The Benefits of Getting on Board a Non-Profit

No, no rim-shots for cash-strapped docs who, tongue-in-cheek, claim that they belong to a "non-profit" organization. But I am going to wander off the ranch a bit to review what these tax-exempt groups do and why you, dear reader, should know and care both as good citizens -- and physicians.

There are an amazing 1.8 million of these entities, 48,000 in the San Francisco Bay area -- my hometown -- alone. In fact, 11% of all jobs in the U.S. are in this sector, so we are dealing with a major, underappreciated force for good in our society.

Non-profits were established by Congress to be tax-exempt to encourage activity in areas that are deemed valuable to society. These activities cover everything from faith-based, educational, arts-oriented, medical, and affinity groups to certain political and advocacy organizations. Without getting into specific legal definitions and restrictions, we all know the genre, no doubt contribute to some and, hopefully, are involved with a few.

The tax exemption allows for a sometimes large financial subsidy and certainly a much-appreciated limitation on paperwork requirements. (Though there are periodic flurries of calls for greater scrutiny when scandals erupt based on a lack of accountability and transparency.)

Non-profits are easy to start and typically are headed by a person or persons full of zeal to alleviate some perceived wrong, or fill some unmet need. And God bless 'em. But many of these non-profits either fail or totter along on a financial shoestring due to undercapitalization, poor planning or inadequate management acumen. To paraphrase many songs, you can't live on love alone. Or, as the academics put it, "If there is no margin (of profit) then there is no mission (accomplished)."

Because of the assumed passion for whatever the cause and because of the above-mentioned problems leading to constant cash-flow crises, pay scales in this sector understandably lag the commercial sector. Yet one of 10 Americans, having the good hearts that they do, choose to work for one of these groups. Millions more volunteer to keep them running.

I've been unable to track down credible data -- and I do show my prejudice -- but I am not aware that any country in the world can match our record in these regards.

But all is not uniformly well in the functioning of non-profits. To help them out, there are the usual bevy of paid consultants available. And there are pro-bono groups, such as the Stanford Graduate School of Business Alumni Consulting Team, of which, wearing a different hat, I am a partner. We are engaged for specific projects to help struggling nonprofits.

Yes they may individually need money, marketing advice and managerial shoring up, but what they really require is more advice and training at the board level. If you think about it, being a non-profit board member is a unique position -- one many of you should consider. It is both an opportunity to serve a cause you believe in and to learn more about the nonprofit arena. Many physicians do serve on health-related non-profit boards of course, but that’s not a requirement, just a choice. And, for you cynics, it can't hurt your practice to have an increased visibility doing good in your community.

What do board members do? They are the conscience of the organization, managing resources for charitable purposes and keeping management on track to achieve the non-profit’s mission. Governance and support, in other words. Did you know very few charities engage in measuring their impact in a meaningful way? Perhaps you could help.

To find the right board to join, start with your interests or organizations with which you already have a relationship. Ask about the process of selection, clarify expectations and responsibilities. Confirm the time commitment, any financial remuneration and desirable skill sets. You’ll also need to know if there is board training provided to get you established. Plan to meet with the non-profit’s executive director and current board members, and attend a meeting and/or an event. Even if it doesn't work out, you will have benefitted from the process and be in a better position to refocus your attention.

I can hear your excuses now: I'm too busy. I don't know where to start. I’m used to people coming to me, not vice-versa.

Let me tell you a story. When I was first in practice, an uncle sat me down and asked what I was doing for my community. I mentioned my practice, hospital and medical-society committees. He said that those were fine but that they were in support of my profession, not the community directly. He eloquently outlined my ability and my duty to do more, to give back -- that more was expected of me. Sort of a Kennedy-esque "Ask not..."

I felt chagrined, and since that day I have always been involved in some kind of voluntary community activity. See how social pressure may have more impact on charities than altruism? Whatever the impetus, I have learned that you always have time for the things that you want or need to do, and that there is never time for the things that you do not want or need to do.