Surgery managers sing the governing body blues
By Stephen W. Earnhart, MS
CEO
Earnhart & Associates
Austin, TX
We have had numerous requests for a column about interacting with the governing body (for ambulatory surgery centers) and board of directors (for the hospital folks). Regardless of what side of the street you live on, the issues are the same. In this column, we will refer to them both as "the board." (How ominous!)
Dealing with the board can, is, and always will be interesting. Some board members are micromanagers, others have no idea what they are doing, and some are merely figureheads put in place by well-meaning bureaucrats. Some are glacial calm, while others are fluid. No board is ever the same. The key is figuring out how to deal with it in an effective manner.
Board relations are so important that I once hired a staff person for my company solely based on her ability to deal with board members concerning various projects.
The best advice I can give is that the adage, "garbage in, garbage out" works here. A new board will quickly size you up and determine from that point on how it will interact with you. A mistake many administrators make is to be too wishy-washy with their board or to try to be friends.
Rarely does a hospital or surgery center hire administrators based upon their personalities. They are looking for substance: decision-making people who are action-oriented, like the board members.
Knowing what issues the administrator takes before the board will define the board’s opinion of that administrator. The hardest aspect of any job is deciding what is expected of you. Most boards have very high expectations of their administrator. You want to impress these people, because your job does depend upon their impression of your skills. Rarely can individual surgeons protect an administrator with whom the board has lost confidence.
Most administrators tell the board far too much! Which of the following items should be an agenda item on the board meeting?
- An employee threatens to quit unless he gets a raise.
- The C-arm breaks down again, and cases need to be rescheduled.
- Blue Cross threatens to pull its contract because of supposed noncompliance issues in billing.
- A waterline break occurs overnight in one of the operating rooms.
- A higher-than-normal infection rate is reported in your follow-up phone calls.
The answer is "none of the above." At this point, none of these are board-level issues. Period. Any one of them could become an issue, but not right now. It is the administrator’s job to obtain more information on these items. Not all of them may be appropriate for board-level action.
The board is the last place you ever present a problem. If the board members need to solve your problem, then they do not need you. Rarely do you need to give any information to the board that deals with employee issues, equipment, budgets, or other issues that they hired you to deal with. The less that is said, the better.
A good example of what to take to the board: "The C-arm circuit board burned out the day before yesterday causing us to cancel Dr. Brown’s surgery schedule. The repair will take about one week and cost us $1,500. Our budget will cover it. Dr Brown was upset, and he may call you about it. However, his cases have all been rescheduled, and I personally apologized to each patient who has been inconvenienced." Then go on to the next item!
I hear people complain about micromanaging board members. They could be doing that because they have been placed in the position by the person you replaced. (Of course, it cannot be you!)
The bottom line: Do not present information that is rumor, lacking in detail, not substantiated, or does not have a viable solution to accompany it. You never want your board to be surprised by issues, but always weigh the value of what you bring to it.
If you don’t want your board to run your surgery center or department, don’t give it the opportunity.
(Editor’s note: Earnhart & Associates is an ambulatory surgery consulting firm specializing in all aspects of surgery center development and management. Do you have additional questions? Contact Earnhart at 3112 Windsor Road, Suite A-242, Austin, TX. 78703. E-mail: [email protected]. Web: www.earnhart.com.)
We have had numerous requests for a column about interacting with the governing body (for ambulatory surgery centers) and board of directors (for the hospital folks). Regardless of what side of the street you live on, the issues are the same. In this column, we will refer to them both as the board. (How ominous!)You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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