| Challenges Exist on Both Sides: | |
Board meetings are often frustrating for both CEOs and trustees. CEOs often complain to other CEOs, or to their own subordinates, about how frustrating it is to deal with their boards. Trustees often complain to each other about how frustrating it can be to deal with the CEO, and how dissatisfying board meetings are. True, some of the dissatisfaction is due to the difficulty of forging consensus among trustees, all of whom have their own points of view. Some of it is also due to misuse of trustees’ time and the underutilization of their talent. And, some of it is due to having to put up with trustees who talk too much, lead discussions astray, ask irrelevant questions, or don’t bother to read board materials. But some of it is also due to the friction inherent in having outsiders, who are volunteers and perceived as amateurs, supervising a seasoned executive who is a true specialist in a highly specialized institution within a complicated field. The friction is more evident in health care than in other fields, because health care is so specialized, because trustees are community leaders, and because boards of non-profit hospitals and health systems need to attend to a broader set of imperatives than simply maximizing shareholder return. From the CEO’s perspective, dealing with boards is often burdensome. On top of everything else they need to do, dealing with board business and trustee relationships takes a lot of time. As if leading a hospital or health system wasn’t already a full-time job, the board’s demands on the CEO’s time have expanded. As a result, CEOs have often had to focus on getting the board’s business done, rather than engaging trustees in debates about major issues, which only consumes more valuable time. Board service isn’t as satisfying as it should be for trustees who are leaders in their own right and bring more talent to the task of governance than they get the chance to use. Good trustees want to have plenty of opportunity to offer guidance and advice. They also want to have opportunities to exercise leadership. In general, they relish the opportunity to work with the CEO to forge consensus in support of a major new initiative, or to learn enough about clinical quality to work with management and the medical staff on quality improvement processes. CEOs who understand this are at the forefront of the trend toward more collaborative relationships between themselves and their boards. They understand that the old model can’t work, particularly when their trustees want to be more involved.
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