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How are we expanding physician leadership capacity to improve MSA succession?
Directors-at-large can trial roles and build skills before stepping into executive leadership roles.

"New directors have time to prepare before moving into more formal executive positions. They can determine if they are suited to and want to do this type of work." - Dr. Dave Coupland, MSA President, NMSES 


The Nanaimo Medical Staff Engagement Society  is successfully encouraging more physicians to consider executive roles, using a "stepping stone"approach.

Members can test the waters of an executive role first-hand as a Director at Large. They experience engagement work in real time, get to know leaders they will need to work with, and gain a hands-on understanding of executive roles before committing to a role.

Our story: steps & takeaways


Strategy and steps

In efforts to encourage more advisory council members to succeed them in their executive roles, NMSES created three Directors at Large positions on the executive team – non-voting roles that do not change the governance or structure of the physician society.

Physicians on the advisory council who show an interest in taking on an executive role down the road can voluntarily put their name forward for a Director at Large role.

Instead of just hearing about engagement progress through monthly advisory meetings, Directors at Large directly participate in meetings and discussions first-hand, get to know the people involved, and experience all of the executive roles and responsibilities directly.

Directors at Large are invited to shadow executive members to weekly Facility Engagement meetings, monthly meetings with local health authority leaders, and MSA meetings with medical staff.

Directors at Large directly participate in engagement discussions, meetings and committees – including those in which they have a keen interest. They begin to understand the role that relationships play in advocating for patients and the medical staff,  and get to know the people involved and various leaders they will need to work with to be effective.

They join quarterly meetings with senior Island Health executive members that include the President and CEO, VP of Medicine and Quality, VP of Clinical Services, and the Executive Director of Medical Staff Governance.

Physicians would not otherwise have as much opportunity to meet and get to know these senior leaders.

Conversely, the senior health authority leaders establish relationships with the Directors at Large before they step into an executive role, for smoother transitions down the road.

The Directors at Large roles have created a benefit for the executive team: additional perspectives and new ideas, broader medical staff representation, and backup when executive members are not available for a meeting. 

With knowledge of the current focus and issues, one of the three Directors at Large can step in and take part in a meeting on behalf of an executive member, and report back on it. 

The executive is additionally supported by Executive Project Manager Bobbi Marcy.

It makes a big difference for members to know that relief and support is available to help them avoid burnout when they take on a busy executive role.

Ultimately, a physician will be personally motivated to take on a busy executive role. Why take time from clinical practice and family to do this work? What are the rewards?

For NMSES members, it is the attraction of being part of an enthusiastic and close-knit medical staff family that works together to improve patient care and the community of colleagues. 

It is seeing how their commitment and enthusiasm has influenced real change, and led to enormous accomplishments to date with even more potential for the future. Physicians want to be part of that change.

Stepping stone to succession strategy




Quick Tips

DOWNLOAD: Step-by-Step Strategy



Director at Large Handbook

Executive Member Handbook

Advisory Member Handbook


DOWNLOAD: Fillable Handbook Templates (WORD)

RELATED: Facility Engagement Governance Webinar: Succession Planning Slides  Video


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