As much recognition as hospital boards may receive, little is often known about the individual board members sitting in those boardroom chairs. How did they get there? Why do they spend so many unpaid hours working on hospital matters?
Healthcare attorney Neal Goldstein, JD, partner in the Chicago office of Seyfarth Shaw LLP, began serving on Chicago's Sinai Health System's board in 2005. He decided to serve partly out of his interest in professional development, partly out of Chicagoan sentimentality and partly out of wanting to make a difference. Sinai is located in the heart of Chicago's West Side and has been hailed as a model for urban healthcare delivery.
Mr. Goldstein discusses what he has learned about hospitals through the board.
Q: When did you begin to serve as a board member for Sinai Health System? Why did this work interest you?
Neal Goldstein: I joined the board in fall 2005, and I actually recruited Sinai — they didn't recruit me. I had been looking for an outside charitable endeavor that meant a lot to me personally, and also had synergies with my work as a healthcare lawyer. A lot of my work is on the physician side, so I felt this would make me a more complete attorney and I also thought I would have something to offer on the board. Being on the board has opened my eyes immensely to the issues hospitals face. I'm now a more effective lawyer for physicians because I understand much better the hospital perspective.
I chose Sinai because it's located in an area where my parents grew up and met. My mother was actually born there, so it's always had a place near and dear to my heart. The final thing, though, is that Sinai is based on the concept of "tikkun olam," which is Hebrew for "repairing the universe." It's really cool and fascinating that this Jewish institution is in the heart of Chicago's West Side, where Jews haven't lived for decades. Still, it's serving the community and repairing the world.
Q: Have you noticed any changes in board rooms since healthcare reform went into effect? If so, what are the biggest differences?
NG: Well, we have a separate quality committee that I chair. This committee evolved from what was a subsidiary board into a committee of the main board. Our committee focuses on quality measures, and how the institution performs in those measures relative to national benchmarks. Many of the things healthcare reform has introduced which has hospitals scrambling, Sinai has been doing for years. Has healthcare reform changed things for our board? Not really, but it sort of validated that we were right all along in making quality a top priority. It tells us we were doing the right thing by placing quality at an equal level with the more traditional board function of finance.
The other thing is, I'm seeing the whole debate over healthcare reform play out at Sinai. We have a significant Medicaid and uninsured patient population, and we also treat many undocumented immigrants. At Sinai, we are on the frontlines of the debate.
Q: What have you learned about communication within a board room? Are there any best practices you can share?
NG: We have a large board, with approximately 45 people serving on it. We also have an executive committee, which I serve on, that is made up of 15-20 people. The executive committee has monthly meetings, and the larger board meets quarterly. This helps keep everyone in the loop.
Also, Sinai's administration is really good about keeping us informed. We'll get emails sometimes twice a day with news from Sinai, and that's important because it's not always good news. I've been amazed at how forthright the administration is. Their view is that we each play a role in Sinai, and the board's role is to challenge management and hold it accountable. They really have embraced that.
As far as communication within meetings, we're respectful of everybody's opinion. We're also sensitive about people's time. If you come to a Sinai board meeting, put on your seatbelt — you're going to a get a ton of information very fast. We encourage people to participate and speak their minds, but we also encourage them to get to the point.
Q: You come from a law background. How has this bolstered your contributions as a board member? Are there any other fields or pools of knowledge you find yourself tapping as a board member?
NG: As a healthcare attorney, I feel like I've been able to make a contribution to this board. My niche is anything involving a relationship with a physician. That includes financial relationships, in particular the Stark Law, relationships related to governance, and so on. So if Sinai's general counsel tells us that in order to remain compliant with Stark we have to do X, I can validate and explain that to the board speaking as a fellow board member.
Also, Sinai has a medical group of employed physicians. There are approximately 200 of them, and physician relationship issues come up all the time, whether financial, regulatory [or] personality-based. And that's my world; that's my niche. Also, before I became a lawyer, I was an accountant. I love numbers and spreadsheets, so I can draw on that financial background as well.
Q: Can you recall an instance on the board when a decision, meeting or other matter of business was more difficult than you expected?
NG: I went into the board room without knowing what I was getting myself into. I'm just blown away at how complicated a hospital is. It is a multi-faceted, complex organism. The first year I was on the board was like the first year of a physician's residency. It was a time of huge education and growth. It's still a learning experience. Nothing surprises me because it's all a learning experience. The only thing I didn't expect is the amount of time you can spend doing Sinai work. If I ever stop practicing law, I'd love to just work as a full-time board member at Sinai.
Learn more about Neal Goldstein.
