On the conduct of meetings

What does your calendar say about you?

Consider what you did at work today. There’s a good chance a significant portion of your time was consumed by meetings - attending them, preparing for them, or recovering from them.

If you’re like me, you probably dread them. For leaders, meetings aren’t an occasional inconvenience; they are the texture of professional life. Research from Harvard Business School’s CEO time study shows that senior executives spend the majority of their working hours in meetings, while data from Microsoft suggests that meetings consume roughly a third of the average professional’s workweek - and often far more in remote settings, where three or more hours per day in virtual meetings is not uncommon.

Yet the returns on this massive investment of time are often dismal. Studies synthesized by Harvard Business Review and workplace research from Atlassian consistently find that a majority of meetings fail to meet their objectives, with as many as 70% perceived as unproductive. The cumulative cost is staggering. Survey data from Salary.com estimates that employees lose dozens of hours each month to unnecessary meetings—adding up to an economic impact measured not in millions, but in the hundreds of billions of dollars annually.

A single one-hour meeting with eight average-salaried employees costs between $338 and $700, depending on how you account for indirect costs. That number often surprises people, but the math is straightforward:

· Direct cost: The salary expense of having people in a room (or on Zoom) instead of doing other work.

· Opportunity cost: The value of what those people would have produced had they not been at the meeting.

· Recovery cost: The time it takes to regain focus after a meeting ends.

While exact figures vary by study, the direction is unmistakable: meetings dominate modern work—and too often fail to deliver proportional value.

Here’s the paradox: leaders spend more time in meetings than almost anyone else in their organizations, yet, by their own admission, most of those meetings do not deliver tangible results. If meetings are the primary place where leadership is exercised, decisions are made, alignment is built, and culture is shaped, then running them well is not a soft skill or mere courtesy. It is a core executive competency - and one that is almost never formally taught.

Why Most Meetings Fail

A strong McKinsey Quarterly article, Want a Better Decision? Plan a Better Meeting by Aaron De Smet, Gregor Jost, and Leigh Weiss, argues that effective meetings start with a simple question: Should this meeting even happen? From there, it’s essential to clarify the purpose of the meeting and define roles and responsibilities with precision. Meetings, if they are to occur, need to be better managed.

Too often, meetings prioritize politeness over progress. This tendency is especially pronounced in academic administration, where there’s pressure to invite large numbers of people - even those only tangentially related to the issue - so no one feels excluded. As one author observed, some organizations pursue collaboration so aggressively that they become excessively polite and overly inclusive. True collaboration doesn’t always mean inviting everyone or keeping perfect decorum; sometimes it means being decisive and focused.

I once was tasked with assessing the strengths and weaknesses of an academic unit. In preparation for the report, I asked my assistant to schedule a meeting with the CFO to discuss budget priorities and ways to manage expenses within the unit. When another member of the unit found out I had scheduled a meeting with the CFO, he asked if he could attend. I considered his request and then responded, No. He was surprised, and after recovering some composure, he reiterated his request. I repeated my earlier response. He then tried to coerce me into extending an invitation to the meeting. I responded that I would be asking questions that may make him uncomfortable, and I would rather not have the distraction of him attempting to justify past expenditures and defending earlier management decisions. He left my office and returned to his office, slamming the door to emphasize his displeasure. The assistant who had witnessed the exchange quietly remarked, Smart move. Leaders have an obligation to ensure that only individuals who are essential to the task at hand are invited to meetings.

Researchers in another McKinsey piece, What is an Effective Meeting?, reinforced the point with a blunt subtitle: effective meetings are all about purpose, preparation, and presentation. Their research found that 61% of executives believe at least half the time they spend making decisions is ineffective, and only 37% say their organizations make decisions that are both timely and high-quality. As McKinsey alum Tom Peters memorably put it: The only thing on Earth that never lies to you is your calendar.

My Own Response to Meeting Fatigue

Years ago, frustrated by repeated systemic failures, I started collecting observations about bad meetings and filed them in my System Failure File. Whether in hospitals, pharmacy organizations, or higher education, the inability to run good meetings is almost always a leadership and systems problem.

