Meeting Management Tips
Author: Cynthia M. Roehr, CPA, CMPE
As the new calendar year starts, so starts the incumbency for many new group presidents and officers. Each position has a multitude of roles and responsibilities. One role which is often under-appreciated is that of the group meeting chairperson. This role is key to navigating group decision-making, enhancing group cohesiveness and focusing on long-term strategies.
Group or executive committee meetings typically gather practice partners together to reach consensus on significant or sensitive issues. A skilled chairperson not only navigates these often emotion-packed discussions with tact and firmness, but also effectively brings the group through difficult discussions by reminding them of the group’s culture, vision and/or strategy and arriving at an accord.
While medical schools are ideal training grounds for clinical knowledge, few programs include development of non-clinical leadership skills, such as meeting management. This article outlines best practices used to assure group meetings are productive and efficient.
Before the Meeting:
1. Set the date early. Many groups find it beneficial to have a standing meeting calendar. However, if meetings are scheduled on an ad-hoc basis, provide at least 2 weeks’ notice to allow members time to adjust their obligations and attend. Typically, agendas are not ready this far in advance, so along with a “save-the-date” email, include the major topics for the meeting. This will allow thoughts to percolate. And be aware of group governing rules and regulations – some bylaws require written notice and/or specific timeframes for notices ahead of meetings.
2. Choose a secure meeting location. While this sounds like a “duh,” remember to have meetings in areas where any discussion is not overheard by outsiders. Espionage is real. And not everything your group might discuss is appropriate for public (or medical community) consumption.
3. Send out an agenda. Send the agenda at least 3 days in advance. This should include all topics, and if not self-evident, a brief description of the issues associated with each.
a. Set time-estimates for each topic. This will emphasize to members which topics are most important.
b. Identify those topics that will be brought to a vote. Consider including draft-language of the ballots if it is expected to be complex. For example, some votes, such as offering Dr. Honeycutt a job, are easy; but if the topic is to offer Dr. Honeycutt a new type of position, such as part-time with voting rights, delineate the specifics ahead so everyone has time to ponder the nuances.
c. Require that all voteable topics be included in the circulated agenda. Changes to the agenda can certainly occur as the meeting date draws near, but voting on topics omitted from the circulated agenda can create angst and dissatisfaction among absent members.
4. Business vs. clinical topics. Separate clinical discussions from business discussions. Ideally, work to establish separate meeting dates, or at least adjourn from the business agenda before moving to the clinical agenda. Undoubtably there are topics that have overlap, but discussions will be much more focused and productive if they are separated.
5. Use email to circulate announcements and general information. Don't waste time at meetings talking over mundane matters that can instead be sent in an email. If a topic is informational only, email should be adequate. If it’s background on an upcoming discussion item, highlight that the email is required-reading prior to the upcoming discussion.
a. Circulate sub/ad-hoc committee updates. The presidential role typically includes keeping track of projects and assuring all are making progress. Most keep sub/ad-hoc committee leaders accountable by requiring periodic, timely updates and/or minutes of their meetings and projects. If the group is also to be kept abreast of the committees’ work, consider using email or a secure website portal to keep everyone abreast. Removing oral committee reports from the meeting will avoid depleting valuable meeting time.
6. Consider utilizing a consent agenda. Consent agendas are not widely employed, but are very useful. These are a list of items that need group approval but are routine and without controversy. Samples might be quarterly retirement plan contributions, recommendations of sub-committees, or routine administrative actions. Send these topics via email and then use a single vote to approve the amalgamated topics at the meeting.
7. Collect proxies. Given that some group members are on-call during meetings, most groups allow proxies. If unlimited proxies can be accumulated, a single individual can load-the-ballot-box on certain votes, resulting in disgruntlement of other group members; conversely, best practice allows any one person in attendance to vote for at most two absentees. Anytime proxies are utilized at a group meeting, the proxy-assignments (i.e. who is voting for whom) should be made prior to the start of the meeting and documented in the official meeting minutes.
8. Come with proposals. Use the executive committee or subcommittees to hash-out the details and options and always come to the group meetings with options. Sometimes the proposal will be a single recommendation, whereas other times it will be a choice between A versus B. It’s okay if the committees do not recommend one choice over the other. And it’s also okay for the choices to be tweaked and/or amended during the meeting. By outlining a draft of the decision upcoming, the group’s discussion and concensus will be greatly accelerated.
9. Prepare slides/handouts. It significantly enhances everyone’s understanding and concentration if attendees have the issues bullet-pointed in front of them. The visuals don’t need to be fancy or verbose, just understandable.
