This book is aimed at ECOMS (Executive Committee of the Medical Staff) Chairs or the equivalent. Much of the focus is on dealing with problem staff members, full and fair hearings, and credentialing/ decredentialing. If you find yourself in need of such information, no doubt you'll be grateful for these chapters, but I was disappointed to find the book (which calls itself a "Practical Guide", after all) to be lacking instruction for more mundane situations like conducting medical staff meetings, preparing for JCAHO (now the "Joint Commission") inspections, interacting with other institutions (e.g. one's Preferred Provider Network), and the like. I haven't found this to be very practical, so three stars.