The Medical Group Management Association defeated a ballot proposal that would have created four voting seats for physicians on its governing board.
Members voted 61% in favor of guaranteeing representation for physician-administrators, but that was short of a two-thirds majority needed to amend the bylaws.
The ballot proposal would have enlarged the board from 14 to 18 voting members. The board also has 10 non-voting seats. The proposal was part of an ongoing effort by MGMA to incorporate physician leadership, a trend taking hold in healthcare networks and medical groups.
The vote was taken Oct. 5 at the annual MGMA conference in Boston, which was attended by a record 3,600 members. The MGMA is the country's largest association of medical group administrators. It has 15,900 members from 6,200 practices, representing 124,000 physicians. About 650 of its members have medical degrees.
MGMA Executive Director and Chief Executive Officer Frederick "Fritz" Wenzel said there is a "blurring of the lines" between clinical and managerial roles as outcomes and quality improvement gain importance. Physician-administrators are critical to the MGMA's education programs, he said, and all MGMA committees have physicians.
"It's our belief that the physician-manager team is the most effective in leading and managing our healthcare institutions, and if that's the case we need that strong physician influence on the development of MGMA as an organization," Mr. Wenzel said.
Many members agree, according to comments collected by the MGMA. Wrote one medical group administrator: "If MGMA doesn't reach out more proactively, physicians and physician-administrators will evolve separate, more visible alternatives to MGMA."
But a minority opposed physicians being given "favored" status when they can advance through MGMA societies and committees and run for board seats like everyone else.
Some opponents also expressed mistrust and resentment. One likened creating special board seats for physicians to "letting the fox into the henhouse." Another asked: "How many MGMA members sit on the board of the (American Medical Association)?"
There was also disagreement over how physician leadership would affect ties between the MGMA and the American Group Practice Association, a physician organization with which the MGMA considered merging earlier this year. Some MGMA members felt having more physicians on their board would foster collaboration between the two groups; others said it would make them rivals.
According to the MGMA, every physician-administrator who has been nominated for a board position has been elected, but that hasn't always guaranteed physician representation. The association has had three voting physician-administrators on its board in the last five years, each serving a one-year term.
The newly elected MGMA board has one nonvoting physician: Mark Shields, medical director of the Dreyer Medical Clinic in Aurora, Ill. Dr. Shields will advance to a voting seat next year.
Meanwhile, the MGMA and the AGPA are beginning to collaborate. They're planning their first joint conference, to be held sometime next year.
And, Mr. Wenzel said MGMA leadership will try again next year to add physicians to the board, but perhaps will add only two seats instead of four.