Why Physician Leaders Must Be Fundraisers, Too

In the nonprofit world, fundraising is an essential duty of executives who expect their organizations to meet transformative goals. Here’s how to make your efforts more meaningful.

Physician leaders play a crucial role in the development of not-for-profit and academic health care systems and educational institutions, and any physician or health professional aspiring to a top leadership role in either setting must be familiar with fundraising processes as well as be ready to provide leadership and direction. In fact, applicants for dean or CEO positions frequently are asked about their experience and willingness to engage in fundraising.

Those who already have reached leadership roles within health organizations often have participated in some form of development activity, either being solicited by or doing the soliciting for charitable organizations. Many fundraising experiences in social contexts, however, don’t translate well into the medical school, health system or university environments, where fundraising is an organized and crucial component of governance at senior levels. These organizations have established structures that demand that senior physician leaders work with institutional advancement officers to develop priorities, align strategic visions with solicitations, steward potential donors and help close gifts. Further, they are expected to make sure the stated purposes of each gift are fulfilled and respected, and that the funds are used appropriately. In this process, they must partner with IA officers, lawyers, trustees and others within the organization.

It’s essential to understand the difference between fundraising and institutional advancement. Skeptics might say this is merely semantics. In reality, the two concepts are related but conceptually different.

Fundraising should be understood as an important component of institutional advancement — not its sole outcome. Institutional advancement encompasses raising money for specific projects as well as the enhancement of the image of the organization. It helps define an organization’s identity within its social realm.

An important function of institutional advancement is the development of a good relationship between potential stakeholders and the organizations they are inclined to support. Cultivating potential donors, and exploring their motivations and emotions, are time-consuming but important tasks for IA officers and organization executives. Not only should these activities attract donations but they also should enhance recognition of — and the ability to fund — projects that ultimately create everlasting impact and kinetic progression for the organization. Thus, fundraising is a means of achieving the institutional fulfillment of its mission, as a part of the larger social process of recognition and civic standing.

Donors whose interests focus on health or science invest in causes that are emotionally close to them. They perceive them as improving lives and bearing tangible fruits. They fulfill an inner desire for recognition by making a difference. Health care, scientific and educational institutions and their leaders — among them the academic physician leader — become shareholders in that dream. They have a fiduciary obligation to safeguard the intent with which the gift was made and to wisely deploy the funds to achieve the desired results.

Stewarding donors requires an ability to ignite a passion in the donor that’s congruent with the needs of the organization — and vice versa — as well as an ability to connect at personal levels. The donor’s personal stories and emotions often are at the center of their philanthropic interests. It’s important for academic physician leaders to know the donors, to understand what motivates them, and to be respectful of their approaches, desires and personal priorities.

Asking for Money

Physicians, even those in leadership positions, tend to be reluctant to ask for money, especially with grateful patients. They sometimes believe such actions interfere with the physician-patient relationship. A paper published by the Journal of Clinical Oncology says that, in a survey of about 400 physicians, more than half perceived direct solicitation to be a conflict of interest. Discomfort with direct solicitation was more prevalent among women physicians and younger professionals, while physicians who had been in practice longer appeared more comfortable.1

Logically, having less experience is uncomfortable. Institutions must create a culture of giving as well as a culture of engagement, essentially training individuals at all levels in the mechanics of fundraising. Discomfort will disappear more easily when employees are properly trained, enabling them to connect with the higher goals of an organization. Experience and a clear sense of institutional priority and clarity of the mission are natural aids to the process and help to overcome hesitation.

The academic physician leader’s own experience as a donor is important because it informs attitudes and emotions about the process. Many individuals who want to make a contribution enjoy meeting with highly ranked academic officers and learning about them as people and professionals, as well as about the institution they represent. Ultimately, they want to understand how they can make a difference with their money, however generous or limited it may be.

It’s important for leaders to be sincere and respectful, never obsequious or overly solicitous. Many donors are accustomed to being asked for money and are used to giving. They are quite interested in learning and deeply exploring the meaning of their potential gift, thus making the request much easier.

The focus must always be the potential donor’s interest. A common mistake made by physicians and academics, in general, is to focus only on their own interests, consequently becoming disappointed that their personal pitch wasn’t heard. Donors must feel an affinity for the cause and have a sense that they are giving to something they hold dear or where they can make a difference.

