Quick Leonard Kieffer is fortunate to have a strong network of Of Counsel partners, former industry‐ leading executives who provide subject matter expertise and insights into various segments of the healthcare world to augment our recruitment process. Below, three of our Of Counsel partners share their thoughts on the current and future leadership challenges and opportunities for healthcare associations and medical societies in light of COVID‐19.
As the leader of a healthcare association or medical society, what would be top‐of‐mind for you in ensuring that you were most effectively fulfilling your mission to your members during the pandemic?
Steve Lieber, former CEO of the Healthcare Information and Management Systems Society: My main concern would be the balancing act of how to deliver the content my members need that is relevant to the work they are doing while ensuring that we are not overwhelming them by taking critical time away from what they are dealing with on the front lines. In the healthcare IT world, in particular, I would be seeking out examples of how others are using technology to get through the challenges facing frontline workers and then creating a means for members to access that information when they want to. With the demands on healthcare workers right now, the idea of pre‐scheduled events – even those that are virtual – does not make much sense.
Adrienne White‐Faines, former CEO of the American Osteopathic Association: Prior to COVID‐19, the culture and engagement of members and staff of organizations was primarily affirmed through physical presence; the pandemic, however, has now created the need for an increased level of empathy from leaders, requiring more profound ways to ensure cultural connectivity. In addition, at the broadest level, the COVID‐19 crisis opens the opportunity for leaders to reflect on all the work of the association– its policies, activities, strategies, processes and programs. Through this lens, an organization can innovate, rebuild and refresh in new ways, to adapt to a new world order.
Karen Hackett, former CEO of the American Academy of Orthopaedic Surgeons and the American Association of Orthopaedic Surgeons: Although some specialties are currently overwhelmed with taking care of patients, other specialties, such as my former world of orthopedic surgery, have seen their workloads drastically decreased as a result of the cessation of elective procedures. Current leadership, therefore, will be dependent on specialty, and engaging staff to meet specific member needs will be very important. For those specialties that are awaiting the opportunity to ramp their work back up, this may be a good time to engage them in additional learning to position them for the future. Going forward, I do not believe that either member needs or society offerings will be the same as they were in the past, and this is the time to think about what the future is going to look like and how associations can best serve their members in the future.
Steve: It is true that some associations are struggling to keep their businesses alive, which is a challenge they may never have experienced before in terms of their business model. Those associations may now be looked at to fill new roles and value propositions for their members beyond purely clinical training – these new challenges relative to business operations could be within the purview of what the association ought to be helping its members address.
Adrienne: To that end, I think it is really important for the physician and healthcare associations, across various specialties to be asking themselves, "What should we...?" not "What were we...?" Associations
have a unique opportunity to now get ahead of processes to help their members – and as a profession – define how to move forward in a new healthcare landscape. Association leaders really need to help members proactively evolve and own some of the changes, as opposed to resisting all, because things will not go back to the way it was.
Associations and professional societies depend on the revenue generated from annual conferences and other large convenings. As those events have been cancelled in the current season and the status of the upcoming season is unknown, what should associations be thinking about from a budgetary perspective both now and in the coming year?
Karen: As an association leader, I would be thinking really hard about what next year is going to look like because I don't know that it will go back to the way it was in the short‐term, if ever, especially for associations that have a lot of international attendees at their events. From a budgeting standpoint, I would be very, very conservative about what next year's conference, annual meeting, annual convention, etc. is going to look like because I think it is going to take longer than 2021 to come back to where it was.
Adrienne: As associations think about their revenue‐generating activities, it will also be important for them to do a deep dive in examining their reserves and reserve policies, especially given volatile markets. Over the next 18‐24 months, they may have to start investing in some technology and restructuring their budgets, so it is not just a matter of considering the current flow of revenue that has been lost, but really what they will be investing in for the future to build their platforms for delivery.
Steve: Hopefully, before COVID‐19 hit, associations had diversified their incomes and are not relying upon their annual conference for more than 50% of their revenue. While I was at HIMSS, we drove down the annual conference revenue share from 75% to 35%, while at the same time growing the whole organization, and I did that very purposefully so that we were not so much at risk. However, to the extent that an association has not done that and has a huge percentage of its revenue tied up in in‐ person events, this would not be a time to hunker down; as Adrienne noted, this is a time to be thinking about what to invest in and a retooling opportunity for the organization. It is important to not cut important talents and capabilities that will be needed post‐COVID, but to be in a position to jump on opportunities when others might still be trying to figure out how to recover. The attitude should not be, "Just because everybody else is laying off or furloughing, I guess we ought to, too"; organizations have the potential to actually thrive in this environment if they are positioned right, governed right, and led right. A number of associations have reserves to draw upon and this is clearly the most opportune time to do so. It all depends on where you sit, what the hand is that you are holding, and figuring out what is going to work best for where you are and what you have.
What is your sense of how convenings that have been a mainstay of associations – coming together as professional colleagues for networking, learning, innovation, and advocacy – will play out in the near and far future? Has the world changed for associations and the way that they convene, gather, and collaborate?
