Pilot Plan Evaluated
“I cannot help expressing a Wish, that every Member of the Convention, who may still have Objections to it, would with me on this Occasion doubt a little of his own Infallibility, and to make manifest our Unanimity, put his Name to this instrument.” Benjamin Franklin
At the Constitutional Convention of 1787, Franklin spoke of the great challenge for the delegates, to put aside lingering doubts and to create a new form of constitutional government. The members of the Illinois State Medical Society (ISMS) now face a similar, albeit less daunting, challenge as the Society decides the fate of the current three-year Pilot Plan of organizational and governance reform.
In response to Resolution A-100 (A-17), the 2018 House of Delegates adopted a Pilot Plan to modernize the Annual Meeting and reform governance. During this trial period, the Special Committee chaired by Thomas M. Anderson, MD, was tasked with implementing the broad goals of Resolution A-100. The Society is now at the end of the three-year Pilot Plan, and the entire matter is to be put before the membership at the Virtual Annual Meeting later this month.
One of the least controversial aspects of the proposal was the recommendation to condense the Annual Meeting from three days to two. Post-meeting surveys show that the large majority of members believe that the Annual Meeting has been conducted more efficiently with the condensed format and that additional time is not required.
A year-round resolution process has also been introduced, in order to have more timely consideration of pressing issues. Since 2019, resolutions may be submitted by any member and are reviewed by ISMS Councils and Committees, acted on by the Board, and ultimately affirmed by members at the Annual Meeting. With the system of annual resolutions in place from 2017-2018, the average number of electronic comments on the resolutions via online comment forums was 36 per year. With the continuous resolution process in place from 2019-2021, the number of comments rose to 400-800 per year. This suggests that the continuous resolution system correlates with a dramatic increase in membership engagement, a measure that may also serve as a proxy for involvement in the democratic process itself.
There were also significant changes at the Board level, with consolidation of Board positions from 25 to 20. The members of the Board of Trustees now include the six elected officers, ten Trustees, student and resident Trustees, the immediate past president and the AMA delegation chair (ex officio). The elected Trustees evolved from an entirely geographic system to a system with five Regional Trustees based on geography and five At-Large Trustees representing different practice patterns and other demographics, in a balanced representation system more akin to the AMA system of governance.
One of the difficult aspects of the plan dealt with changing the relationship with county medical societies: Membership in a county medical society is no longer required to become an ISMS member. County societies remain valued partners, and have been given the opportunity to participate in joint marketing and billing with ISMS. For the 28 county medical societies that ISMS issues joint bills, 71% of the ISMS members also join their respective county society. Meanwhile, the response in terms of ISMS membership levels has been dramatic. After a decade-long period of declining ISMS membership, the first two years of the Pilot Plan, 2019 and 2020, each saw 13% increases in dues-paying membership. This success is partially from recruiting several new group members that operate statewide or across multiple county borders; these groups came in under a new streamlined group dues structure developed under the pilot. The challenge for 2021 is to keep up the momentum, despite the pressures of the COVID-19 pandemic.
At the 2021 Annual Meeting, these various issues will come before the members in the form of a resolution containing Bylaws changes and Constitutional amendments. Unlike the dilemma faced by Benjamin Franklin, the members of ISMS will actually have a chance to review empiric data, the three-year results of the Pilot Plan. We now have an opportunity to make these positive changes permanent, and I am confident we will do so.
On a personal note, I would like to thank the members of the ISMS for the privilege of representing them as ISMS President this past year. This experience has been both humbling and educational. I am particularly pleased with the knowledge that the Society’s Presidency will be left in the capable and dexterous hands of J. Regan Thomas, MD. I hope we have all come to appreciate that no matter how daunting the challenges facing the ISMS, the Society continues to adapt to the challenges and continues to represent the interests of both patients and physicians.
Robert W. Panton, MD
April 2021