Board Leadership: The doctor will see you now

November 27, 2017

Banksy Peace Love Checkup El Payo

Robert Frost once wrote, “An idea is a feat of association, and the height of it is a good metaphor.” As a former English teacher and current consultant to non-profit organizations, I couldn’t agree more.

I thought about metaphors as we kicked off another year of the Dodge Board Leadership Series in Morristown on October 14. My opening workshop is more about ideas than anything else — it is about how we think about leading nonprofit organizations with ambitious missions and all too often minimal resources. This year, I offered an association that, if not already a good metaphor, could become one.

I brought up the idea that when we go to the doctor, whether for an annual physical or an acute illness, we are very used to getting some quick diagnostic data: our weight, pulse, and blood pressure. My question was: what is the equivalent if we are focused on the health of a nonprofit organization? What are the baseline “readings” that can tell us how we’re doing?

Checkup Quinn DombrowskiPlease pause over this question. If it’s not too late, don’t scroll down to see my answer, because you may take this association in a different direction that will be more helpful to you. I’ll make this paragraph long enough so that you have a chance for your own leaps of association. Perhaps you’ve already noted that our weight and heart rate and blood pressure readings are reflections of what we have done in the months before the doctor’s visit. I can’t think of a time when I have stood on that way-too-precise scale, for example, and not vowed to exercise more before the next visit. So, our metaphorical question might be expanded a bit: what is a non-profit’s equivalent of exercise?

So, what did you come up with?

Maybe instead of weight, we ask whether our staff and board, all of them, have a clear, shared sense of mission and vision for the future. Maybe instead of heart rate, we measure whether we have a balanced budget with a diversified funding base. Maybe instead of blood pressure, we examine whether the organization has a living, breathing strategic plan whose implementation is in the hands of effective working groups.

Those are good indicators of health, but let’s ride this metaphor a little harder. In both human and organizational health, a single measure may be misleading. Our heart rate could be elevated because we were late for our appointment and ran in. Our blood pressure could be up because we don’t like doctors. Our weight could be up because we’re just back from two weeks in Italy.

What would be a more comprehensive reckoning of health — something more like an annual physical with blood tests and maybe a whole-body CAT scan? How would we really know we are healthy, or really know what needed attention?

Let me offer one framework for generating more comprehensive diagnostic data. It comes from the LEAP Ambassadors, a group of 150 professionals (including myself) from various fields dedicated to high performance in the social sector and in public sector agencies with social missions.

In The Performance Imperative (PI) for Small Nonprofits, we identify six “pillars” of high performance. (There is a seventh pillar for larger organizations, which involves periodic external evaluations.)

  • Pillar 1: Courageous, adaptive executive and board leadership
  • Pillar 2: Disciplined, people-focused management
  • Pillar 3: Well-designed and well-implemented programs and strategies
  • Pillar 4: Financial health and sustainability
  • Pillar 5: A culture that values learning
  • Pillar 6: Internal monitoring for continuous improvement

Imagine a scale for each of those pillars, one that we create ourselves that helps us monitor our organizational performance in these areas. That’s at the heart of the opening workshop in the Dodge series — the case for formative assessment, for taking assessment into our own hands and measuring what matters.

If you want to see how the LEAP Ambassador group suggests how to go about measuring success in these areas, go to

Creating those scales would be like exercise. For a human being, the salutary benefits of exercise come from getting moving. Paradoxically, for organizations, they come from slowing down.

For me, the most important indicator of organizational health is how much time staff and board members spend, separately and together, on important matters when they are not urgent.

In my book, I call this mission time. It is where we find clarity what we are doing and why. It is the place for true re-creation. It is essential for the practice of formative assessment.  We must slow down to do it, which feels counter-initiative when we are pursuing urgent and worthy missions. But I believe the healthiest organizations create and protect mission time, however busy they are.

I’d love to know what readers of this blog would do with this metaphor, and whether you think it’s useful. I do.

In fact, when it comes to leading and governing nonprofit organizations, I take my lead from Robert Frost: “Unless you are educated in metaphor, you are not safe to be let loose in the world.”

David Grant is the former President and CEO of the Geraldine R. Dodge Foundation.  He is the author of The Social Profit Handbook: The Essential Guide to Setting Goals, Assessing Outcomes, and Achieving Success for Mission-Driven Organizations (2015).