In recent years there has been an ongoing trend in business and industry, and now healthcare, to move into a “competency-based” thinking model: to identify, articulate, and evaluate ourselves against core competencies. At first glance, competency-based thinking seems perfectly reasonable, and perhaps an even elegant or sophisticated way to consider hospital and health system governance—until one realizes that “competence” typically connotes a minimal or, at best, average level of performance. So why would a dedicated, hard working governing board that until now has been told and encouraged to pursue recommended practices settle for mere “competence?” In this article, Sean Patrick Murphy, senior vice president & corporate general counsel, Solaris Health System, challenges boards to look beyond the basics.