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Editor-at-Large: My Annual Critique of the House of Delegates
Richard E. Burney, MD
Every year as the MSMS House of Delegates (HOD) rolls around, I am roused once again to examine and process and offer constructive criticism. Topics in the past have included bemoaning the plethora of resolutions that were trivial or irrelevant or asked for the impossible. I have questioned whether the HOD as presently structured is really the most effective way to develop policy. I have hoped for more creativity in the virtual process we have been forced by COVID-19 (SARS-CoV-2) to adopt. And every year I am reminded of the perceptive adage that every process is perfectly designed to achieve the results it gets, and hope for process improvement.
The past several years have seen major changes in the structure of the Society, the most significant of which has been reform of the way in which Board members are selected. The pandemic forced the HOD to go virtual last year. This led to changes in the process, the chief one being a trimming of the resolutions so that only those thought to be most timely and important were to be considered. This was a good first step. However, the virtual format highly restricted discussion of the selected resolutions – in fact, there were no live interchange between delegates and reference committee members prior to the reference committee deliberations. Thereafter, delegates were limited to an up or down vote on the reference committees’ reports. The lack of choice or opportunity for further discussion or debate led delegates to question whether they asked simply to rubber-stamp the reference committees’ conclusions. Although there was opportunity to comment on the resolutions on-line prior to the reference committee meetings, the give-and-take of open discussion in which “whereas” and “resolved” statements could be more
deeply investigated and new ideas may emerge as a result, verbal interchange was clearly missing. The process appeared to favor the administrative side of the society while disempowering the delegate side.
The process for this year’s HOD was modified but only minimally. One improvement was that resolutions were screened by an expert Resolution Review Committee (RRC) panel and resolution sponsors were asked to append a statement of urgency. In my view, the RRC, with MSMS staff Rebecca Blake’s assistance, did a good job of winnowing the resolutions down to those felt to be most pertinent and timely, and they reported their reasoning in a transparent fashion. Some controversial resolutions were deferred because the committee, probably correctly, predicted that robust, in-person discussion would be needed, which the virtual HOD process in its present form would not allow.
Like last year, a website was established to give delegates the opportunity to review and comment on the resolutions prior to the reference committee meetings. I thought at one time that a more drawn-out virtual process, such as the current one, would permit time for more research and individual deliberation. I think now that I was wrong in this assumption. The comments I saw – in the form of “I support” or “I do not support” this resolution – generally came in late and, to my reading, rarely seemed to arise from in-depth knowledge of the issues. The discourse was one-sided, which does create the environment in which insight is gained. This is a weakness inherent in the virtual deliberative process, and it occurs at one of the points in the process at which more discussion needs to be taking place. No reference committee had more than 6 or 7 resolutions to consider.
8 Washtenaw County Medical Society BULLETIN APRIL/MAY/JUNE 2021