By Sanjana Vig MD
I made the decision to get an MD/MBA when I was still in high school. I had an interest in medicine but I hated the idea of being yet another Indian doctor. How unoriginal. So when my dad introduced me to someone who had done this dual degree, it was my “aha!” moment. As far as I knew, this was something different, could set me apart and no one else I knew was doing it. Perfect!
Now, we are paying the price. Literally.
We dance to the tune that managers play for us, not quite understanding why certain things are done or why certain policies exist. On more than one occasion, I have heard, or even myself have asked: “why do I have to fill out this form” or “there has to be a better way”, or “I know a better way!”
Hospitals are, at its most basic form, a business. Yet we are never taught about even the most basic business components, let alone how to run one. We have no exposure to accounting and financial topics; we passively gain teamwork and team building experience during residency, but there are also business leadership concepts and communication strategies that we do not learn.
Healthcare is dynamic and constantly changing. With the Affordable Care Act and whatever congress is trying to accomplish now, changes are happening, and will be coming, that directly affect how hospitals are managed, how insurance is handled and ultimately how we get paid.
There is clearly a gap between physicians and managers, not just in communication, but in understanding as well, and it needs to be bridged. Doing so requires physician leadership that can be present at the table, engage in administrative discussions, assist in formulating business decisions and be a voice for clinicians.
Why an MBA?
Much of the push back I got as a student was, sadly, from other students. I was regarded as a sell out for wanting another degree, because, apparently, this meant I wasn’t serious about medicine. In addition to that accusation, I was questioned for not getting and MPH (Masters in Public Health) or MHA (Masters in Healthcare Administration), as those degrees were seen as being more in-line with a medical career.
My response: I wanted a broad understanding of business and finance. In my mind, while those degrees are certainly helpful, they would not help me achieve my goal. I wanted to understand all business, not just healthcare. I wanted all related business topics on my plate, not just public health issues. I wanted to understand consumers as a whole, not just hospital and clinic patient populations. I wanted to understand money making from the perspective of any business, not just medicine.
For me, personally, an MBA means I can work in any hospital, any clinic, or any government or private sector healthcare organization, and I wanted those options.
Benefits of a dual degree
A 2011 study by Dr. Amanda Goodall examined the top 100 hospitals, as determined by US News and World Report, and compared their CEO’s. Those with physician based leadership scored 25% higher in hospital quality measurements. While there’s no direct causal relationship identified here, there is support for the idea that leadership without clinical expertise can lead to inferior management abilities in the hospital setting.
Plus, a physician leader has instant credibility with both clinicians and managers, making it easier to bridge that gap between both parties. Managers are more likely to trust someone with some business acumen and physicians are more likely to trust someone who understands the daily clinical issues they face. Having a physician be a part of administrative discussions also helps protect other physicians and related clinical interests.
On a more personal note, the additional degree can serve as a point of leverage to advance career goals and move up the managerial chain much faster than would otherwise be possible. If moving up the chain isn’t part of your goal, then just having the knowledge, period, can help you develop a better understanding of why certain decisions are made and at the very least, help you converse intelligently with administrators in a way that is effective and productive.
In todays’ climate, where hiring mid level providers is seen as more cost effective and MD’s are too expensive, giving yourself another skill set will make you irreplaceable and even desirable.
While a second degree, or a career in leadership, is not for everyone, I believe that physicians owe it to themselves to take back control of their careers. Even without a degree, you can be proactive about paying attention to the business aspects of your jobs, asking questions, obtaining information and empowering yourself with business knowledge so that you don’t get left behind.
Be a boss. (You already are one)
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