Individual Gifts

For instance, we received a significant sum from a donor who, as an applicant, was admitted to medical school on a scholarship to help offset his disadvantaged background. He enjoys giving others the opportunity that he received. When presented with an option to name a chair, he showed no interest. His passion stems from the gratitude of his own opportunity, reflected in his desire to establish student scholarships — not from wanting to give his name to an academic chair, no matter how big an honor it can be.

Another donor chose to give to educational programs, to honor her parents who were teachers, affirming that education is her passion. Another wanted her physician father’s name to be remembered by generations of students and physicians by endowing a professorship. Yet another will donate only to activities conducted by a specific physician he says saved his life.

Leaders must be prepared to honor the benefactor's intent and appreciate their passion — and try not to usurp it.

For many people, funding scholarships for students choosing residencies in primary care specialties is much more significant and meaningful than supporting research on the latest cancer drug. A potential donor interested in the arts and music might be more willing to support a humanities course than a research program or naming a room or building.

Most institutional gifts are the result of consistent stewardship of potential donors and the creation of affinity for, and connectivity with, a given institution over many years. This work cannot be done by academic physician executives alone. A professional team, with individual roles ranging from organizing creative activities to engage donors to drawing legal contracts, is essential for success.

Given the high turnover rate among leaders, donor stewardship often begins with executive predecessors. Effective leaders know they must learn quickly about all major prospects and engage in the re-establishment of relationships on behalf of the organization. Many donors who make significant gifts are older by the time their estates have matured and their finances are in order. Most affluent donors are sharp, knowledgeable and supported by expert financial advisers and lawyers. They know how much, when and how they can or should give to obtain maximum impact for the cause and for their own tax situation.

The best situation is when a donor has a passion or interest about an area in which the organization has an outstanding reputation. Many donors are experienced, socially connected, and have clear ideas regarding the reputation of the organization and when or how it should be enhanced; thus, their input is enormously beneficial.

There are numerous ways they can show their philanthropy: an outright gift, a pledge, or a planned or estate gift. Donors are obligated legally to fulfill irrevocable pledges. It is on the basis of such pledges that programmatic and financial decisions are made by organizations. Conversely, organizations are legally and morally obligated to the donors to honor the intent of the contribution. Failing to use a donation for its intended purpose — such as keeping an endowed chair vacant for a prolonged period, or failing to conduct the research the donor funded — could cause the withdrawal of a gift, create a rupture in the relationship and possibly lead to unpleasant legal proceedings.

Academic physician leaders should expect institutional advancement officers to create clear and compelling cases for support based upon the institution’s short- and long-term funding priorities. IA officers should, in turn, create and implement detailed solicitation plans for each prospect they identify as having the capacity, inclination and interest in making a significant gift to the institution. Executives should receive an assessment and analysis of the potential for success of every fundraising project based upon readily available data. The report should include the size, wealth and readiness of the potential donor population affiliated with the program, department or priority. And IA officers are expected to show a professional demeanor that encourages other institutional authorities, such as vice presidents, department chairs and faculty, to participate willingly in the cultivation and solicitation process.

An IA officer must have easy and prompt access to the organization’s leaders. Holding regular meetings, making space in the schedule for travel, being open to suggestions on how to handle a specific donor, and becoming familiar with a donor’s biography are essential to the relationship. Likewise, leaders must discuss and approve a schedule of visits with donors at various levels of commitment, meet with affinity groups (namely, alumni, who are very important in academic circles) and carefully review proposals by paying close attention to the alignment of the request with institutional priorities. They also should follow up with thank-you notes (personalized if possible) to the donors and maintain periodic communication under the advice of the IA officer.

It’s also important for leaders who are experienced in fundraising to mentor younger or less-experienced individuals, with the help of their IA officers. Many times, the fresh and detailed enthusiasm of someone at a more junior level can ignite donor interest.

Institutional advancement and fundraising are essential functions of physician leaders in the academic and not-for-profit world. Their efforts in this important leadership area are essential for an organization to meet its aspirational and transformative goals. By working collaboratively with institutional advancement professionals, treating donor prospects as partners in a common interest and enhancing the organization’s civic standing and reputation, a physician leader can succeed in transforming dreams into tangible institutional accomplishments and sustain donor relations.

Daniel V. Schidlow, MD, is the Walter and Leonore Annenberg dean and senior vice president of medical affairs at Drexel University College of Medicine in Philadelphia, Pennsylvania.

Donna G. Frithsen is vice president for institutional advancement, campaign strategy and operations, development, medicine and health affairs at Drexel University in Philadelphia, Pennsylvania.