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Healthcare attorney Neal Goldstein, JD, partner in the Chicago office of Seyfarth Shaw LLP, began serving on Chicago's Sinai Health System's board in 2005. He decided to serve partly out of his interest in professional development, partly out of Chicagoan sentimentality and partly out of wanting to make a difference. Sinai is located in the heart of Chicago's West Side and has been hailed as a model for urban healthcare delivery.
Mr. Goldstein discusses what he has learned about hospitals through the board.
Q: When did you begin to serve as a board member for Sinai Health System? Why did this work interest you?
Neal Goldstein: I joined the board in fall 2005, and I actually recruited Sinai — they didn't recruit me. I had been looking for an outside charitable endeavor that meant a lot to me personally, and also had synergies with my work as a healthcare lawyer. A lot of my work is on the physician side, so I felt this would make me a more complete attorney and I also thought I would have something to offer on the board. Being on the board has opened my eyes immensely to the issues hospitals face. I'm now a more effective lawyer for physicians because I understand much better the hospital perspective.
I chose Sinai because it's located in an area where my parents grew up and met. My mother was actually born there, so it's always had a place near and dear to my heart. The final thing, though, is that Sinai is based on the concept of "tikkun olam," which is Hebrew for "repairing the universe." It's really cool and fascinating that this Jewish institution is in the heart of Chicago's West Side, where Jews haven't lived for decades. Still, it's serving the community and repairing the world.
Q: Have you noticed any changes in board rooms since healthcare reform went into effect? If so, what are the biggest differences?
NG: Well, we have a separate quality committee that I chair. This committee evolved from what was a subsidiary board into a committee of the main board. Our committee focuses on quality measures, and how the institution performs in those measures relative to national benchmarks. Many of the things healthcare reform has introduced which has hospitals scrambling, Sinai has been doing for years. Has healthcare reform changed things for our board? Not really, but it sort of validated that we were right all along in making quality a top priority. It tells us we were doing the right thing by placing quality at an equal level with the more traditional board function of finance.
The other thing is, I'm seeing the whole debate over healthcare reform play out at Sinai. We have a significant Medicaid and uninsured patient population, and we also treat many undocumented immigrants. At Sinai, we are on the frontlines of the debate.
Q: What have you learned about communication within a board room? Are there any best practices you can share?
NG: We have a large board, with approximately 45 people serving on it. We also have an executive committee, which I serve on, that is made up of 15-20 people. The executive committee has monthly meetings, and the larger board meets quarterly. This helps keep everyone in the loop.
Also, Sinai's administration is really good about keeping us informed. We'll get emails sometimes twice a day with news from Sinai, and that's important because it's not always good news. I've been amazed at how forthright the administration is. Their view is that we each play a role in Sinai, and the board's role is to challenge management and hold it accountable. They really have embraced that.
As far as communication within meetings, we're respectful of everybody's opinion. We're also sensitive about people's time. If you come to a Sinai board meeting, put on your seatbelt — you're going to a get a ton of information very fast. We encourage people to participate and speak their minds, but we also encourage them to get to the point.
Q: You come from a law background. How has this bolstered your contributions as a board member? Are there any other fields or pools of knowledge you find yourself tapping as a board member?
NG: As a healthcare attorney, I feel like I've been able to make a contribution to this board. My niche is anything involving a relationship with a physician. That includes financial relationships, in particular the Stark Law, relationships related to governance, and so on. So if Sinai's general counsel tells us that in order to remain compliant with Stark we have to do X, I can validate and explain that to the board speaking as a fellow board member.
Also, Sinai has a medical group of employed physicians. There are approximately 200 of them, and physician relationship issues come up all the time, whether financial, regulatory [or] personality-based. And that's my world; that's my niche. Also, before I became a lawyer, I was an accountant. I love numbers and spreadsheets, so I can draw on that financial background as well.
Q: Can you recall an instance on the board when a decision, meeting or other matter of business was more difficult than you expected?
NG: I went into the board room without knowing what I was getting myself into. I'm just blown away at how complicated a hospital is. It is a multi-faceted, complex organism. The first year I was on the board was like the first year of a physician's residency. It was a time of huge education and growth. It's still a learning experience. Nothing surprises me because it's all a learning experience. The only thing I didn't expect is the amount of time you can spend doing Sinai work. If I ever stop practicing law, I'd love to just work as a full-time board member at Sinai.
Learn more about Neal Goldstein.
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Why Hospital Board Involvement in Physician Compensation is CriticalThinking Beyond the Financial Aspect of a Conflict of Interest
Boards and Physician Leaders Share Concern About ACO Journey