• Rotating leadership: Many medical associations have a rotating presidency or chair position, often with terms lasting only 1-2 years. Frequent turnover can affect long-term strategic planning, consistency, and progress in long-term initiatives.

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• Limitations of the right resources: Staff support for the CEO of most medical associations, especially smaller ones, is limited. Often staffs are small, focused primarily on member services, and often don't have experience in developing long-term strategies, therefore leaving it entirely on the CEO’s shoulders.

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• Dual focus on profession and public: Medical association Boards must strike a balance between servicing their members' interests and broader public health issues, which can lead to difficult ethical decisions, friction, and the need for careful communications and stakeholder management.

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• Policy and advocacy role: Medical association Boards typically participate in healthcare policy discussions and advocacy, necessitating a thorough understanding of complicated legislative and regulatory concerns. CEOs who engage in lobbying must be proficient at negotiating complex political landscapes and balancing various perspectives among board members on policy issues, and adapt quickly to policy changes, which can be difficult in a consensus-driven setting.

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• Slow decision making:  Given their medical background, board members frequently demand decisions to be supported by strong evidence, which results in well-thought-out recommendations but can hold down processes. The medical profession frequently emphasizes consensus, which can result in lengthy decision-making procedures as Boards aim for broad agreement.

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• Conflict of interest management: Given the potential, and often need, for industry relationships (e.g., with pharmaceutical or medical device companies), medical association Boards run the risk of conflicts of interest without clear guidance.

 

Outside facilitators can help make significant strides

An independent facilitator can greatly improve alignment between a medical association’s board and CEO, leading to stronger governance, clearer strategy, and better outcomes for the organization and its members. Bringing in outside help is valuable for strategic planning and complex tasks like balancing member and commercial interests, committee governance, optimizing the annual meeting, managing industry partnerships, developing new offerings, and member segmentation. External facilitators offer key advantages, including:

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• Neutral third-party perspective: Outside facilitators provide an unbiased viewpoint, free from internal politics or historical baggage. They can also objectively assess dynamics within the organization and offer fresh insights that insiders might overlook due to familiarity. Moreover, they can provide a confidential environment for honest discussions, allow sensitive issues to be addressed without fear of internal repercussions, and can gather anonymous feedback to surface hidden concerns.

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• Specialized expertise: Outside facilitators bring experience from various organizations, offer best practices and innovative approaches to problem-solving, and can provide benchmarks and comparisons with other medical associations.

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• Improved communication: Outside facilitators create a safe space for open dialogue between the Board and CEO, facilitates difficult conversations that might be avoided internally, and helps translate between clinical and business perspectives.

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• Time, space, and leverage: Outside facilitators provide leverage for the CEO by allowing them to participate fully in discussions without the burden of leading them, creating dedicated time and space for strategic thinking and debate, and ensuring the process receives full attention without distractions.

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• Structured process and progress: Outside facilitators implement a systematic and diligent approach to identifying and addressing misalignments, ensure all voices are heard through structured exercises and discussions, and keeps the alignment process on track, moving forward, and goal oriented. 

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• Conflict resolution: Outside facilitators are trained to handle and work through disagreements constructively, can defuse tension and emotions that may have built up over time, and helps find common ground and mutually acceptable solutions.

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• Accountability: Outside facilitators establish clear action items and follow-up procedures, provide an external check on progress and commitments made, and can revisit and reinforce alignment periodically.

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• Professional development: Outside facilitators offer learning opportunities for both Board members and the CEO, introduce new tools and frameworks for ongoing alignment, and enhances leadership and governance skills for all participants.

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• Customized approach: Outside facilitators tailor the alignment process to the specific needs of the medical association, addresses unique challenges in the healthcare and association landscapes, and can adapt methods based on the organization's culture and goals.

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• Change management: Outside facilitators help manage the transition to new alignment strategies, supports the implementation of agreed-upon changes, and assists in communicating alignment outcomes to stakeholders.

 

Determining the right type of facilitator 

While many can lead discussions, it takes a skilled professional to help CEOs and boards establish long-term strategies or tackle complex issues. The next section outlines three types of facilitators, from low-touch moderators to high-touch consultants, along with their benefits, drawbacks, and ideal use cases.

 

At one end of the spectrum are moderators, who facilitate discussions by keeping conversations on track and encouraging input from all participants, without offering any specific expertise. They often use generic frameworks and question prompts but lack industry or subject matter knowledge. Moderators typically “show up” on meeting day to act as MCs and may provide basic summaries afterward, though without insights, recommendations, or analysis.

 

Moderators offer the advantages of requiring minimal prep time from the CEO and board, being cost-effective, and using a simple approach. However, their formulaic methods may not fit the association’s unique needs, and they don’t contribute fresh ideas or challenge the group’s thinking. Moderation works best when participants are similar in perspective, already knowledgeable about the subject, and mainly need help processing information to make informed decisions.

 

At the opposite end are management consultants, who provide in-depth expertise through research, best practices, and financial analysis. Unlike moderators, consultants bring industry knowledge from a team and work closely with the CEO and board before the meeting. Afterward, they deliver a detailed report with outcomes, implications, and next steps. Consultants use a range of frameworks but excel at tailoring or creating new ones to fit the client’s specific needs.

 

The benefits of hiring a consultant for strategy sessions include diverse perspectives, high customization, and the ability to tackle complex challenges. Downsides are the high cost and the time commitment required from the executive team. Consultants can also overcomplicate processes, making them thorough but less actionable. Consultants are best used when the board lacks expertise, such as entering new markets or adopting new technologies, or when major strategic changes or organizational transformations are needed.

 

In between are consultative facilitators, who blend traditional facilitation with consulting expertise. They guide groups through complex discussions and strategic planning while offering expert insights and recommendations. Unlike moderators, they actively engage in discussions, challenge assumptions, and present alternative viewpoints, remaining neutral but offering informed opinions when needed.

 

Unlike traditional consulting, where solutions are developed independently, consultative facilitation is a collaborative process. The facilitator works with the client group to co-create solutions, combining their expertise with the group's knowledge. Unlike moderators, consultative facilitators conduct targeted interviews with board members and staff to quickly understand the organization, frame issues effectively, and provide informed insights that drive the conversation forward.  

 

The benefits of using a consultative facilitator include faster decision-making through a blend of facilitation and business expertise, greater buy-in through collaborative problem-solving, and a structured approach to addressing complex issues. This approach is ideal when organizations need to leverage internal knowledge while also gaining external insights and guidance. It offers a pragmatic, efficient solution that can be tailored to the organization’s specific needs while being cost- and time-effective.

 

In conclusion

Aligning medical association boards on strategy and complex issues can be challenging, but expert facilitators with the right skills and approach help CEOs create real momentum. Effective consultative facilitators are problem-solvers with an analytical mindset who get to the point quickly and efficiently. They offer corporate and industry expertise, strategic thinking, and customize sessions to engage participants. They take a hands-on approach before, during, and after the session to ensure success.