QUESTION:    Nationally, what are you seeing with regard to the composition and structure of Medical Executive Committees and what is the national norm regarding term limits for Department Chairs?

ANSWER:    In many hospitals, the Medical Executive Committee (“MEC”) has become unwieldy and ineffective. One trend we are seeing is an effort to re-engineer the MEC and reduce the number of physician members and hospital/administrative representatives. The goal is to create a more nimble, effective body that can respond promptly to the challenges facing the Medical Staff and the Hospital, and also be a forum for thoughtful discussion, planning, and action.

Seven to nine members is considered by many leadership gurus to be the “best practice”/optimum size for leadership committees and professional boards in order to conduct efficient operations and promote thoughtful discussion and action. An article in the Harvard Business Review observed that research on group dynamics indicates that, in larger groups, members “cease to take personal responsibility for the group’s actions and rely on others to take the lead.” Large groups also “inhibit consensus building.”

As another trend, the “agendas” for MEC meetings are being re-evaluated to be sure that the issues that truly need discussion and planning take precedence over the important – but more “routine” and ongoing – agenda items that appear each month. Consent agendas are definitely on the rise!

Finally, we are seeing that many MECs (and all Medical Staff committees really) benefit from having the expectations and requirements for committee service explicitly articulated and shared with the committee members, prior to their service. While many of the principles are common sense, we are finding that making them explicit helps MECs (and other committees) function better.

The most common “term of service” we are seeing nationally for Department Chairs is still two years and reappointment for additional terms is generally permitted. But increasingly, the initial term is lengthened to three years in order to permit more leadership development and effective functioning.

In many hospitals, Department Chairs are no longer elected by members of the Department. Rather, there is  a “Nominating/Leadership Development Committee” that is responsible for not only nominating candidates for Medical Staff office, but also selecting committee chairs and members and Department Chairs, after obtaining feedback from others. This requires a lot of education with the Medical Staff, but this model has proven to be very effective in improving the quality of overall Medical Staff leadership.