MSMS: The Next 150 Years

Frequently Asked Questions

Why does MSMS need to change?

MSMS membership held steady from the early 1980s to the mid-1990s, when it began to decrease. In the 2000s, the decline in membership was offset by the addition of discounted group members, but the combined impact of individual member erosion and retiring Baby Boomers has re-established the negative trend in recent years.

On the revenue side, the discounted group membership increased the number of members, but was less significant in offsetting the decline in individual member dues revenue. Non-dues revenue, predominantly influenced by the group insurance market, is still significant revenue for MSMS, but the erosion of the group insurance market and the elimination of a specific product due to the ACA have reduced this revenue.

Over the last eight years MSMS has cut $6.8 million in expenses and 58 staff because of these trends. Any further reductions would harm core services that MSMS provides to members.

What are the major forces impacting MSMS today?

  1. Physicians face an increasing number of regulations from government, payers, and health systems. The challenge of keeping up with those, in addition to continuous advances in clinical care, taxes their time and attention.
     
  2. Associations no longer have a monopoly on information, which is now available from a wide variety of sources on demand.
     
  3. New generations of physicians have different expectations about work-life balance, which impacts the time they might devote to a professional organization.
     
  4. Another significant force in medicine is the increased diversity in professional settings. Decades ago physicians were predominantly in small independent practices. They needed the types of services small businesses require and support in building their practices, which associations offered. Today physicians are in many different practice POs or PHOs, large academic centers, hospital employment, single or multiple specialty group practices, and so on).
     
  5. In addition, the dual forces of market consolidation and sub-specialization in medicine mean their focus is much more specific, leading them to be more involved in other types of organizations.
These forces impact the value physicians perceive in organized medicine.

What would happen if MSMS operated as is?

If current membership trends continue, MSMS will be in a deficit position in the next several years unless it cuts core services.

Why did MSMS hire Tecker International?

The experts from Tecker provide a methodology to define new approaches to old problems and to help organizations get past the “we’ve always done it this way” thinking, to create solutions that reflect how the world has changed, and will continue to change.

Their motto is, "Don't rush to no," so a significant amount of work preceded the special session of the House of Delegates.

Do we have to choose one of the three proposed models?

The three models that will be discussed at the House of Delegates will allow delegates and alternates to compare and contrast, to provide feedback on what they like and don't like about each, and to point out details that should be considered as we move forward.

There will be no formal voting, and it is not intended as an effort to pick one model over another.

Who is driving this change?

The House of Delegates has created efforts to address the same challenges in the past, and this most recent effort was initiated by the MSMS Board of Directors to take a more comprehensive look at long term solutions.

Who will make the decision to change?

The current governance structure of the organization and the membership model is established in the bylaws, so the House of Delegates would approve any changes.

Following the House of Delegates discussion, the Task Force will develop a work plan to continue to define details and determine consensus. Any significant changes would require a revision of bylaws.

Current bylaws allow for special meetings of the House of Delegates, and given the importance of setting the path for the future, it is expected that this work will continue as quickly as possible and that special meetings will be used to further the momentum, rather than waiting for another year to pass.

What if I don't like any of the models?

The remodeling summit held in October defined five proposed models. Because there was some repetition in those models, the Task Force consolidated down to three, and those three are being used to solicit feedback from House of Delegates members. That feedback will help to determine areas of consensus and parameters that will help the Task Force make further refinements in the next several months, resulting in a single proposal for consideration.

The three models that will be discussed at the House of Delegates will allow delegates and alternates to compare and contrast, to provide feedback on what they like and don't like about each, and to point out details that should be considered as we move forward.

There will be no formal voting, and it is not intended as an effort to pick one model over another.

What has MSMS already done to adapt?

MSMS has already affected operations without reducing key essential services:

  1. Made reductions to live within our means, cutting $6.8 million in expenses and 58 staff positions in the last eight years.
     
  2. Reorganized internally for relevance and efficiency.
     
  3. Launched new non-dues revenue ventures for future funding.

Has MSMS ever considered modifying its structure before?