10. Send a text meeting reminder. Everyone has hectic lives – so send a simple text to group members the day before - or a few hours ahead of - each meeting to encourage and enhance attendance.
At the Meeting:
1. Start the meeting on time. Wasting other’s time is inconsiderate. Enough said.
2. Consider feeding attendees. Food encourages attendance. It doesn’t have to be extravagant, but it should be set-up ahead so the meeting discussions can start on-time. And don’t let food be a distraction. Avoid arrangements where caterers disturb the discussion by roaming during the meeting (see secure location above).
3. Use Robert’s Rules. Some might study and implement these rules in their entirety, but at least abide by the following:
a. Formally start and end the meeting.
b. Require that meeting minutes are kept, that these minutes are reviewed by all members and approved at the next meeting. Prompt completion and secure archival are also important.
c. Keep attendance and record it as part of the minutes.
d. Require that decisions are made via formal motions and that motions are only voted-on after being formally seconded.
e. Assure that all votes are cast and counted with integrity. Vote totals should be recorded in the minutes.
4. Establish meeting rules of conduct. Best practice is to recite or at least show the group’s rules before the start of each meeting. These would typically include behavioral norms, such as not interrupting each other and silencing cell phones, but should be developed and molded to fit the group’s culture and needs.
a. Contrary to what we might wish, not all members readily accept that the goal of group meetings is to make decisions on what is best for the organization, not what is best for an individual. Thus, it is also suggested that the mission, vision and values are recited before each meeting. It should only take a minute or two, but this effort reminds all of the mindset members are to use when considering the topics ahead.
5. Require a quorum. Struggling with attendance? Make a change. Are meetings too long? Are topics relevant? Are members being disrespectful? These are all solvable issues. And if members are just not interested in attending, put some money in the game. “Absence penalties” or “meeting attendance payments” are true motivators. The fastest way to change behavior is to have money forfeited to a peer.
6. The most important topics should be first. While it would be nice to “warm-up” to the main-event, it’s vital the most important topics receive full-discussion and are not impaired by meeting-fatigue. Dive-in and get them done.
7. Have a timekeeper. Someone needs to be responsible to assure that topics stay on schedule. The timekeeper should be empowered to interrupt and/or announce the allotted time has expired. Time-management doesn’t need to be rigid, but some shepherding is necessary to assure all topics are completed.
8. Allow topics to be fully discussed and ripen. This might sound contrary to having brief meetings, but best practice is to discourage groups from introducing and voting on ANY new topic in a single meeting. Pushing topics through the process quickly is a huge member dissatisfier and can rapidly derail trust in leadership. Thus, it is recommended that whenever possible, members be allowed to fully digest and analyze topics over consecutive meetings. This doesn’t mean that you repeat the same discussion at two successive meetings – it means the topic is introduced and fully discussed at the first meeting and then voted-on it at the next. Certainly, there will be times when the second meeting yields another discussion – but that is an indication the topic was more complex or controversial and allowing such discussion is healthy. Only vote after addressing and/or discussing any concerns that are voiced. Occasionally, topics are too time-sensitive for a two-meeting process – in these instances use long-winded emails in lieu of the introductory meeting to provide pertinent information and candidly outline the identified concerns.
9. Use anonymous voting. Voting by show-of-hands gets skewed by intimidation and politics; and all groups have politics. Group culture can benefit from the purchase of an electronic (interactive) voting system. Such systems allow voting results to be tabulated and shared immediately and their anonymity helps remove existing tribalism. Some systems are sophisticated enough to weigh votes differently for part-time vs full-time individuals, etc., allowing resolution of some governance issues as well. There are many systems available; their cost is minimal while their impact can be transformational.
10. Keep the meeting moving. The meeting chairperson has the ability to interject organizing comments such as “we have A, B and C listed. Are there any other perspectives?” or “I hear a growing consensus for XYZ, would anyone like to offer a contrary position or alternatively make a motion?” It can be very effective to have individuals identified that are prepared to make the necessary motions to get the voting process underway. Just don’t pre-script too much so the process feels contorted or rigged. And consider tabling a topic for a later date if the group seems to be struggling or is needing more information. The mastery is in knowing when to shut-down a topic. Use fellow officers to help.
11. Invite Discussion. Does the chairperson’s body language and style invite everyone to participate? Be mindful of potential hidden biases. Be sure that no members are being ignored or silenced. One effective technique is for the chairperson to circle the room and ask each person to give their two-cents on a topic. Each could say “same as Joe” if they wish, but it assures that even the quiet members have their chance to speak-up. If you are new to meeting management, consider asking peers for feedback and coaching tips.