When I became a dean and gained some control over the meetings I led, I created a set of guidelines that I expected everyone on my team- including myself - to follow. I shared them with my leadership team and with cohorts of AACP Leadership Fellows, hoping to spare them some of the daily drag of unproductive meetings and to protect their time and energy for actual work. I’ve refined these rules over the years, but the core principles are still the same. In the spirit of turning personal frustration into something useful, I’m sharing them here.

Meetings don’t have to be soul-crushing. With intention, discipline, and a willingness to break a few polite habits, they can become one of the highest-leverage tools in any leader’s arsenal. The question is whether we’re willing to treat them with the seriousness they deserve.

Drawing on McKinsey’s research and hard-won institutional experience, I developed a set of ground rules, On the Conduct of Meetings, that I now consider non-negotiable. What follows are the rules for conducting productive meetings.

On the Conduct of Meetings

Ground rules

1. Only hold meetings when all alternatives have been exhausted (informal meetings, memorandums, delegation, etc.).

2. Keep meetings brief (one hour or less) and on track (use an agenda).

3. Limit membership in the meeting to essential personnel.

Rules of Conduct

1. Keep the membership to seven, including the chairman.

2. Establish a beginning date, frequency, and time of subsequent meetings and (most importantly) a termination date.

3. Set an agenda; distribute it 2 –3 days before the meeting, and stick to it.

4. The chairperson’s job is to lead the discussion, not dominate.

5. Have task leaders who are responsible for individual items within the agenda. They should also be responsible for background, research, and, if draft documents are involved, distribution and revision of drafts.

6. Avoid the use of miscellaneous or odd-and-ends category, as it only invites endless discussion.

7. If a consensus cannot be reached at the meeting, defer the item to a working party or subcommittee to avoid unnecessary wrangling during the committee meeting.

8. Begin and end meetings on time. Note individuals who arrive late and depart early in minutes. Make sure that everyone brings their calendar to the meeting to facilitate planning of the next meeting or individual task meeting.

9. Have someone (other than the chairman) keep the minutes and ensure that they are circulated for corrections and additions as soon as possible following the meeting.

10. Draw out the silent. Everyone has a view; get them to express it.

11. Meetings consist of (1) questions, (2) answers, (3) positive reactions, and (4) negative reactions.

12. Close a meeting with the following:

a. summary of accomplishments/actions

b. an assignment list with names of responsible parties

c. thanks to the participating parties

d. establishment of the next meeting and general agenda.

13. Minutes should contain the following:

a. time, date and place of the meeting

b. who chaired the meeting

c. who attended, who was absent and why

d. all agenda items (and other items) discussed and decisions reached. If action was agreed upon, record and underline the name of the person responsible for the assignment.

e. time the meeting ended

f. date, time and place of next meeting.

14. Finally, most issues are decided by consensus. If you can’t convince three smart people that something makes sense or is at least worth trying, it’s probably not a good idea.

None of this is complicated. What it requires is intention - and the willingness to lead rather than accommodate.

Here is what I have come to believe after decades in academic medicine, administration, and executive leadership: meetings are not inherently wasteful. Run well, they are among the highest-leverage tools available to any organization. They build alignment that no memo can replicate. They reveal disagreement before it becomes dysfunction. They create the shared context that makes distributed teams coherent. They can, when the culture is right, be where an organization’s character is made visible.

But that version of meetings doesn’t happen by accident. It happens because someone in the room — usually the leader - decides it will. Leaders decide whether meetings become soul-crushing time sinks or high-leverage catalysts for decision-making, alignment, and culture. On the Conduct of Meetings establishes sensible guidelines for managing the biggest time sink in a leader’s life – meetings. That choice is made not once, in a policy document, but dozens of times each week, in how you open a meeting, whom you invite, whether you let it drift, and whether you have the discipline to end it when the work is done.

Your calendar is not neutral. It is a reflection of your values as a leader. What does yours say about you?