Lilly Marks
Published 2/26/2025
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Alexandra E. Page, MD, FAAOS
Organizations across non-profit and for-profit industries use strategic plans to guide decision making and growth. When the AAOS Board of Directors (BoD) developed and began activating the current AAOS Strategic Plan, its two public board members were integral voices, bringing their broader experience in organizational strategic planning. The public board member position on the AAOS BoD engages a leader outside of orthopaedics to provide perspective and expertise to enhance a group otherwise comprised of orthopaedic surgeons. A public member has existed on the BOD for 22 years, but in support of developing a competency-based board, a second public board member was added in 2023.
Lisa N. Masters, MBA, and Lilly Marks have both served many years as leaders in fields beyond orthopaedics, and they have brought that experience developing and executing strategic plans in other industries to inform the AAOS process in the public board member role. They shared their perspectives in an interview for AAOS Now.
Lilly Marks
Lisa N. Masters, MBA
Ms. Marks served as vice president of health affairs for the University of Colorado (CU) and executive vice chancellor heading CU’s Anschutz Medical Campus, a $13 billion enterprise with more than 30,000 employees. Under her leadership, the organization undertook multiyear strategic planning in response to healthcare consolidation. A vital early step was to identify behavior and performance changes necessary for change. Transparent communication helped stakeholders understand the “why” of strategic initiatives, and an iterative approach of obtaining and incorporating stakeholder feedback engendered mutual understanding and consensus. The effort set the stage for the organization to evolve from a single hospital to a system of 13 hospitals, ranked number one in the state for quality, market share, and earnings.
From this experience, Ms. Marks identified three key components for success. First, she noted, “Success is heavily dependent on leadership, discipline, and the courage to drive a path forward that is based on exhaustive analysis and clear-eyed reality.”
Second, avoid “a strategic process built on platitudes, hyperbole, aspirational statements, or political theater but devoid of a viable action plan,” she advised. “Making decisions based on the reality of environmental imperatives, even if they’re occasionally unpopular, is critical to achieving goals and missions.”
Finally, leadership must remain focused. Her work on CU’s campus required “discipline to forego other attractive opportunities that arose . . . but would have been a diversion of critical financial and human resources and inconsistent with our strategic path and goals,” she said. In Ms. Marks’ experience, a supportive culture, fact-based decision making, and the courage to stay the course allow an organization to realize success with strategic plan development and execution.
Reaching goals while supporting the mission
Although the AAOS Strategic Plan adjusts to a changing environment, the mission remains constant. Ms. Masters addressed how the mission remains the guiding star for the organization’s decisions and actions. Ms. Masters brings her 36-year tenure as an executive with Bank of America to AAOS strategy, with experience in human resources. She led global initiatives on leadership, executive development, and organization design for more than 200,000 employees worldwide. For Ms. Masters, success comes from recognizing the strategic plan as a dynamic tool. “The strategic plan serves as a decision-making tool for leaders up and down the organization to help them align their work and their resources to the plan and thus to the mission,” she said.
Further, Ms. Masters stressed that the metrics and targets incorporated into the strategic plan drive accountability and transparency. Reviewing and reporting outcomes on an annual basis allow stakeholders to see exactly how AAOS lives up to its mission. “[A] strategic plan is a tool to help organizations maximize their impact and stay true to their core purpose,” she summarized.
Using the plan to guide decision making
Ms. Marks expanded on how the strategic plan should guide decision making, helping AAOS determine the “why,” “what,” and “how.” She said, “The ‘why’ … helps you build consensus for the work you’re about to do by explaining why it is so critical to the organization’s success, even though not everybody may be initially aligned.” Next, plan development defines “what” the organization is going to do.
Finally, Ms. Marks concluded, “It’s really critical that we spend time on ‘how’ we’re going to do it. Too many strategic plans spend a lot of time at the 100,000-foot level. But if you cannot land the plane, you’ve accomplished nothing.” Execution is realized through tactics that align with the stated strategies and goals. Ultimately, Ms. Marks observed, “A well-executed, well-designed strategic plan actually is the framework and the foundation for how you can put your limited resources to their highest and best use [and] gives you the guardrails for … making that happen.”
Best practices
Important best practices when developing and implementing a strategic plan include early and recurrent involvement of all stakeholders, as well as ongoing communication. Ms. Masters noted the necessity of communicating direction, decisions, and impact directly to members in an organization such as AAOS.
Reflecting on possible missteps, both board members cautioned against rigid adherence to a strategic plan. Ms. Marks observed that the environment will change, and mid-course corrections may be necessary: “You can’t use it as a straightjacket.”
Ms. Masters called blind adherence “risky business,” noting how it limits flexibility and prevents adaptation. She offered the example of Blockbuster, where lack of flexibility led to extinction. Less overt, she noted that blind adherence to a strategic plan “can discourage creativity and stifle innovation.” Furthermore, sometimes strategies include elements that prove to be less effective than planned and need adjustment. “With rigid adherence, volunteer leaders and staff can feel compelled to continue to follow a plan that may not be effective or doesn’t reflect the realities they face on the ground,” she noted, adding that this experience “can lead to reduced morale and productivity.”
With input from the complete BoD, including the expertise of the public members, as well as outside experts and staff, AAOS followed best practices to develop its strategic plan. Intentional plan activation and adoption, while recognizing the need for a dynamic plan in the face of environmental changes, will enable AAOS to continue serving the profession to provide the highest-quality musculoskeletal care.
Alexandra E. Page, MD, FAAOS, is a foot and ankle specialist in private practice in San Diego, California, and the deputy editor of AAOS Now.
Read more on the new AAOS Strategic Plan
In 2024, AAOS Now published a series of articles from AAOS leadership exploring the four goals of the new Strategic Plan. Review the following articles to learn more about each goal and the strategic objectives that will help AAOS meet these targets.