12. Shut-it-down when appropriate. Just as important as welcoming input, is ending it. If someone is off-topic, repetitive, disruptive, etc., politely cut them off and move the meeting forward. If someone is known to be long-winded, queue them as they are invited to speak – i.e. “Dr. Burns, we’re almost out of time on this topic…” Remember, if you won the gavel, it’s your job to use it - and you are correct that it is not always fun.
13. End on time. Meetings lasting more than 90-120 minutes tend to be ineffective. If meetings routinely need more time, either meet more often or manage the topic discussion better. No one enjoys a marathon meeting and the goal needs to be assuring participation and attendance.
After the meeting:
1. Collect all paper. Do not allow the group’s private information to be inadvertently shared with the hospital or others.
2. Monitor “after-meeting” meetings. If there are members routinely critiquing the group, group leadership or the group’s decisions, those individuals need to be confronted and such behavior discouraged. If, however, those “after” meetings are social, they are probably something to encourage. Camaraderie typically yields loyalty and stronger working relationships.
3. Circulate minutes promptly. The minutes should concisely summarize the decisions and task assignments. Make sure the minutes, while complete, are not overly revealing when it comes to topics that could cause the group embarrassment or legal jeopardy.
4. Follow-up. This is a common failure – decisions are made during the meeting, but who is telling all those impacted of those decisions? For example, if the group votes to hire someone, did anyone actually call the candidate? And more importantly, did someone tell the attorney so the employment contract can be sent? Many groups assign the Secretary or another officer to this role – but regardless it is imperative that all impacted parties are aware of the discussions and decisions from the meeting that affect them. Meeting minutes should include a “next step/decisions” for each topic and someone must assure that appropriate follow-up occurs.
5. Avoid emailing confidential information. And never email anything that would be embarrassing as the headline of a news story. (Does the group have a written policy prohibiting members from sending group information to outsiders?)
6. Build consensus on upcoming votes. When facing significant group issues or decisions, effective leaders find it helpful to have one-on-one conversations with peers apart from group meetings. Such communication efforts require a great deal of time, clearly signaling to group members the importance of an upcoming decision and assuring it receives their attention. In these efforts, do not avoid those with contrary perspectives; these individuals should instead be your focus. By identifying weaknesses and concerns, the proposals can be tailored to mitigate dissent. And group members that are not in leadership typically appreciate having value attributed to their voice. (Hold these conversations in private, secure settings.)
Similarly, leaders should encourage respected peers that support upcoming decisions to vocalize their views; ask them to speak-up at meetings and/or share their perspectives with contrarians. Care must be used to avoid coercive appearances, but there is nothing to hide if leadership is openly working to advance the objectives of the group.
7. Do not ignore non-partners. Remember that not all political clout belongs to those in elected leadership. Groups have non-partners (CRNAs, AAs, part-timers, pre-partners, etc.) that are not privy to meetings and/or all communication, but may have major influence in members’ perspectives. Keep these non-partners informed on the major goals and issues and include them in consensus-building activities.
8. Over-communicate. The best leaders understand that their primary job is communication. It is nearly impossible to over-communicate. But under-communicating is detrimental. A favorite axiom is “in the absence of good information, people create stories on their own.” Good communication assures the group is always working with facts.
9. Use anonymous surveys to gather perspectives. Use some type of information gathering (such as surveymonkey surveys) to track the pulse of your organization. Are there hidden topics out there? Or are there issues receiving great effort that are not controversial and could be resolved quickly. Anonymous input can yield great insight.
10. Engage members. Ask members to engage in ad-hoc roles and committees. Groups don’t run themselves and having members involved assists in this process. Rome wasn’t built in a day, nor was it built by one (wo)man.
11. Ask for input. Especially as a new chairperson, consider asking members whether the meeting was effective and a good use of their time. The feedback will be more candid and helpful if done anonymously via a surveymonkey-type tool.
12. Traction is the key to completion. Nothing gets done until someone actually puts traction to the project. Be organized. Use lists. Assign responsibility. Set deadlines. Follow-up. And communicate along the way.
Effective meeting management is a skill that takes time to develop. But mostly it takes planning and hard work. Invest the effort and it will yield results. Congratulations and good luck to all of you newly holding the gavel for your group.
Cindy Roehr is a CPA with over a quarter-century of anesthesia and practice management experience. She has been a frequent speaker at ASA and MGMA conferences and consults with groups on provider performance evaluations, hospital contracting, governance, financial modeling and RCM issues. Additional information about Ms. Roehr and additional articles pertaining to practice management may be found at www.roehrconsultingllc.com