Lucy Kellaway, Financial Times management columnist, recently suggested that every board needs one troublemaker at the table to stir things up. (Actually, Kellaway used a far more evocative term for this type of person that neither my boss nor my mother would like to see in print.) Anyway, a troublemaker — someone who is unconcerned about his or her likability, unafraid of creating conflict and unwilling to let sleeping dogs lie — supposedly brings a refreshing disregard for polite conversation and instead "dashes in on the attack, battering-ram style, leaving it up to the chairman to restrain them before serious damage is done," Kellaway says.

I disagree. Boards don't need a troublemaker at their table any more than I need one at my breakfast table (2-year-old daughter: I'm talking to you). The best boards grant their members unspoken permission to raise questions and challenge assumptions. Ideas and perspectives can bubble up because no one fears a dismissive sigh or eye roll. Members want to be likable because they know a cordial, cooperative board gets more done than a disjointed one. Perhaps most important, each member can be trusted to represent the hospital and reliably relay input from the community, unlike a troublemaker, whose incendiary nature makes him or her an unapproachable loose cannon.

So, think long and hard about your current and future board makeup and have the courage to call out the folks who detract rather than add to the discussion, and let them know that behavior is unacceptable. The rest of the board will thank you.

And speaking of thank-yous, thanks to you, Trustee readers, for spending another year with us. Your dedication inspires us. See you in January.