For many medical groups, the practice administrator is the one leader who sees how every major thread connects: growth plans, payer strategy, workforce pressure, technology investments, culture, and patient expectations. That same integrated view is essential in governance, where the structure of the board and its committees quietly shapes which issues get attention, whose voices are heard, and how quickly the organization responds to change. 

Boards carry the organization’s fiduciary responsibilities, but they rely on committees, officers, and processes to connect those responsibilities to day-to-day work. Administrators are deeply involved in building and maintaining that system: helping define the mix of skills needed on the board, supporting leaders of key committees, coordinating agendas and dashboards, and ensuring that oversight of finance, quality, compliance, technology, and people does not happen in silos. 

This feature reframes board structure, roles, and committees through the organizational governance competencies an administrator needs to master. 

Why board structure matters for administrators 

The expectations for boards — and the administrators who work with them — are rising fast: 

• Cybersecurity and IT compliance costs are climbing; nearly three out of four medical groups reported higher cybersecurity expenses in recent years, and IT is now one of the biggest non-labor cost pressures for many practices. 
• AI-enabled tools (scribes, diagnostic support, analytics) bring new productivity opportunities and fresh questions for boards about data governance, bias, and consent. 
• Governance structures that once worked — such as all-shareholder boards in large practices — may struggle to keep up with today’s complexity. 

Guidance on effective medical group governance stresses clear expectations for the administrator, formal evaluation of the role, and explicit structures for decision-making and oversight. 

In the Body of Knowledge, these expectations show up as Organizational Governance competencies: understanding board structures, supporting committees, managing risk oversight, and keeping governance aligned to mission, vision, and values (MVV).