BOSTON, (Reuters) – Institutional Shareholder Services recommended Friday that NextGen Healthcare Inc (NASDAQ:) Inc shareholders vote for the four nominees to its board and remove cumulative voting.

This influential proxy advisory firm supports management and the board rather than supporting Sheldon Razin (the founder of NextGen), who has appointed four directors to this board. Razin has voiced disapproval at the company’s low financial returns.

ISS stated that recent management and board changes “appear adequate to place the company in a better position to implement its strategy for growing revenue.” It added, “The dissident have not made it clear that they believe additional change would be preferable at the time.”

NextGen, which was founded in March 2013, hired David Sides (a veteran of healthcare information technology) as its chief operating officer. He succeeded his predecessor who resigned three months ago.

Razin, who was a board member since 1974, has nominated two of the current board members, and two other candidates, to fill in for four board members.

Razin was the only member of the board that management nominated, though he was present on four other boards.

The Oct. 13th voting day for shareholders is October 13.