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March 1, 2013 Volume 77, Number 3
Administrative Update: A Year of Management Transition Jerry A. Cohen, M.D. ASA Immediate Past President


We have made great strides in improving the manage-ment of ASA over the past year and a half. In the September 2012 NEWSLETTER, James Grant, M.D., ASA Treasurer, summarized the careful process by which we selected our new CEO, Paul Pomerantz (see page 8 for Paul’s first NEWSLETTER report). This capped a lengthy process of management review and long-term planning for positioning ASA among the most successful specialty societies. This process took place in several parts relating to recognition of the need to evolve our management structure, deciding on that management structure, implementing changes and the transition to the new structure. I would like to use this space to review history and the current status of ASA’s management as we prepare to welcome our new CEO on board, full-time. I would also like to review the process by which we made the ASA fully prepared to take advantage of this new leadership.

For many years, ASA has operated two separate offices, one in Park Ridge and one in Washington, D.C. The Park Ridge office predominantly managed operational issues, and the one in D.C. predominantly managed our advocacy issues. This is somewhat of an oversimplification, but essentially correct. Each location had an executive vice president (EVP), theoretically co-equal partners. As one might expect, and as our consultants had cautioned us when we created this divided structure, it was not likely to survive as more than a transitional form of management. They believed the divisions would eventually develop competing interests and that staff, and ASA members, would begin to align with one or the other in a way that would not be productive. When that happened, the structural divisions would result in divisiveness and inefficiencies that would frustrate staff, the elected leadership and members. The amazing fact is that we functioned well for years, despite the obstacles to efficient integrated management. The dedication of staff and ASA member volunteers helped us make great progress as did the considerable talents and efforts of the former ASA executive vice presidents, despite the lack of integration. Ultimately, ASA could not progress further with the side-effects of divided management.

Beginning in March 2011, the ASA Board of Directors (BOD) began to discuss how we should integrate management. We considered initiating an immediate search for a CEO, but decided that it would be better to set the goals for an internal candidate and see if they could be met by the time of our annual meeting. The House of Delegates (HOD) was divided on appointing an internal candidate, but did eliminate the EVP positions from the management structure in favor of a single CEO, to be approved by the BOD. The mechanism for selection was not described. Both individuals who had been serving as the EVPs notified me, as ASA President, that they wanted to be considered for the CEO position. In November 2011, I met with the Administrative Council to develop a plan for selecting the CEO. To be fair to both candidates and diligent in our search, we decided that our search needed to be conducted by an independent search firm, not our ASA Human Resources department, and that it should be implemented on a national level to be competitive and produce the best candidate. We hired Spencer-Stuart to do this and appointed an ad hoc committee chaired by former ASA President Eugene Sinclair, M.D. to bring a final candidate to the BOD. The work of this committee was detailed, diligent and laborious. By June, our search consultants informed us that candidates were hesitant to consider the position until ASA leadership was able to implement the actions of the HOD eliminating the EVP positions. No one would expect a prospective CEO to want to have that burden. In addition, uncertainty among the staff affected morale, as was expected. The Administrative Council carefully considered the alternative actions it could take and decided in early June that it would be necessary to implement the elimination of the EVP positions and immediately hire an interim CEO. The EVPs remained candidates, but were released from ASA employment toward the end of June. This was to say the least a very difficult and painful decision, given our close working relationship with the EVPs, their accomplishments and our personal affection for them. We hired Barbara Fossum, Ph.D. as the interim CEO on July 2, 2012, and she reported directly to the ASA President.

In hiring Dr. Fossum, it was our hope that she would be able to reorganize the management and the staff in order to streamline the organization and transition it to a management structure with a CEO. In selecting Dr. Fossum, we wanted to be sure that the day-to-day operations of ASA would not only remain stable, but would become more integrated and immediately benefit from this integration by coordinating the efforts of staff and helping them to feel a part of a single organization with staff in two locations, not the staff of two separate and competing divisions. In short, we needed an inspirational interim CEO with great management skills and capable of working miracles in a short period of time. It was our great fortune that Dr. Fossum was that person and that she had previously acted as our management leader during our previous management transition. She hit the ground running and rapidly gained the trust of the staff and ASA leadership.

Dr. Fossum’s accomplishments between the time she was hired and the announcement of the new CEO are the things of which legends are made. She conducted a careful workload analysis, rebalanced resource allocations, improved interdepartmental communication and improved the information technology support needed to support that communication. She helped us improve the depth of our staffing structure and the definition of staff titles and responsibilities to make for an orderly advancement of staff, and she improved the speed with which we could hire new staff. She created processes for management that were more efficient and greatly improved support for governance. She dispelled concerns that advocacy would not be given sufficient resources by implementing the leadership’s imperative for expanding and improving the competence of our state advocacy affairs and health policy research capacities. To do this, she strengthened support for advocacy, markedly deepened the staff structure by adding positions to increase capacity and effectiveness of the advocacy support staff, and improved staff communication and collaboration that could only happen with a single CEO structure. Although we had a number of resignations, they were fewer than expected, and Dr. Fossum took advantage of opportunities to strengthen our capabilities with new hires. She took advantage of the creativity of upper-level management to develop their own management plans, develop transparent mechanisms for pay and promotion, and develop new positions to improve the delivery of services rather than tasking already overburdened staff. Dr. Fossum has been remarkably effective in operationalizing the policies of the governing body and coaching staff to do its best work. Our D.C. and Park Ridge staff and staff leaders have been remarkably adept in taking advantage of new opportunities to improve management and workflow. In short, vital improvements that I thought would take years to accomplish have been accomplished in months, leaving the new CEO, Paul Pomerantz, with a vibrant and well-integrated organization.

In her speech to the HOD, Dr. Fossum outlined her three primary goals: to maintain service to members, prepare ASA for a new CEO, and to keep ASA moving forward. I would add that she accomplished another goal, which was to unshackle the staff from a management structure that did not make the most of its talents while resolving seemingly irresolvable obstacles.

She has more than met all of these goals and leaves ASA in a much-improved position as we welcome our new CEO to lead a stable, effective and high-functioning ASA staff.



Jerry A. Cohen, M.D. ASA Immediate Past President


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