Universal truth 1: There is no such thing as too much communication.

Ask any CEO for the secret to a positive relationship with the board (and especially board chair). Chances are, it’s substantial communication outside of the boardroom.

Following a rigid schedule may not be possible if your board is small (e.g., fewer than 10 members). However, strive to meet one-on-one with your board chair and vice chair every other week. Try to meet with individual board members monthly. These informal conversations can:

  • Provide CEOs the time they need to discuss complex or controversial issues and garner feedback. Not only does this information help CEOs lay the groundwork for educated discussions, it also fosters judicious decision making when board meets collectively.
  • Prepare board members for any unexpected negative financial news.
  • Alert trustees to HR issues like sexual harassment or labor disputes.
  • Make board members aware of any angst between management and the medical staff.
  • Present the stage to air any issues that could bring negative publicity or community backlash.

Universal truth 2: Blindsiding your board is a bad idea.

If a member of your management team has ever dropped a bomb on you, you’ll remember the shock and sting of that surprise. This is something you should not pay forward, especially to your board.

Universal truth 3: You serve at the pleasure of your board.

It’s dire to remember this pecking order or your days as CEO may be numbered. Many board members volunteer their time to serve, whereas CEOs are paid to guide the board and oversee the implementation of its directives.

If the board chair is not functioning at prime or if the board is missing the big picture, it’s up to the CEO to enlighten.

Also, only go out on limb for a worthwhile issue, regardless of your action’s consequences. Carefully pick your battles.

Universal truth 4: You must foresee the future and help your board foresee it, too.

Most board members who serve healthcare organizations have limited knowledge of the intricacies of the healthcare industry. For example, CEOs in the 1980s had to anticipate the effect of managed care on their organizations. A board member may only be familiar with the basic functions of insurance, as a consumer.

CEOs need to effectively communicate their vision to the board. By doing so, they prepare their governance team for tomorrow’s challenges. Since fortunetelling is more art than science, this leads us to our last truth.

Universal truth 5: CEOs are paid to take risks, albeit calculated risks.

There are times that CEOs deliver news that their boards don’t want to hear. Any board not willing to listen to this information is bound to bob on a sinking ship. Although CEOs serve at the pleasure of their board (universal truth 3), they’re paid to speak up and occasionally suggest potentially unpopular courses of action.

For example, we know a healthcare organization whose CEO urged the board to create an HMO. Although the HMO succeeded in care management and reducing cost per patient, it financially drained the system. Advising the board it was time to seek an alternative drew mixed (and sometimes tense) reactions among members. But it had to be done.

Be sure to also learn about universal truths for board members.

J. Larry Tyler, FACHE, FHFMA, CMPE, is Chairman and CEO of Practical Governance Group. He offers 40 years of experience partnering with boards in governance advancement and C-level search.

Errol Biggs, Ph.D., FACHE, Vice Chairman at Practical Governance Group, also is Director of the Graduate Programs in Health Administration and Director for the Center for Health Administration at the University of Colorado Denver. Here he teaches governance in the center’s graduate on-campus and executive programs.

For more information, please call Practical Governance Group at 904-606-5744 (main).