Karen: I do not think that face‐to‐face meetings and conventions are going to go away because face‐to‐ face interaction is really, really important for most associations. However, I don't think that they will be at the magnitude they have been in the past, which means that associations will have to think about different ways to get information to their members to make sure they remain relevant, and that may have a significant impact on staff; some staff may be able to move into the new reality and some may not, which will also present challenges.
Adrienne: It is important to assess the expectations of members and really get a feel for their tolerance for these changes. Some associations will have higher technological expectations and others are going to be slower to adapt; assessing comfort levels will ensure that people will buy in, or indicate what communication is necessary to help members adapt to new processes. Thought will also have to go into where the greatest value comes from face‐to‐face interactions, recognizing that people's new tolerance for technology may help associations begin to balance their budgets by utilizing more virtual experiences – which must, just as in‐person experiences, be as pleasant and professional as possible.
Steve: Looking at it from the business side, any association with a significant exhibition or trade show component to their annual events will have a real problem dealing with the aftermath of those cancellations. What I am hearing from most of the spring trade shows is that they are trying to hang on to as much of that exhibitor cash as they can and offering to roll over a percentage of that to next year's event, in essence putting themselves on the hook to deliver the experience again next year; I think that there is a little bit of shortsightedness in thinking that those big trade shows will take place at this time next year. A strategy toward smaller meetings would be my first‐year plan, operating with an opportunity for my big event but trying to minimize my obligations and commitments in the near‐term. Local events will open up faster and leaders will be able to create very rich environments of influential members in major metropolitan areas, employing social distancing with no out‐of‐town travel. Certainly, the margin will be much lower because of the overhead and logistics associated with multiple events and the inability to charge as much; however, associations want to continue to create opportunities for vendors to access their members in order to retain their business.
With the economic shock that is taking place in the association world and changes to its traditions, do you foresee increased collaboration between associations to achieve economies of scale?
Karen: That may happen down the road, but I think right now, associations are probably more so looking inward to see what they can do to serve their members – and maybe rightfully so.
Adrienne: I think that there is a huge opportunity to enhance appropriate collaborations – doing a conference together or working together to disseminate critical information that combines perspectives – to better leverage the power in numbers. As associations start to position themselves for the future, they should consider alignment opportunities to best amplify their voice on given issue.
In a post‐COVID world, what is your prognostication for how much of the engagement work of associations will be virtual/digital/online in 2021 and beyond, versus the amount that is in that format today?
Steve: I think those last executives who resisted remote working will have recognized it as a model that works, so we will see a significant increase in the business operations of an association moving in that direction, with organizations becoming increasingly accommodating of hiring people who do not live in the city where they are located and having many more executives working from a variety of places. On the member‐facing side, I think the level of virtual interaction will be highly influenced by culture; in some associations, the one‐to‐one relationship is incredibly important, and even though the efficiency of conducting meetings virtually has been demonstrated, they will want to return to being in‐person because that is their culture.
Karen: I agree that many staff will be working remotely because they have had to and they have seen that it will work, and I agree that culture will come into play with regard to governance issues. On the member education side, some education is very difficult – or not as productive – to do remotely, requiring a hands‐on experience, so I believe that will be driven by each individual association.
Adrienne: For the staff, it will absolutely be necessary to think about how to more intentionally incorporate options for remote activity and flexibility for every employee, which will require all associations to review their HR policies, many of which may be antiquated and not well structured around remote work opportunities. Some areas that will need thought: equal access to remote capability, onboarding procedures, communication mechanisms (e.g. retraining staff on effective virtual meeting procedures), and the impact of remote work on individual performance goals and measurement metrics. HR leadership will need to ensure that they have created an environment that is operationally consistent for remote work. From a member perspective, although people often think of the loss that occurs due to communicating in a virtual environment, there is also a huge gain through the ability to reach and share information with much larger audiences. Many associations are used to cascading down the delivery of information through multiple group meetings, and can now really create effective communication forums and open them to thousands of people, when appropriate, which is more difficult to do face‐to‐face.
Final thoughts in reflecting on an association leader's challenges and opportunities today?
Karen: As I think about associations budgeting and planning for the future, I am reflecting on the fact that many associations own their buildings and, with staff working remotely, will not need that space for their staff; likewise, they may rent out space, and those tenants may have multiple employees working remotely. So for those associations that own buildings, they will need to think about what that means to their business model going forward, as it is obviously a significant expense.
Steve: This is all about change – change being forced on us versus change that we are manufacturing ourselves – and leaders who are comfortable with change and comfortable in an environment with a significant amount of uncertainty will be the ones that come through this with the strongest outcomes and the strongest organizations. Even in terms of relationships between management and staff, if leaders do not recognize and embrace the changing world, they will miss the opportunity to retain a positive environment and feeling of connectedness in their organizations. In this period of dramatic change in all aspects, leaders must be flexible, comfortable dealing with ambiguity and uncertainty, understand that they cannot control everything the way they might have before, and get ready to be able to change again if what they have planned for the short‐term cannot happen.
Adrienne: I would close by reminding everybody that it is so important, from a leadership perspective, to really embrace the opportunities to change, created from this disruption – for members, staff, operations, policies, etc. All will require reconsideration, and it will be critical for leadership to see the possibilities of what can be, as opposed to getting bogged down in the overwhelming magnitude of all the change. Everybody will be looking to that leader who sees hope and possibility, moving forward.