Yes, MSMS has had several attempts to change its structure in the past:

  • 1981: Task Force on MSMS Structure
  • 1997: Governance Task Force
  • 2002: Task Force on Regionalization of County Medical Societies
  • 2003: Task Force on Regionalization of County Medical Societies in West Michigan
  • 2006: Task Force on Federation Issues
  • 2011: Governance Task Force

These task forces were focused on specific problems, and they did not have the scope or tools available to define comprehensive strategies to address the underlying changes.The one change that resulted from these activities was to add a student, resident and young physician seat to the MSMS board in 1997. Efforts to consolidate districts, reduce the size of the board, define qualifications for board members, or regionalize county societies were unsuccessful.

What does MSMS need to be stronger?

MSMS is steeped in tradition. By modifying three main components, it will become a more diverse organization able to adapt swiftly to the ever-changing world of medicine:

  • A smaller, more nimble board with full fiduciary responsibility and skills-based leaders.
  • A more modern way to get member feedback on priorities and policies.
  • More flexible membership options and consistent pricing across the state.

This is an ambitious, important, and timely endeavor. We appreciate the time that you took to review this information and look forward to more input from you and your colleagues as we move forward.

Never has there been a more important time to ensure that physicians come together and do collective good for the patients that they serve, as we set the path for the next 150 years.

Task Force on Membership & Sustainability

  • Theodore Jones, MD, Chair
  • Jack Billi, MD
  • Betty Chu, MD
  • Stephen Dallas, MD
  • Kenneth Elmassian, DO
  • Mike Genord, MD
  • S. Bobby Mukkamala, MD
  • Bassam Nasr, MD
  • Venkat Rao, MD
  • Richard Schultz, MD
  • David Share, MD
  • Michael Smith, MD

Organizational Remodeling Handout

Tecker International

Tecker International, L.L.C. is an international consulting practice focused on meeting the special needs of associations managing through change. The most successful approaches to research, strategy development, thoughtful counsel, facilitation, and education are carefully integrated to help its client’s organizations solve complex problems and reach new goals.
Mission Statement:

The mission of the Michigan State Medical Society is to improve the lives of physicians so they may best care for the people they serve.

The Next 150 Years: Organizational Remodeling Discussion for the MSMS House of Delegates - Handout

Following the July 2014 session on long-term membership and non-dues revenue trends, the Michigan State Medical Society (MSMS) Board of Directors composed a Task Force on Membership and Sustainability. The members of the MSMS Board determined the accelerated changes in the broader health care environment and significant changes in the physician demographics have made it difficult to engage new generations of physicians in a structure that was built when the vast majority of physicians were in small, independent practices.

The focus of the Task Force on Membership and Sustainability were as follows:

  1. Identify who the Society serves;
  2. How is the Society serving those identified;
  3. Establish the future sustainability of the organization; and,
  4. Develop the optimal governance structure for MSMS.

Because the financial model and governance are intertwined and because there have been many discussions about change over the last four decades that did not have an impact, the Task Force on Membership and Sustainability and the MSMS Board of Directors determined an outside consultant with expertise in this area would allow MSMS to develop an organizational structure that will guide the next 150 years.

Core Purpose:

The core purpose of the Michigan State Medical Society is to bring all physicians together to achieve our mission.

The MSMS Board chose Tecker International to assist with restructuring MSMS. Throughout a series of sessions, MSMS leaders, members, and non-members gathered to examine the components of the infrastructure model and to asses the current structure and processes.  This information was used to create several models of what MSMS’s infrastructure could look like in the future given the different needs that physicians have today.

During the review process, there were four areas evaluated:

  • Operational excellence;
  • Product or program leadership;
  • Customer intimacy; and,
  • Representational effectiveness.

Throughout this process common themes began to emerge:

  • Smaller, more nimble governance;
  • Enhanced role for specialty societies;
  • Change in the geographic organization of MSMS membership and governance;
  • Addition of Physician Organizations (POs) to MSMS governance; and,
  • Modification of the House of Delegates to focus on policy, allowing the Board to focus on operations.
Core Values:
  • Advocate on behalf of physicians and their patients
  • Provide leadership
  • Promote quality healthcare
  • Demonstrate ethical behavior