case for good governance case study

Case Study: Making the Change You Want to See

How a 120-year-old association enacted meaningful change through good governance


Founded in 1900, the American Association of Orthodontists (AAO) focuses on advancing their members’ success through education, advocacy, and research that drive excellence in patient care.

Though the organization has been in operation for more than 100 years, AAO leadership wanted to ensure their governance practices enabled—rather than constrained—effective deliberation. Seeing an opportunity to increase effectiveness, reflective of the dynamic marketplace changes, they wanted to walk through what good governance looks like and what they should consider changing.


Partnering with AMC consultants, AAO engaged in a multi-step process that began with an evaluation, through the lens of good governance, of who the organization is, how they operate, and why they follow the processes that they do. Next, AMC facilitated a robust discussion about what AAO might consider changing and how that could look.

When creating governance changes, challenges often arise when the body making the bylaw changes is outside the governance discussions (in AAO’s case, a House of Delegates). As part of the process, AMC worked with AAO to create effective messaging about why the changes were important that AAO could then distribute to the appropriate stakeholders. 

“Mark [Engle] was able to educate our board on association governance and best practices,” said Lynne Thomas Gordon, MBA RHIA CAE FACHE FAHIMA, executive director of AAO. “As a result, our Board and House of Delegates voted for significant changes based on Mark’s leadership and guidance.”  


AAO was successfully able to accomplish adding at-large directors to their board, a meaningful change especially for an organization as established as AAO.

“Two women were elected to serve on the board for 3 years,” said Thomas Gordon. “Significant – yes! In our 120-year history, only two women had previously been elected to serve.” 

The association was also able to reshape agendas and other operating practices of the board, ensuring their focus and processes were more strategic in nature.