Bylaws and governance monthly: It’s almost a New Year--Have you adjusted your bylaws to accommodate a new leadership era?

For many healthcare organizations, a new calendar year brings with it new medical staff leaders. But as new leaders come on board, what training do you need to provide them to ensure that they have the skills and tools to do their jobs well?

Just as there has been an increasing emphasis on transparency and accountability for physicians regarding patient care, organizations are placing increasing emphasis on the transparency and accountability for medical staff leadership. This is happening for two reasons:

• Medical staff leaders realize that their positions are not honorary—they are tough work.
• When medical staff leaders are paid by the hospital for all or part of their leadership duties, the hospital needs to ensure that the physician is performing commensurate with his or her compensation.  

All great medical staff leaders must be great clinicians, or they are not respected by their peers.  But not all great clinicians are great medical staff leaders. However, these skills can be learned. Many medical staffs are creating position descriptions for their leadership positions, including:

• President of the medical staff
• Department/clinical service chairs
• Credentials committee chair
• Quality committee chair

All of these positions have very involved duties and require the physician to dedicate a great deal of time, which is why they are worthy of a job description.

If you choose to create job descriptions for these positions, be sure to include criteria on leadership training. This means that leaders need to have either received training prior to taking the post or be willing to participate in training within the first few months of their leadership terms.

Because of this increased complexity of medical staff leadership, consider turning your traditional nominating committee into a leadership and succession planning committee. This committee develops appropriate position descriptions, vets candidates against these criteria, and recommends candidates for placement on the ballot. In many institutions, the committee is also in the performance evaluation of leaders and assists in recommending resources for improvement, if necessary. Its task is also to identify potential leaders so that they can receive appropriate training. The ultimate objective is to have leaders fully trained by the time they are in the leadership position so that they can hit the ground running.

The following is some sample bylaws language describing the responsibilities of a leadership and succession planning committee.

The leadership and succession planning committee:

1. Develops criteria for leadership positions to include tenure, leadership training, previous experience in leadership positions, and character.
2. Provides an annual slate of nominees for the elected medical staff positions.
3. Provides an annual list of potential leaders.
4. Defines a process for evaluating current leaders [i.e., department chairs, committee chairs, medical staff officers, and MEC members] and potential leadership candidates.
5. Outlines a plan and processes for developing potential leaders.
6. Submits recommendations for medical staff committee chairs based on the potential leaders’ needs for development and readiness to serve. (The [president of the medical staff] will consider these recommendations for committee chairs but will not be bound by them).
7. Develop job descriptions for officer positions.
8. Report twice a year to the MEC.

Mary Hoppa, MD, MBA, CMSL, is a senior consultant with The Greeley Company, a division of HCPro, Inc. in Marblehead, MA.