Presidential power

I served for three years as the board president of a small specialty hospital, and was frequently amazed at the deference I was given by my colleagues, most of whom were both older and richer. (Much of the voluntary sector, leaving aside trade associations and other business-related groups, operates by the Golden Rule -- he who has the gold makes the rule.)

In fact, I used to joke about the limits of presidential power. If I had come to my board and said that our specialty was no longer relevant to the healthcare community, and that we should choose another niche, they would have said that I was closer to the situation than they were and that we should move forward with the transition. If I had recommended replacing the administrator, they would have told me that would create burdens for me, but if I was game to go to it. But if I had recommended that we move our board meetings from Wednesday to Thursday, they would have said, Are you crazy? We've always met on Wednesday!

As it happened, there was a real demonstration of this when the administrator resigned early in my presidency. During the previous gap between administrators -- which had taken place before I was in the leadership core -- the medical director had been given the position of acting executive director during the search -- and the consensus was that it had been a disaster. There was a also a strong consensus that the medical director job needed to be full time, not combined with non-medical administrative resposibilities.

However, the doctor made it clear that he was a candidate for the (combined) executive director job. In consultation with the executive committee, I suggested that he would compromise his candidacy by becoming interim or acting executive director. He was okay with that until I told him that rather than name anyone to an interim post, we were creating an administrative committee on which he would serve along with the comptroller and the HR director. At this, he went ballistic -- not just because of the shared authority, but, I have always suspected, because the comptroller was black and the HR director was a woman. He demanded a meeting with the executive committee, to ask them to over-rule my plan, and I arranged it.

There were two major points in his presentation to the excom:
1. By forcing him into this troika, we would be emasculating him.
2. He did not think he could work under those circumstances, and unless the troika plan was rescinded, he would probably find it necessary to leave.

When we went back into executive session, my colleagues recognized how difficult it would be to keep the hospital running smoothly if we were simultaneously without an executive director and a medical director. They also recognized that the added stresses caused by a dual vacancy would be borne directly by me. The upshot was a decision to let me decide, with the assurance that I would have their full backing and support for either decision.

Well, guys, I told them, here's how I see it: Status quo means emasculating the doctor. Conceding to him means emasculating the president. If I have to decide who gets emasculated, that's an easy one.

P.S. The doctor stayed not only during the search, but for more than a year after the new executive director came on board.