Article
The imperative for governance transformation in academic medical centers sits at the nexus of clinical care, research, and education. They are mission-driven yet financially constrained; community-rooted yet globally competitive. The next decade will demand that boards balance fiduciary responsibility with innovation, clinical excellence, digital adoption, and workforce resilience.
Smaller, More Agile Boards: Future boards should trend toward a leaner size (11-15 members), promoting more dynamic discussion and strategic focus.
Hybrid Governance Models: Incorporate external advisors or "fellows" to broaden perspectives without overextending board size.
Flexible Committee Architecture: Standing committees should include:
Finance and Strategy
Digital Transformation and Innovation
Academic Affairs and Research
Quality and Clinical Excellence in Patient Care
Governance, Leadership, and Culture
Clinical Expertise with Translational Impact: Academic physicians who understand the path from bench to bedside.
Digital Health and AI Leaders: Executives with deep understanding of health IT, data science, and automation.
Population and Behavioral Health Experts: To guide strategies for whole-person care and community impact.
Private Sector Operators: Leaders from finance, retail, and life sciences to offer external innovation and execution disciplines.
Civic and Policy Experts: Individuals with public service backgrounds to help navigate complex policy landscapes.
CEO and Executive Team Pipeline: Regular assessment and mentoring of internal talent to lead across missions.
Physician and Department Chair Leadership Development: Governance support for longitudinal programs in academic leadership.
Board Development: Ongoing education in governance, industry shifts, health policy, and digital health.
Succession Planning: Defined emergency and planned succession processes for key leadership roles.
Sustainable Financial Models: Including academic subsidies, alternative payment models, and cross-subsidization.
Digital and AI Strategy: Governance of data use, privacy, AI implementation, and digital front doors.
Academic Excellence and Innovation: Continued focus on research commercialization, grant competitiveness, and inter-professional education.
Workforce Strategy: Oversight of labor challenges, wellbeing, training pipeline, and hybrid work.
Community Health: Metrics and accountability for health disparities, SDOH, and community partnerships.
Clinical Excellence: Deliver the highest-quality care closer to patients’ homes.
Strategic Alignment: Adapt research and educational activities to changing societal needs and the evolving healthcare system.
Advocacy and Stakeholder Engagement: Advocate for the value of AMCs to policymakers and the public.
By focusing on these areas and adopting a forward-thinking approach, AMC boards can effectively navigate the complexities of the current healthcare environment and ensure the continued success of their institutions.
The academic medical board of the future must be smaller, sharper, and more strategic. Success will hinge on member expertise, dynamic committee structures, intentional development of leaders, and deep engagement with technological and societal shifts. By acting now, AMCs can future-proof their governance structures for a more resilient, agile, and innovative healthcare future.
Sarah Eames leads the Russell Reynolds Associates’ Healthcare Services practice. She is based in New York.
Sarah Brook leads the Russell Reynolds Associates’ Academic Healthcare practice. She is based in Stamford.
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