The missed opportunities are actually on both sides of the ledger—practices that public hospitals can learn from private hospitals and those that public hospitals can teach private hospitals.1 In our work with numerous public hospital boards, we have found that they often feel like governance stepchildren. This most often occurs when their scores on board self-assessment surveys are lower than those of their private hospital board peers. However, in our experience, there are lessons about effective governance that can be learned from both public and private hospital boards.