As I contemplate the content for this last blog as President and CEO of AUPHA, I naturally look for those gems of wisdom to pass along to all members and to the next person in this position. After much reflection, I realized that successfully managing this position, and success in our careers generally, do not depend upon flashes of brilliant insight that enable us to alter directions. We accomplished much in the last six years by moving forward systematically and consistently on initiatives developed by the Board and informed by a host of prior AUPHA leaders. While the next CEO will surely have new ideas, as I did, he/she will most likely build upon our existing efforts, all designed to provide value to AUPHA members. There are many, in fact probably too many, important initiatives to pursue. I want to leave you all with thoughts directed towards the next CEO but relevant to all AUPHA members so that they can provide new leadership appropriate support.
I started my career at the American Medical Association and spent most of my time associated with large academic health centers or substantial universities. These organizations had significant infrastructure to support all that I did. AUPHA and many associations of our size are fundamentally different. Our scale and scope of operations require the leadership and all staff to assume a broad range of responsibilities, often with little or no backup or support. Your AUPHA staff do an amazing job of keeping the bus moving. These thoughts then reflect my experience moving to a smaller organization. Five observations are key from my perspective.
- It is vital for the CEO to develop a strong, supportive working relationship with the Board. AUPHA has had the good fortune to attract smart, committed faculty to serve on and lead the Board over the years. These folks come from different academic and professional disciplines, employment environments, and perspectives. This diversity can effectively back the CEO at every step. Without their enthusiastic support, it will be difficult for new leadership to function, much less to make progress in any direction.
- Although small, the AUPHA staff enable the CEO to move the organization forward. While that may seem obvious, a competent, committed and loyal staff does not just happen. Building mutual respect and trust frees the new leader to focus on his/her activities. It takes time to build that trust (both ways) and trust requires constant nurturing. This is particularly vital in a small organization.
- The new CEO will have great ideas but must implement them with a steady hand. We learn from the failure of leadership at all levels that erratic, inconsistent, unreliable and/or untruthful statements and actions by leaders can confuse and frustrate the board, membership and, in particular, staff. Having a plan and direction and keeping true to it presents constant challenges given the many pulls and pushes from both internal and external constituents. There is a lot of noise in the world today and leadership needs to stay the course.
- Multiple purposes. Unlike an organization with a single, unifying purpose, AUPHA has multiple purposes arising from our varied and diverse membership. Yes, our mission is to “foster excellence and innovation in health management and policy education and scholarship” but this great idea must translate into daily activities. Further, pursuit of those initiatives must reflect the needs of our many members. Because our resources are limited, doing for one group necessarily implies doing less for another. Finding a balance among these multiple purposes requires significant guidance from the Board and others.
- Not about me. Finally, the CEO must subjugate his/her individual ideas and goals to those of AUPHA. It is easy for any leader to refer to “my board,” “my members,” or “my goals.” Membership owns AUPHA and their interests must always come first. The CEO must not take AUPHA in a direction of private benefits. This is easy to state but more difficult to implement as we often observe in government or association settings.
With these points made, what really makes running AUPHA difficult? I have struggled with three interrelated constraints.
- The roles of the CEO in shaping the position of AUPHA naturally become highly political in these days. Like all of you, I have positions regarding some of the key issues facing our healthcare and educational systems. AUPHA has not developed and articulated formal positions for most of the key issues, however, thus, as staff, I must be careful in how best to mention and discuss. For example, the third bullet above (Steady) could be interpreted as a criticism of current national leadership. I will let you all make that determination but the generalized statement stands independent of the context of politics. In the interest of creating unity within AUPHA, I have censored my thoughts and statements routinely. I could probably violate that now because I am a few days from retirement.
- Financial Risk. The range of ideas offered as means of generating member value and/or net revenue is substantial. Board members, faculty members, AUPHA leadership and staff can and have proposed a host of wonderful initiatives. All of these have great potential and supporters often point to successful implementation in other organizations. It is difficult to say no to a plausible idea, passionately presented, and containing the words “innovation, future oriented and/or modern.” Most of these suggestions are fundamentally sound if taken individually. In the aggregate, however, too many initiatives can spread limited resources thin. Remember that these new ideas emerge in addition to the many activities that AUPHA already pursues. A limited staff and budget cannot adequately develop, implement, and support too many initiatives. These wonderful ideas represent significant risks to the organization as we spend directly for the technology (usually). More importantly, they threaten the bandwidth available from staff and management.
- Technology Innovation. The shiny objects that appear daily in email, text, and phone solicitations represent a different set of noise confronting association executives. Association management systems, voice and data communication systems, social media placement, data scrapers, publication software, and meeting management systems are a few of the many technologies that offer “solutions.” As in the financial risk discussion above, each of these technologies, have attractive features. For a small organization, however, having the breadth and depth of necessary internal expertise constitutes a challenge. AUPHA staff each have a wide portfolio and they do their job well. We do not have sufficient expertise to evaluate comprehensively complex technologies on the front end or to fully implement the many features of the technology once acquired.
Now these cautions may lead you to the conclusion that to succeed, the association executive must hunker down and never express an opinion, take a risk, or adopt innovative technologies. That also is a recipe for disaster. All organizations, and especially those operating within a rapidly changing healthcare and education environment, need to be flexible and adapt to change. We have made many changes over the years, too few for some and too many for others. AUPHA is now in a sound place with strong financial resources, great staff, committed members, and a rich history. I welcome whomever the Board selects as the next CEO and wish him/her/they the best. Like all of you, I will continue to be available as needed to assist.