Ask the expert: What voting thresholds are needed for a Bylaws amendment to pass?

Requiring a simple majority (50% plus one), two-thirds, or three-quarters affirmative vote are traditional options. Some medical staffs now use a mail or electronic ballot that lists the proposed changes and states that a staff member who does not return the ballot within the required time frame is presumed to have cast an affirmative vote.

The premise is that if you fail to vote, you have indicated trust in your elected leaders to make proper decisions. An alternative is to state that no action is required to vote yes and that the ballot need only be returned if the medical staff member wishes to vote no. Although positive affirmation of a vote is preferable, voting members may not vote for various reasons, and voting quorums or thresholds may not be achieved. Some medical staffs have found the passive method of voting to work well.

Those who are displeased with an amendment are more likely to vote than those who are either pleased or are apathetic. Thus, the two-thirds approval rate can be measured by a one-third disapproval rate. Unless at least one-third of the voting members return a ballot voting no, the amendment passes.

This week’s question and answer are from The Greeley Guide to Medical Staff Bylaws, Third Edition by Mary J. Hoppa, MD, MBA, CMSL and Joseph D. Cooper, MD.