Philip S. Barie, MD, MBA, FCCM
Professor of Surgery and Public Health
Weill Medical College of Cornell University
New York, New York, USA
For the past year, the theme of my Critical Connections column has been to help the reader to become a leader, to help the emerging leader become established as a Society of Critical Care Medicine (SCCM) leader, and to provide understanding of how SCCM functions and accomplishes its mission. In this last installment, the governance of SCCM is outlined, and the structure and function of the SCCM Council and its Executive Committee are described. I also want to establish what it takes to lead SCCM as a senior volunteer and how our leaders are identified.
The SCCM Council is our highest governing body, accountable to the SCCM membership itself. The size and composition of the Council is dictated by our By-Laws as a California not-for-profit corporation. The Council consists of 20 members, 13 of whom are elected for three year terms, which is at the upper limit of size to function effectively. Sitting ex officio are the chancellor of the Board of Regents of the American College of Critical Care Medicine and the chair of the Chapters and Affiliates Committee. The remaining five Council members are the elected officers, namely the President, the President- Elect, the Immediate Past-President, the Secretary, and the Treasurer, whom Council empowers to function as an Executive Committee.
Election to SCCM Council is not a ceremonial position; the position carries great responsibility. The Council meets formally four times annually to set policy, to approve procedures and to provide oversight to Society operations as well as the activities of our Sections, Chapters, Committees, and Task Forces. Council members serve as liaisons to several key Committees and Task Forces, providing advice and encouragement. They also ensure that activities remain true to the group’s charge (all such groups exist for a reason) and SCCM’s vision and mission. Paramount is the Council’s fiduciary responsibility to make certain that SCCM assets are managed with diligence and prudence. Also crucial is the effort devoted to maintaining our strategic relationships with like-minded organizations, such as the European Society of Critical Care Medicine and the American College of Chest Physicians, with which we may partner or take concerted action to advance our mission when there is “strength in numbers.” Ultimately, SCCM Council members must put parochial and personal interests aside and act in SCCM’s best interests.
The Council is the ultimate decision-making body regarding the governance of SCCM, but importantly does not micromanage the daily operations of the Society. The Council delegates the day-to-day operations of the Society to its capable Executive Vice President/Chief Executive Officer, David J. Martin, CAE, who is in regular contact with the senior leadership. Governance of SCCM is facilitated by the able support of Diana Hughes, Director of Organizational Affairs.
Six Council seats are held by members-at large. To ensure diverse representation, the remaining seven Council seats are occupied as designated seats by members of the Anesthesiology, Internal Medicine, Nursing, Pediatrics, Clinical Pharmacy and Pharmacology, and Surgery sections. A rotating seventh “collective” seat, held currently by a member of the Neuroscience Section, exists to ensure that smaller sections are represented. Some of these smaller sections have grown to the point that they technically now meet the criteria to hold a Designated Seat. While these sections understandably have expressed frustration with this situation, the composition of the Council will not change in the foreseeable future. Although SCCM is a professional membership organization, it also is a business with assets, liabilities and employees as well as members. The Council exists to run the business and to serve the members. Therefore, balance between diversity and expertise must be maintained. Attractive as it may be to believe or expect otherwise, SCCM is not a participatory democracy, and SCCM Council is not a house of delegates. The effective function of the Council is a matter of strategic importance, and academic studies indicate clearly that effectiveness degrades when a board of directors exceeds the present size of the SCCM Council. Council size, composition, and electoral processes were reviewed and ratified in 2007 by the Council at the suggestion of the SCCM Strategic Planning Committee, which includes representation from the general membership.
Candidates for election to SCCM Council are sought exclusively from the membership, SCCM having no outside independent directors. Previously, candidates were nominated primarily by the sections, which still do have substantial input, especially in regard to the Designated Seats. In an important change, nominations now can be considered from all SCCM members, including Chapters, Chairs of Committees or Task Forces, or those SCCM staff who have worked closely with a member of SCCM’s Creative Community in Critical Care (C4). Self-nomination also is possible. The criteria are those discussed previously in this column: visionary leadership, a track record of hard work and productivity in service to SCCM and to critical care, and specific expertise (e.g., in education or finance) germane to the business operations of the Society. Nominees must be able to put SCCM’s interests ahead of their own.
Candidates are vetted and the electoral slate is prepared by the SCCM Nominating Committee, which is chaired by the Immediate Past-President. All Council seats, except the two ex officio seats, are contested by election. A member of a section that is contesting its Designated Seat in a given year may not run for an at-large seat, unless the election for the Designated Seat is being held to fill an unexpired term. When the proposed slate is presented for ratification in September, the Council may only accept or reject it, in which case the matter is returned to the Nominating Committee for further deliberation. The Council may not modify or make suggestions for modification of the slate. Balloting is held electronically in November each year. All SCCM members are encouraged to vote, as only a fraction of SCCM members usually do so.
As discussed earlier, the Executive Committee of the SCCM Council consists of the President, the Immediate Past-President, the President-Elect, the Secretary, and the Treasurer, all of whom are members of the Council first and foremost. The primary function of the Executive Committee is to exercise routine functions of the Council that arise between regularly scheduled Council meetings or that have been delegated specifically to the Executive Committee by the Council (e.g., final ratification of a document that has been reviewed and approved in principle by the Council, pending final wording). The Executive Committee may act for the Council only when the Council is not in session and may call a special meeting of the Council when dictated by a matter of urgency. The Executive Committee meets biweekly by teleconference between meetings of the Council, and Council members are encouraged to participate as their schedules permit, if they are not scheduled to provide a liaison report. Yours truly, as president, meets weekly by teleconference with Martin, Hughes, and invited guests to discuss operational matters.
New members of the Executive Committee are selected by the existing Executive Committee from among seated Council members who have served at least one complete three-year term on Council. Decisions are based on demonstrated leadership, selflessness, and effective work within groups. The Secretary and Treasurer then run unopposed for election to alternating two-year terms before automatically running unopposed for election as President-Elect. Thus, after election as Secretary or Treasurer, there begins a five-year cycle. The selection of new Executive Committee members by the sitting Executive Committee, rather than by Council or through a contested election, also has been considered by the Strategic Planning Committee. There is no consistency to this process among our peer organizations in the not-for-profit medical association world. Considering the complexity of SCCM as an organization, the depth and breadth of knowledge needed to govern effectively such a complex organization, and the length of time it takes to gain such insight and expertise, it is believed that the SCCM governance model meets the organization’s needs in an optimal fashion.
It is hoped that these insights into SCCM’s governance will allow the reader to lead more effectively if already involved in SCCM’s work or to become involved if not. At the very least, please vote in the annual online election. This is your organization; the senior leadership runs it on your behalf.
It is further hoped that these columns have been of interest and value to you. It has been my pleasure to write for your information and benefit, and an honor and privilege to serve as SCCM President for 2008. I appreciate your support during my tenure, and I ask that you support President-Elect Mitchell Levy, MD, FCCM, when he succeeds me early next year.
