By the time it gets to the board of directors, it has been vetted in multiple stages along the way. Rarely do we bring something up to the board level and there is a big brouhaha."
The agenda, the structure, the frequency, and length of the meeting may vary from practice to practice, depending on what works for the practice, Hertz says, but there are also some fundamental commonsense rules that should apply, regardless of whether you've got two or 200 physicians in your practice. For example:
"Meetings need to start and end on time," Hertz says. "The people who show up on time shouldn't be penalized for the people who don't. It's disrespectful not to start on time and end on time. The more you don't start on time, the more people say, ‘Why should I show up on time?' and then it becomes a downward spiral."
Meetings need to have a structured agenda and a facilitator to ensure that the agenda advances. "What we really want is the meeting to move forward. I've sat through many meetings where nobody moves. Somebody introduces a topic and it just meanders. There has to be some leadership," Hertz says.
In most physician practices, the president of the board or a managing partner should lead the meeting. "I've seen a lot of practices where the administrator or manager chairs the meeting, but I'm not a big fan of that," Hertz says. "They are an employee. It's your practice. You're the governance. The manager can meet with the chair or the president, re- view the agenda and the material, point out any land mines or other things they need to be aware of, but, ultimately, a board needs to do the board's work."
Physicians need time to prepare for the meeting. Hertz says one of the most common complaints he hears from physicians is that they aren't given a chance to plan for the meeting. He recommends publishing agendas as far in advance as possible.
"You come to the meeting and somebody gives you a 15-page report and expects you to comment on it. That is not right," Hertz says. "I also hear, ‘I came to the meeting and all I heard was reports and I left.' Well then, why have a meeting? Put it in writing and e-mail it to me."
Hertz says some practices don't issue the agenda because they say their physicians won't bother to read it. "I say, ‘I don't really care.' The right thing to do is give it to the docs in advance and they read it or they don't. It's their choice, but that is the proper way to do it."
Don't rehash the same issue in meeting after meeting. "Some practices allow that. Some practices say, ‘We made the decision. We are moving on.' If it is a major decision that the board is going to make and the board isn't made up of all the partners in the group, it is incumbent on the part of the board to get the shareholders' input before the meeting and before the decision is made." In the end, the board can't allow itself to get bogged down on one issue. Make a decision. It all comes back to leadership.