A practice has no formal committee structure as complexity grows. Which governance improvement is needed?

• A. Establishment of board committees
• B. Strengthening management oversight
• C. Expanding clinical oversight
• D. Increasing marketing and community outreach

Answer: (A)

As complexity grows, the board needs structured ways to oversee different areas without being overwhelmed. Establishing board committees creates focused groups (such as for finance, quality and safety, audits, and compliance) that dive into specifics, provide independent review, and report back to the full board. This distributes governance responsibilities, improves oversight, and supports more informed decision-making as the practice expands.

Strengthening management oversight shifts emphasis toward management itself rather than enhancing board-level governance. Expanding clinical oversight sounds important, but it targets clinical operations rather than reorganizing governance structure. Increasing marketing and community outreach falls outside governance concerns.