We need fewer doctor MBAs and more doctor healers

We need fewer doctor MBAs and more doctor healers

I read an article in the Boston Globe about how doctors are flocking to get Master of Business Administration (MBA) degrees in record numbers. The prestigious program at the Massachusetts Institute of Technology, MIT, apparently now has more students from the health care sector than any other field — accounting for almost 20 percent of the class.

A large number of these are doctors wanting to go down the administrative route. At a time when health care needs fewer administrators and more frontline staff, I’m not sure this is the best news, especially if these doctors are intending to leave clinical practice. The article also touched upon the fact that some of the doctors enrolled in the program were hoping that the MBA would help them improve their practice and engage patients better. This reason surprised me, and I couldn’t help thinking whether I had missed something here? I’ve worked up and down the East Coast, and the most successful doctors and practices that I have seen are certainly not that way because the doctors have a business degree.

I’m sure that getting an MBA in any field, whether it’s health care or another industry, imparts the student with excellent knowledge and skills. Undoubtedly in today’s world it may help further an executive career. Education is never a bad idea. I have even done a few online modules myself that were part of an MBA course, and found the topics useful and informative.

What makes me a little bit more skeptical is the belief among some doctors that the degree alone can rapidly propel them into a senior management position in health care, and equal success in that role. A lot of these MBA candidates are barely out of medical school themselves. Many medical schools are combining an MBA with their medical degrees (over 50 percent now offer the joint degree). I’ve met some newly graduated doctors who are starry-eyed about the prospect of senior executive health care positions without even finishing their residency. That’s a really bad idea. Physicians have to experience the coalface to fully understand the challenges that health care faces. It isn’t just the theory behind the problems that shows up in numbers, statistics and spreadsheets; health care is a complex beast that requires detailed understanding and knowledge of the frontline clinical processes and systems.

In this arena, there’s no substitute for experience, common sense, and understanding people. Quality improvement and addressing issues such as patient experience require these basic skills. Doctors should attend as many courses as are valuable to advance in these areas, but they don’t necessarily need more letters after their already prestigious MD.

I have had the opportunity to work with several colleagues who are qualified in business administration. Some are excellent (usually those from clinical backgrounds). Others are a bit more lacking in understanding what frontline health care is really all about. Which brings me to my next point. The best doctor administrators I’ve encountered are the ones who still practice medicine. They have usually been fine doctors with a real interest in clinical medicine. It’s important that when ambitious doctors and nurses move into administration, they continue to practice in some form, even in the smallest capacity. Not only will that keep them in touch with the frontline, but will earn the respect of their fellow colleagues.

Pursuing a path in administration does not have to be separate from a clinical path, ideally the two can be combined and mutually beneficial. Anyone who seeks to use the administrative path as a way of getting away from patients, probably deserves neither. This may sound harsh, but how can someone who doesn’t enjoy patient interactions and being a doctor, possibly be best placed to lead in the field? It’s the same in other professions that involve contact with people. An attorney who doesn’t enjoy meeting clients, but wants to be a judge. A teacher that dislikes teaching but wants to be a headmaster. It simply doesn’t work.

At a recent Society of Hospital Medicine annual conference, a talk was given by Dr. Patrick Conway, the CMO of the Centers for Medicare & Medicaid Services. He gave an excellent presentation and revealed that he still works as a pediatric hospitalist at the weekends. He enjoyed it and recounted stories of his experiences. I found that wonderful.

Health care isn’t like buying a sofa or visiting a restaurant or hotel. The sales, marketing and customer satisfaction principles of other industries are very different. So doctors, don’t make the mistake of thinking a business qualification will necessarily help you understand people and processes better. Experience, sincerity and being able to put yourself in your patients’ shoes will produce the real leaders of the future. We need fewer doctor MBAs and more trusted doctor healers.

Suneel Dhand is an internal medicine physician and author of Thomas Jefferson: Lessons from a Secret Buddha and High Percentage Wellness Steps: Natural, Proven, Everyday Steps to Improve Your Health & Well-being.  He blogs at his self-titled site, Suneel Dhand.

