While I haven't read the study co-authored by the American Hospital Association and Ernst & Young on the differences in the handling of governance issues among for-profit and not-for-profit hospitals and healthcare systems, your recent overview ("Governance gap," Feb. 23, p. 44) does not mention at least one critical issue that might account for some of the differences: the imperative for only not-for-profit board members to engage in fund-raising activities.
In the selection of trustees, as well as in their job descriptions, the ability of not-for-profit healthcare board members to "give or get" is an increasingly important criterion. In fact, their greater focus on "financial" matters (vs. the greater focus on "quality of care" data by their for-profit counterparts, as the study indicated) might be significantly accounted for by fund raising and related functions. I would also argue that, with commitments to events and solicitations on weekends and evenings (among other requirements of fund raising), not-for-profits are rightly more concerned about their trustees having "enough time" to perform their duties well.
I would disagree with Gary Roberts' assessment of the need for more generalists on boards and favor James Rice's argument on the need for more specific skills. Fund raising is one such skill. Among the study's suggested "leading practices" to improve a not-for-profit board's performance should be an expertise profile on bringing in donations.
Vice president of development
Phelps Memorial Hospital Center
Sleepy Hollow, N.Y.