First, there is no mechanism for hospital boards to be accountable to the public. Other industries have shareholders to “check” boards (albeit abysmally in recent years). Second, non-health-care-worker members look to clinician members to help decipher medical data. Unfortunately, health-care workers’ philanthropic goals are, to varying degrees, conflicted with concurrent, sometimes competing, financial interests.3 Even the most well-meaning physician has potential financial conflicts, and physicians elected to hospital boards are not necessarily facile with hospital and public health standards. Finally, boards depend entirely on institutional officers for information. Financial balance sheets are easy to quantify; outcomes are evident in black and white. Safety and quality cost money (to actuate and measure) that many hospitals don’t have. And data are vulnerable to manipulation; it is not difficult to spin unfavorable data favorably to mislead uninformed, novice audiences. Salaries are predicated on favorable data, so hospital officers carry intrinsic conflicts into what they present to boards. Frank malfeasance may be rare, but multiple small insufficiencies can combine to overall failure. Hospital board members are likely well meaning, but may be unaware and/or ill equipped to satisfy their obligations.