Definition of accountability:
The quality or state of being accountable; especially an obligation or willingness to accept responsibility or to account for one’s actions; answerable.
Accountability is a relationship phenomenon. You can’t be accountable to yourself. You need to be accountable to another person. You need someone to hold you to account. In emerging and small-group practices, where the dentist-entrepreneur is at the top, acting as the CEO, there is no one holding the budding CEO to account — and that is an elementary weakness for the fledgling CEO.
When you look at highly successful CEOs of any major corporation, the CEO serves at the pleasure of the board. The board holds the CEO to account for his or her performance. The board hires the CEO, provides him or her with a strategic plan, and charges the CEO to accomplish the plan. The CEO’s performance is based on him or her achieving the strategic plan and it’s defined short- and long-term goals.
The board defines the core value and vision. The CEO’s job is to ensure that the core values are deeply embedded in the culture, and the vision is understood by all employees below the CEO. The board defines the overarching objectives; the CEO is accountable for realizing these objectives.
The CEO is accountable for the performance of all below the CEO on the organizational chart. The CEO’s job is to lead and macro-manage those below him or her to deliver. Because the CEO is accountable, the board grants her full authority to hire people for the executive team who they feel confident can produce the desired results, and the necessary leadership to make it happen in their respective divisions — i.e., HR, operations, finance, facilities, recruiting, etc.
In small- and emerging-group practices, the dentist-entrepreneur does not have a board. There is no one to hold them to account. There is no one to question them. There is no one to evaluate their performance. There is no one to whom they report on a routine basis. Without a board, there is no “committed listening” to the CEO’s promises.
Having served on two for-profit boards and having consulted with many boards, I have always realized the power of a board. But until this time, I have been unable to formulate a way to bring that power to our clients.
It is clear that having a functioning board directly increases the performance of the CEO and therefore increases the company’s value. And if a managed-group practice is acquired or merges, having a functioning board in place significantly increases the negotiable and operational value.
“Dr. Cooper has worked with myself and our board for the past year and a quarter. Marc has made a tremendous difference in the performance of the board and my performance as CEO. The board now understands its role and accountability – and I do as well. I highly recommend Dr. Cooper to work with your hospital organization to get your board performing at its highest level, thus enabling the CEO to perform at his or her highest level. The results have been remarkable. “
— Andy Fallat, CEO of Evergreen Healthcare
Kirkland, Washington
Board Work: Governing Health Care Organizations
Book by Dennis D. Pointer and James Orlikoff
What Makes Great Boards Great
