Charles H. Emerson, M.D. President, American Thyroid Association

President's Update
February 2018

We are now into the time of the year when the days are getting longer and our last annual meeting – in late October of 2017 – is becoming a distant memory. Months prior to that meeting I started work on one of the most important functions of the President-Elect. This is to review the members of ATA Committees and appoint, in conjunction with the Board, Committee Chairs and ATA staff, the committees for the coming year. Due to the addition of a new Committee in late 2017, the Guidelines and Statements Committee (See below), it was not until early this year that their composition was finalized.

Now, as I become more familiar with the role of President, and as the new committees are galvanizing into action, I have begun to consider how the perspectives and perceptions of our members might influence their interactions with the workings of the ATA. Clearly those of a new member, of a member of one of the ATA's committees, of a committee chair, of a participant in a major ATA activity (i.e. journal Board, Guidelines authorship), of a "junior" member of the ATA Board, or as an officer of the ATA, are all bound to differ. Reflecting on my recent and earlier experience in these roles leads to the theme embodied in the title of this report. In developing this theme, I hope to highlight the importance of contributions by ATA members at all stages of their careers, and to maximize their participation in the life of the ATA. It is apparent that an understanding and consensus on how the ATA's activities are initiated and decisions made should help each of us navigate within this very special organization and, in doing so, help achieve its goals.

Is the ATA - Should the ATA, be a top-down, bottom-up, or "horizontally-interacting" organization? For new members of the ATA it may seem that the ATA is a top-down organization. Before or soon after they join they are generally aware that the ATA has a staff, an Executive Director, and perhaps somewhat confusing, not only a President but also a Secretary who happens to be a Chief Operating Officer. Policy and decisions, it might seem, are dictated from these sources, clearly a Top-Down model. The core aspects of the ATA's governance, most of which are imbedded in its bylaws and others which are time-honored are, on the surface, a Top-Down model. Matters unrelated to the day to day operations of the ATA that come to the Executive Director – Secretary/COO team are typically considered initially by the Executive Committee (EC), a hybrid body that includes the senior staff person, who is the Executive Director, and the Officers of the Board. These are the Secretary/COO who works most closely with the Executive Director, the President, Past President, President Elect, and Treasurer. Depending the year, the EC may also include the Secretary/COO-Elect or the Treasurer-Elect.

As matters arise the EC discusses them in its monthly conference call or by Email, voice calls, or using web-based software. If the matter is urgent and time-sensitive decisions are made immediately. Otherwise they are referred to an appropriate committee for their recommendation and sometimes they and be taken up directly at the monthly meeting of the Board, a body that consists of the ATA's Officers and Directors. The key to understanding the process, however, is to realize that the source of ideas, concerns, and recommendations that come to the EC can come from any source within the ATA. Their pathway to the EC, however, is not always direct. They may come directly from members, or from members via committees, or tabled for more polished development after being initially brought up at a Board meeting. Matters that originate from staff are usually discussed initially in the EC. Invitations, requests for collaboration, endorsement, and advice that come from outside the ATA usually reach the Executive Director or Secretary/COO first, or come in the form of a joint letter addressed to the Executive Director, Secretary/COO and President.

Whereas the Board is the Governing Body of the ATA, and the EC is the gateway of most items considered by the Board, the Committees are intended to be the lynchpin of the ATA's activities. There are currently 21 committees, one panel and 3 task forces listed on the ATA's website. The charges to the committees cover almost every aspect of the ATA's mission. Committees receive bottom-up and top-down information; they also facilitate communication among ATA members who are working on a particular ATA activity, a "horizontally-interacting" activity so to speak. My goal, and the goal of every President-Elect has been to populate committees, task forces, and ATA projects with individuals who reflect the diversity of the ATA, provide productive and balanced counsel to the Board even when it may not be clear that this is not being acted on as rapidly or as fully as desired, and seek and are receptive to input from members at all levels. If this is successful the function of the ATA can be optimized, invoking the best characteristics of top-down, bottom-up and horizontally interacting organizations. Looking at the roles of members in general, committee members, and members of the ATA Board the challenges are related. For many members it is how to communicate their ideas to committees and in what situations does it make more sense to interact directly with the ATA Staff or Board. For those on a committee the challenge is to make this experience enjoyable and productive. For the Staff and the Board, it is to be receptive and sensitive to input from all sources within the ATA. The last is, in fact, not so much a challenge as it is a pleasure.

In a future report I hope to expand on these comments, particularly as they relate to differences in the charges and work of various committees. Knowing the committees that are more or less working committees, those that deal with strategic questions and those that work most closely with staff in all phases is essential information.

In closing my report, I want to express my pleasure in serving as your President and to urge you to nominate persons for ATA Awards and for Electoral office. Finally, please note that the BOD approved a new ATA Guidelines and Statements Committee (GSC), Co-Chaired by Drs. Jacqueline Jonklaas and Anna Sawka. The Committee is an outgrowth of the ATA Guidelines and Statements Task Force and was formed to develop formalized procedures for the initiation, integration, development and deployment of all ATA guidelines. The GSC will be working in close concert with the ATA Executive Committee and Board of Directors.


Charles H. Emerson, M.D.
President, American Thyroid Association