It was an executive search firm, Schlichting said, that initially recruited her 12 years ago to the board of pharmacy chain operator Walgreen Co., now Walgreens Boots Alliance, where she still serves.
Professionals wanting to serve on boards also must be willing to network, said Dr. John Koster, retired CEO of West Coast health system giant Providence Health & Services, who today serves on the boards of Sutter Health and Banner Health, among several board assignments.
Koster said he appreciates young executives who are willing to walk up to him and ask his advice on how to get involved in governance. "Let the CEO know what your interests are," he said.
Koster said he shares books to read and other resources available, including training organizations, such as the Health Management Academy in Alexandria, Va. Koster said he participates in a governing summit at the academy every year.
The good news for people pursuing board positions is that healthcare systems, including hospitals, are looking for new skills and talents on their boards as the provision of healthcare gets increasingly complex, Koster said.
Where once health systems largely desired business people and donors for trustees—still attributes in demand for most boards—today they have expanded their search for professionals with acumen in information technology, cybersecurity, population health, insurance, and patient quality and safety, he said.
That's opening the way for fresh blood on boards for people embracing the transition from fee-for-service medicine to value-based reimbursement that puts providers at risk for the cost and quality of care. "Hospitals in the day were viewed as physician workshops. That's changed," Koster said.
The bad news is that the transformation of healthcare boards is happening at glacial speed, Somera said. "It's still a tough network to break into," he said.
The average age of hospital board trustees is actually rising, with just 2 in 10 board members across the industry under the age of 50, according to the 2014 National Health Care Governance Survey Report compiled by the American Hospital Association.
The number of professionals on hospital boards under 50 actually slumped dramatically between 2005 and 2014. Whereas those under 50 made up 29% of board membership in 2005, that declined to 21% in 2014. Meanwhile, those 51-70 years of age jumped from 62% to 68% over that time, the survey showed.
The results were no better for inclusion of ethnic and racial minorities. Though minorities made up 37% of the U.S. population in 2014, only 1 in 10 hospital board members were minorities in 2014, the same as in 2011, and 47% of hospitals had no minorities on their boards, the survey found.
Clinical profession representation on boards also was static, the survey shows. Physicians made up 20% of hospital boards in 2005, 2011 and 2014. Nurses, who typically make up half of a hospital's workforce, saw their ranks on hospital boards decline from a mere 6% in 2011 to 5% in 2014.
Health systems are missing the boat by eschewing nurse representation on their boards, said Larry Prybil, a University of Kentucky professor and former senior health system executive who published a scholarly paper on the subject in 2014 in conjunction with current Trinity Health board member Melanie Dreher and the late Connie Curran, both nurses.
Prybil called the paucity of nurses on healthcare boards "deplorable" given their trustworthiness by the public and their dominant role in hospitals for providing and safeguarding patient care. "To not have a nurse leader on your hospital board is madness," he said.
Half of not-for-profit hospitals had no nurse representation on their boards, according to the paper "Nurses on boards: The time has come."
Dreher, former dean of the Rush University College of Nursing, serves on the audit committee of hospital giant Trinity Health in Livonia, Mich., and is on the boards of the Chicago Board of Health and Wellmark Blue Cross and Blue Shield in Iowa.
As the first elected board chair of Trinity after its 2013 merger with Catholic Health East, Dreher helped to develop a strategic plan to move operations toward patient-focused care that treated patients as the system's customers rather than its physicians. "Hospitals traditionally thought of their physicians as customers and patients as their products," she said.
She rotated out of the chairmanship after three years to become chair of Trinity's audit committee. Dreher says she's passed along some of the initiatives she learned about through participating on various boards. For instance, Trinity hospitals have adopted a "baby friendly" nursery program taken from the Chicago Board of Health that promotes breast-feeding of infants rather than baby formula.
Ultimately, serving on a healthcare board comes down to being committed to the overarching mission of the industry—taking care of patients. Schlichting turns down board offers to concentrate on ones she is passionate about.
Since retiring from Henry Ford Health on Jan. 1, she was recruited to the board of Duke University Health System at her alma mater in Durham, N.C. She also joined the board of Hill-Rom Holdings, the giant hospital bed and equipment maker.
She said she hopes her Henry Ford Health experience of running a health system with hospitals, a large employed-physician group and a health plan will help the organizations she serves navigate the transition away from fee-for-service healthcare.
