Experience its supporting actors…

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I passed the Board of Governor’s (BOG) exam on the first attempt. It wasn’t with flying colors, but I’m proud of the accomplishment nevertheless.

Below are the tools I used and my thoughts on each. These are not affiliate links; they’re just to show what I used.

I bought these based on my experience with the practice test I found online.


  1. They encapsulate complicated topics that we experience in a highly enmeshed way. (ie: Gave me a clean definition of something like CQM)
  2. They come with an online version through Quizlet that has associated tests you can take anywhere…

Experience is the best way to study.

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The Board of Governor’s (BOG) exam is unique.

College, medical school, licensing, boards, maintenance of certification — I’m no stranger to having my knowledge tested. But I feel comfortable saying that the BOG is a different beast.

This was my first experience with an exam where I (a) wouldn’t understand the question or (b) the answers but (c) I also couldn’t figure out how the question was related to the answers.

Many questions felt like this:

243. Which of the following is an example of supply chain downsizing models of financial oneupsmanship?

a. Atlanta, Georgia.

b. Yes.

c. The box…

Even when it feels hopeless.

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“Why bother sticking my neck out? We’re not going to get extra money.”

The pandemic has highlighted the pain middle managers can feel.

You’re placed in an impossible scenario: Asked to conserve scarce resources by administration above while the team you lead is clearly in need — and it’s your job to keep both sides happy.

It’s easy to feel hopeless when you’re treated like Gumby.

The fear that you’re risking your job for asking questions only worsens the feeling. …

6 clues that you’re the problem.

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Toxic people don’t blame themselves.

They aren’t holding up the mirror and reflecting on how they can be better team players. They have limited insight about how they make others feel.

They’re just sort of bulldozing through the cubicles and displacing problems onto everyone around them.

So if you’re this person — thinking that your job is broken and everyone else is the problem, how would you know you’re wrong?

How can you tell you’re the problem if you aren’t willing to believe that you could ever be the problem?

Look for these six signs — they’re clues that maybe…

It’s not because of bureaucratic tasks

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I’ve been crispy for years.

Not all the time, just floating between smoldering and charred. At best, the job is OK and some days are even enjoyable. Other times, I pray to be afflicted by a fugue state and wake up washing dishes in Omaha.

Primarily human but incidentally a physician, I do what anyone would do — I Google my symptoms. I look to the literature for insight. Because we are led to believe that if we know the cause, we can fix it.

This belief is simply a cognitive error.

The more I read the literature, the more…

6 ways to disengage healthcare professionals.

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Healthcare consultants are moles for administration.

Hired by the C-suite, consultants are outsiders who don’t understand the hospital, the culture or the problems. Voluntary/mandatory meetings are set up for providers to be questioned by consultants. Providers who don’t participate aren’t team players — they’re part of the problem.

It’s easy to mistrust this situation.

But, healthcare consultants are saviors for broken systems.

By the time things are bad enough to look for outside help, consultants offer a welcome perspective. They’re a fresh ear for old problems and work to identify common failures and offer evidence based solutions. …

What to do when no one gets you.

Photo by Joshua Ness on Unsplash

Have you ever thought you communicated exactly what you wanted to only to be totally misunderstood?

Times when you receive unexpected responses or worse, no response?

This happens to me with my boss and co-workers. It happens with my wife. It even happens with my eight-year old. My very literal, black-and-white eight year old to whom I give specific instructions! Repeatedly, I have left situations feeling like I’m screaming but no one can hear — like I’m yelling through a broken loudspeaker.

Eventually, I figured out that I am the common thread in all of these situations. And if “no…

Using the practice exam to build a study strategy.

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The Board of Governor’s (BOG) Exam is taken to achieve fellowship status with the American College of Healthcare Executives.

Criteria must be met to take the exam. You have six hours to complete the actual test which is comprised of 230 questions — 200 of which are actual, scored questions and 30 are non-scored.

The practice test I used is here, it’s a 230 question test that I completed in less than two hours. The answer key is here.

The reference manual for the actual BOG exam is here.

There are more up-to-date resources and self-assessment tools available, but I…

Tips that helped me conquer the fear of flying.

When I was a kid, flying was fun.

Turbulence, steep turns, long flights — these things didn’t even cross my mind, they were just part of the flying experience.

Until they weren’t. A single, short commuter flight between Chicago and Des Moines wracked with panic, cold sweats, gripping the seats terror. Nothing unusual happened, I just became convinced that this was it.

I have no idea why — it hit me and stuck.

I avoided flying for years thereafter. I took Greyhound across the country, drove to vacations and passed on opportunities to go afar.

After years of limiting myself…

The art of medicine can be learned through patient complaints.

Physicians often learn customer service in residency. We either receive a complaint or interact with a dissatisfied patient who wants a solution in real time — in either case, it’s too late.

Taking a position with your group or hospital that lets you field complaints exposes you to the failures of our field. It’s akin to self-improvement by focusing on your failures.

Learning common themes across patient complaints allows a better understanding of the patient’s perspective. This will teach you to prevent complaints in the first place.

Doctors checking their…


I get stuff out of my brain by writing about it.

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