There’s an old saying about life in the C-suite: “When things are tough you shouldn’t leave, but when things are great it’s hard to leave.”
So, when exactly does a chief executive know it’s time to step aside? I suppose the answer is different for every executive you ask.
For me, the answer is simple: When I feel that the AMA is best positioned to build on its tremendous success over the past 14 years, and when I can ensure a smooth transition to the next leader.
That time has arrived. I will be leaving as AMA’s chief executive officer and executive vice president when my current contract expires in June 2025, and until then I’ll be working closely with the AMA Board of Trustees to ensure a smooth handoff to whomever is hired to lead this remarkable organization into the future.
By the time I depart, I will have had the privilege of serving in this role for 14 years. That is a long time for a CEO in any industry, but particularly in health care, which is constantly evolving as new public health threats emerge and the needs of patients and physicians change. In fact, I have been the longest-serving CEO at the AMA since the late Jim Sammons, MD, beginning in the early 1970s.
Many things are great about our AMA at this moment, which makes my decision to leave especially difficult. But just as I greatly benefited from a solid foundation when I arrived in 2011, I am committed to ensuring the same for the AMA’s next CEO.
It's difficult to imagine today, but a quarter-century ago, the AMA greeted the 2000s mired in controversy and uncertainty. Our financial foundation was frail. A series of high-profile disputes led to the abrupt departures of senior management, including a number of my CEO predecessors. In other words, things were a tad messy.
We now have outstanding financial stability. Membership, which had progressively declined for the 40 years prior to 2011, has, in the last decade plus climbed to levels not seen for decades. Total AMA membership is up more than 30% since 2011—success that is rooted in our ability to tap into what we know physicians need to help them navigate the increasingly complex world of health care.
Building a lasting strategy
The AMA’s reach has never been greater. Record-breaking web traffic and video viewership. Record-high media visibility. Ever-expanding resources and offerings through our JAMA Network and the AMA Ed Hub™. Our own venture studio in Silicon Valley, Health2047, has spun out nine companies that reflect the commercial translation of our strategic framework.
One of the most important tasks given to me when I was hired as CEO was to help create and implement a long-term strategic framework for the AMA, built upon the policies of the AMA’s House of Delegates. What resulted from that effort was three dynamic, carefully constructed strategic priorities—later to be known as the strategic arcs—that more closely aligned the work of the AMA with our mission:
- Removing obstacles that interfere with patient care.
- Confronting chronic disease and eliminating health inequities.
- Driving the future of medicine by reimagining medical education and lifelong learning.
Each arc is powered by the cross-cutting accelerators of advocacy, equity and innovation. Advocacy is how we work to influence the regulatory environment by elevating the concerns of physicians and patients at the state and federal levels.
Advancing equity is our drive to use the AMA’s influence to help create a more equitable future so that all people and communities can achieve optimal health. And helping lead innovation is our work giving physicians a platform to influence the design and creation of new digital tools to ensure they work as promised in the clinical world.
Since their launch in 2012, these strategic arcs—powered by three accelerators—have brought sharper focus, and impact, to the AMA’s work. And more than a decade later, that impact continues to reverberate across health care in new and exciting ways, influencing not only how physicians work in this rapidly changing clinical environment but how patients experience our 21st-century health system.
Ensuring a successful handoff
As soon as I made the difficult decision not to renew my contract, I began reading about what a successful top-executive transition should look like. My first thought drifted toward obvious organizational accomplishments, such as financial, strategic and operational. But in exploring transitions more deeply, I came to understand that a truly successful handoff is the support that you offer, and the assistance you provide, to give your successor the best chance to excel.
A McKinsey analysis of CEO transitions draws an interesting analogy to the U.S. men’s 4x100-meter relay event, which was introduced at the 1912 Summer Olympics held in Stockholm. Of course, the U.S. 4x100 men’s team is comprised of four of our country’s fastest 100-meter sprinters, each of whom runs one leg of the race, before handing the baton off to the next.
The United States dominated this event in the 20th century, winning gold in 15 of the 20 Summer Olympics between 1912 and 2000. But in the five Summer Olympics held from 2004–2020, the U.S. men’s team failed to win the gold in this event, earning just a single silver medal during that period. It was a shocking result considering our past dominance and that we were heavy favorites to win in each of those years. What happened? Why had our nation’s superior sprinters suddenly underperformed?
The answer was simple: bad handoffs. At its nadir, at the Summer Games in Tokyo in 2020, one sportswriter described the handoffs of the men’s 4x100 men’s relay team as evocative of the bungling Keystone Cops from the silent movie era.
The challenges in medicine today are numerous and well-documented, which makes it even more critical for the AMA to maintain its momentum in this year of transition. A smooth handoff doesn’t guarantee you a gold medal, but a dropped baton will always leave you at the back of the pack.
Looking back, I am thankful for the current and past leaders of our board, senior management group, House of Delegates, our highly talented staff, members and other stakeholders who have helped build our AMA into the powerhouse it is today. We can all be proud of how we’ve advanced the AMA’s remarkable mission—to promote the art and science of medicine and the betterment of public health. And now we must ensure this legacy continues.
Download Dr. Madara’s CEO tenure fact sheet (PDF).
