In this episode, Lucas and Luna examine how the Mayo Clinic's board of trustees governs one of the world's most respected healthcare institutions. The clinic operates as a nonprofit with a unique three-shield model — patient care, research, and education — but still generates over $16 billion in annual revenue. Lucas explains how the board maintains its physician-led culture while making strategic decisions like expanding into Arizona and Florida, launching the Mayo Clinic Platform for data sharing, and navigating the shift to value-based care. Luna asks whether nonprofit boards face weaker accountability than for-profit ones, and Lucas points to the clinic's published community benefit reports and its 'primary value' principle. The hosts dig into the board's composition: 16 trustees, mostly external, with a mix of clinicians, former CEOs, and academics. They also discuss how the board handled the COVID-19 pandemic, including a $1 billion investment in telehealth infrastructure. The episode closes with a question about whether nonprofit healthcare governance is an underappreciated model for other industries.