William C. Stubing.

Between 1987 and 1989, NYAM reorganized to better serve the health of the public in New York City. From its founding, the Academy had worked as a voluntary organization, run by its Fellows, with an honorary president drawn from their ranks and, eventually, a small staff headed by an executive director. When William C. Stubing (1939–2015) took on that role in 1986, his first task was to reform the Academy’s finances. Consulting firm Cambridge Associates provided a blueprint for change, which the trustees, NYAM’s fiscal oversight body, accepted in October 1987.

Dr. Mary Ann Payne.

The same day that the trustees accepted the financial report, Dr. Mary Ann Payne (1913–2010), the Academy’s first woman president, reported to the Council—the governing body that oversaw the Academy’s medical and public health activities—that “in her judgment, the Academy’s existing resources were insufficient to support its present program.” The Council set up a Committee on Strategic Planning with Payne as chair, tasked to “examine and redefine the Academy’s mission; review existing programs, consider new initiatives and establish new priorities.” The Academy re-engaged Cambridge Associates; after 18 months’ work, the firm provided a sobering report to the Council in March 1989. The report called for significant changes, including the establishment of a full-time president with overall authority for the Academy and a reduction in the large number of committees having a hand in governance. The dual structure of a Council and a Board of Trustees was eliminated, retaining just the Board. Although Payne’s presidential term had ended three months earlier, she continued to lead the process as chair of the Committee on Strategic Planning.

Throughout 1989 the Fellows debated the proposals; they were overwhelmingly adopted at a special meeting on August 7, 1989. On July 1, 1990, Dr. Jeremiah A. Barondess took office under the new structure as the first full-time president of the New York Academy of Medicine.