Leadership and governance

Friday, May 01, 2015 12:24 PM

CMS members explore alternative governance structures

by Kate Alfano, CMS communications coordinator

Joe Gagen, JD, facilitated a discussion on governance reform during the Saturday evening fireside chat at the 2015 Spring Conference in Vail.

The Colorado Medical Society is in the process of reviewing its governance structure to identify ways to strengthen and support the society’s strategic goals. Coordinating this effort is the CMS Governance Reform Task Force, chaired by past president Jan Kief, MD, and composed of 17 physician leaders and component society executives. The GRTF has set it guiding principles: To maximize the efficiency and effectiveness of the society in its decision-making while also keeping a member-centric focus, promoting the profession, maintaining transparency, and maximizing member engagement. They will present their recommendations to the Board of Directors in July and to the House of Delegates in September.

Joe Gagen, JD, facilitated a discussion on governance reform at the 2015 Spring Conference in Vail. He reviewed the current policymaking process of CMS, which is based on a geographic model, detailing the roles of the House of Delegates, Board of Directors, CMS committees and sections, and affiliate organizations.

He then presented information gathered from leaders of other state medical associations that have explored governance reform and acted upon their members’ recommendations. In their discovery process, the associations found that modern technology could be used more effectively to engage members and gather their input. Some of this is led by generational preferences: For the most part, people born in the 1980s and later prefer communicating virtually rather than attending meetings and don’t appear to be getting involved in the leadership pipeline at rates equal to their older colleagues.

Other states also found that current decision-making processes are too slow to keep up with the rapid pace of change and a short-term resolution-driven policymaking process opens up the association to inconsistencies with deliberately constructed strategic plans.

These states looked at the latest nonprofit association management and governance literature that emphasizes that effective governance is essential to executing strategic goals, including having boards of directors that are smaller in size – trying to drive better accountability and preventing members from “hiding” within large board structures. Almost every state also found that current governance models were very expensive given the number of people that are engaged.

Gagen presented data on Colorado’s current standing: There are 310 delegate slots in the House of Delegates but in recent years only 260-270 delegates have registered to attend and only 90-120 were present to vote. The HOD was forced to change its requirements for a quorum in 2012 when low attendance was preventing delegates from conducting business. Additionally, the average age of delegates is 59 years old after excluding medical students. There are 38 slots on the CMS Board of Directors, three of which are currently vacant.

CMS membership surveys conducted in 2008, 2010 and 2013 have showed declines in the perception of how CMS communicates with members, the presence of opportunities for members to provide input and suggestions, whether CMS positively impacts the Colorado health care system, whether CMS positively impacts physicians’ careers, and whether CMS reflects members’ priorities.

In most other states where changes were made, the associations chose to eliminate their Houses of Delegates; create annual member forums; hold regular policy forums on selected issues; create policy councils; directly elect officers and their boards; reduce the size of their boards; and create a nominations committee to ensure diversity of expertise, experience and perspective.

All members and component staff urged to participate
Respondents at the spring conference were receptive to the data suggesting that CMS should adopt some of these reforms to improve the governance process and make the organization more representative of the larger membership. This discussion is crucial to the future success of the society and CMS encourages all members and component society executives and staff to continue to participate in the governance reform process.

The task force met April 17-18 and will meet again June 19-20 with individual committee meetings as needed. All documents related to the work of the GRTF are posted on the CMS website, www.cms.org/articles/governance-reform. Members are strongly encouraged to log in to view and comment on these documents. Send additional thoughts to governancetf@cms.org.