Change is afoot at Erlanger and I see little to be lost by it. However, some of it has not been thoroughly reasoned out yet.
The current board of 12 members is appointed by the county (4 members), the city (4), Hamilton County chancellors (1), the legislative delegation (1), the Chattanooga-Hamilton County Medical Society (1) and the Erlanger medical chief of staff.
It now appears the new board will have only seven voting members and, after the initial appointments are made by the county and the legislative delegation, replacements or renewals will be made by the board itself. The board may also have two non-voting members, an educator and a physician. I assume these two will be resource persons.
There is a touch of self-perpetuation in this but "self perpetuation" is not necessarily a bad term. If those who self-perpetuate themselves on the board become obsessed by power (always a problem in any enterprise), this could become a problem. If the board develops pride in the quality of its management and always hunts new members compatible in philosophy and efficiency, it will prove to be a positive thing.
The quality of the two non-voting resource persons will be critical. Erlanger management cranks out reams of paper for each board meeting. If these two members can bottomline a ream of paper and condense the material to understandable terms, it will be a major contribution.
When I was Hamilton County executive, I appointed Chattanooga City Commissioner Jim Eberle to the board and he resigned after a short time. He said, "They rule by the wheelbarrow. You get a wheelbarrow load of paper at each meeting -- more than any human being could read, much less digest. They make no one available to condense it. I simply will not vote on things I do not fully understand."
The people I appointed who loved a lot of detail and hunting informative little needles in big haystacks did best in their time of the Erlanger board.
I have reluctantly come to believe in term limits for elected persons. The average person cannot resist the urge to become arrogant and power-hungry and develop an attitude of ownership about their seat. I doubt that appointed people are much different. So I like the three terms of a three-year limit for members of the Erlanger board.
Some physicians are voicing questions about the new management structure being proposed by our legislative delegation. As one who has tangled with Erlanger's groups and subgroups several times in the past, I urge the delegation to be aware that they will face a lot of political and monetary power. I hope they will proceed resolutely but carefully.
Since Erlanger was set afloat by a 1978 act of the Legislature and a vote of the people, it has sprung leaks and wasted so much money that the people are remaining silent on the plans to change things. Most people feel as I do that we have little to lose. I am actually relieved that Rep. Gerald McCormick and the local delegation are shaking things up and making it clear that a new level of performance will be expected.
One thing that will not change will be half-million-dollar CEOs. Most have cost us dearly and created disasters but maybe a tighter, more responsive board will make changes there, too.