When I worked as the executive director of a free clinic, we had a young Amish patient with a very complicated medical history. Her care was quite expensive, and her parents were not only difficult to work with but frequently did not follow doctors’ orders.
We had many Amish patients, and they were, in general, wonderful to work with. However, this particular patient and her parents were getting under the skin of my medical team; they didn’t feel like we should serve that patient anymore. Frankly, I didn’t want to make a decision either way. It seemed like a lose-lose situation. So, I did what any wise executive director would do: I passed it up to the board and made it their problem!
Not surprisingly, it lit a firestorm within the board. Instantly, factions were made defending the Amish, the staff, the child, other patients in the clinic, and the clinic’s finances. This was clearly an emotional issue for everyone involved. It went back and forth, shots firing from all directions.
All directions, that is, but one. The lawyer in the room, “Ben,” was quiet. He listened patiently for a while until he had enough. “Stop, stop, stop,” he said. “I see several separate issues. Let’s take a moment and pick them apart.”
He proceeded to write the following statements on a whiteboard, one by one.
Do we serve the Amish? Well, the answer was unanimously “yes.” Ben erased it off the board.
Do we provide care even when it is expensive? Again, the answer was “yes.”
Do we serve patients who are not compliant? That hit a core value of the agency. The answer was absolutely “yes.”
Do we serve children? And that gave the board pause.
99% of our patients were adults. Occasionally, we made exceptions for children, but we were not set up to provide pediatric care. The answer to our dilemma suddenly emerged: we needed to find the little girl a new medical home that could provide the quality care she deserved.
With that unanimously settled, the board put down their arms and moved on to the next topic.
Board members who are lawyers are often sought for their legal advice. However, they have a hidden talent—they’re also trained to dissect ideas. They boil issues down to the fundamental roots that are helpful to groups in making a decision. Tackling a tangle of issues is too messy, but by picking the issues apart, piece by piece, we were able to cleanly solve the problem.
I encourage you share this blog with the lawyer on your board (or the lawyer you hope to recruit for your board). Encourage him or her to speak up when they see an issue that needs dissecting. They can be invaluable for solving complicated, hot-button dilemmas. That’s something every board needs!
