Most board members at the nation's top hospitals have no healthcare background: Study

Less than 15 percent of board members overseeing the nation's top hospitals have a professional background in healthcare, while more than half have a background in finance or business services, according to a study published Feb. 8 in the Journal of General Internal Medicine.

The study's authors represent Harvard Medical School and Brigham and Women's Hospital in Boston and the University of Alabama at Birmingham. They wrote that they sought to understand which professions are represented most among hospital boards because they may influence the organization's goals and overall strategy — there also had been little research done around the topic previously.

The study began in July by examining the 20 top-rated hospitals by US News & World Report in 2022, which are all nonprofit academic medical centers in urban areas. 

Only 15 of the 20 facilities publish board information online, and IRS filings for the remaining were incomplete or outdated.

For the 15 hospitals that provide information on their board members, the authors sorted their professional backgrounds across 11 industry sectors using the North American Industry Classification System, which is the federal standard. For board members with healthcare backgrounds, they were further categorized as trained physicians, nurses, or other workers. 

Four key takeaways:

1. At the 15 examined hospitals, there were 567 board members. The study was able to sort 529 into professional categories.

2. Among the 529 board members, 44 percent had a background in finance. Among them, more than 80 percent led private equity funds, wealth management firms, or multinational banks. The remainder were in real estate (14.7 percent) or insurance (5.2 percent).

3. The second and third most common sectors were health services (16.4 percent) and professional and business services (12.6 percent).

4. Across the 15 hospitals, 14.6 percent of board members were healthcare professionals — primarily physicians (13.3 percent) and followed by nurses (0.9 percent).

The study noted that its findings may not represent all hospitals because it only studied the highest-ranked, and some of those hospitals do not publicly report information on their board members. The study also did not examine "the community ties of board members to gauge local accountability of board decisions."

The authors also noted that they did not examine the racial and gender makeup of boards, which they said merits further review — in 2018, 42 percent of U.S. hospital boards had all-white members and 70 percent of members were male.

Read a response to this article by Michael Peregrine, partner at McDermott Will & Emery, and David Jarrard, Chair of Jarrard Inc. Executive Committee here.

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