Your Medical Group’s Governance Structure

How quickly and effective does your medical group make decisions? Both decisions that are proactive and those that are reactive?

I’m by no means assuming that your medical group is broken. What I am assuming is that, no matter how it’s structured, there’s room to improve its governance structure.

[If you haven’t read it yet, get a complementary copy of my book The Medical Group Governance Matrix. Or you can buy the book in hard copy on]

Here’s the point in a nutshell:

No matter how your group is structured, whether as a partnership of limited liability entities, whether as a professional association, a medical corporation, or so on, it has, whether by design or by default, a governance structure.

Governance structures can vary from what I call the “strong leader” set-up in which one person is charged with running the group, a sort of benevolent dictator, all the way to a board structure, that is, a corporate type structure, whether or not your practice entity is a corporation.

No matter the type of structure, the central issue is whether those who are leaders are empowered to actually lead, or whether they are hobbled, either by rules or by group culture into a situation in which voting across a large number of people is required, or consensus among a large number of people is required, before even, for example, a “strong leader” can take action.

What that results in is gummed-up governance because the group can’t respond to threats, it can’t even respond to questions, say from a hospital with which it has a contract, without significant delay.

It also hobbles the group in terms of taking proactive action, because when you turn to a number of partners for consensus, you’re setting yourself up for a watered-down position. And, there’s the danger of falling prey to fear among many that taking on, for example, new facilities or new group members, might threaten them in one way or another.

The first step is to establish the baseline: In what shape is your group’s governance structure, not simply as documented but in actual practice? Where do you actually want to be? Where might you be? 

That process starts with a governance audit.

Again, I’m not assuming you’re broken, I’m assuming you can get better, more efficient, and more importantly, more effective.

Comment or contact me if you’d like to discuss this post.

Mark F. Weiss

Leave a Reply