Image credit: Shutterstock.com

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  • SteveCaley

    It is everywhere in the history of armies, that those with the most efficiency in putting fighting men on the line prevail; and those most generous with the medals and decorations, fail. Citations abound; almost every war has them. Yet, the glory of becoming a General, especially one far from the actual shooting and dying, always prevails. The front lines are ugly, whether in medicine or warfare. The romance of the suits and medals always tempts.

  • guest

    Short answer: it is becoming more and more unpleasant to be in full-time clinical practice, as our work becomes increasingly micromanaged by bean-counters and non-clinicians. Savvy med students are looking to escape this reality by getting qualified to go right to the administrative level, without ever having practiced.

  • Thomas D Guastavino

    During the Gold Rush Days, a few miners struck it rich, most labored long hours for little gain. The smart guys guys learned that more money could be made by selling the picks and shovels to the miners. Therefore, it should not be surprising that there is a wave of docs rushing back to school to learn how to shovel it.

  • MentalPatient

    When my husband’s daughter went thru a well-respected MBA program, her values completely changed to a more or less sociopathic point of view – the transformation was extreme. She talked about the lectures where she was “learning” about business, and it seems the professors spent quite a lot of time bragging about how good it was to have a lot of money and having their Italian suits custom made for them while vacationing in Italy. And so on. It seemed clear to me that she was taught to have extreme love of money at ANY cost. It was appalling and an eye-opener. Her views appeared to normalize some time after she got out of that program and back in society, but I wonder what the long term effects are.

    This is only one example, but I remember there was a controversy over business schools and ethics a few years back, and I see it does come up on a quick Google search. Therefore, I find it alarming that so many people training to be doctors would be going thru MBA programs.

  • buzzkillerjsmith

    Why be an MBA doc? Then you’re a double threat–suit and white coat. A law degree and then some time as a journeyman plumber and you’ll take over the world.

  • buzzkillerjsmith

    Beautiful moniker. I used to love pts who came in with a CC of “sick and dizzy all over.”

  • SteveCaley

    But “teamwork” is not something reserved to a carefully-guarded Secret Book of Knowledge given out at Wharton or Sloan, some secret whisper on induction to the MBA program.
    During the Long March, Mao Tse-Tung ran about with a thousand guerillas, and successfully put the run to a MILLION Kuomintang government troops – and then took over the largest country on the planet. I’m sure he used the Chinese word for teamwork. And he was only a copycat of Quantrill and Mosby’s Raiders during the American Civil War.
    “Teamwork” only occurs in situations where people are inclusive of complementary persons who work for a mutual goal. Mutual respect and trust, that’s the ticket.
    Sometimes, the approach taken by ONE group is that of beating up, being cruel to and destroying another group with which it does not wish to play nice.
    The Russian Jews had a terrible record for teamwork with the Tsar’s Boyars during the time of Imperial Russia. No matter how nice the Jews tried to be, it always wound up with THEIR houses burnt and THEIR heads cut off. It’s hard to focus on the good side of that result.
    My point is, it’s hard to preach teamwork to a village that got burnt down last year. Doctors are in survival mode, like the Jews during the pogroms.
    Or, as Woody Allen put it – “The lion will lie down with the lamb, but the lamb won’t get much sleep.”

    • buzzkillerjsmith

      You had me wincing. Very nice smackdown indeed.

  • Karen Ronk

    Maybe a lot of doctors who are so disillusioned with practicing medicine had unreasonable expectations. Or maybe the system they find themselves in is unreasonable and soul destroying. And then there are doctors who are just following the money trail. All of the above plus more, I am sure. What I am sure of, is that the patient should always come first. Period.

  • Ava Marie Wensko George

    I think that the bigger message has gotten lost here. Physicians, private practice and employed, have no idea what it takes to be successful from a business perspective. Yes, practicing medicine is about patient care. However, healthcare is a BUSINESS, and if you do not understand it, understand how to participate and add to fiscal responsible health care in America, then you are missing out on 50% of what it really takes to be a successful physician. MBAs are crucial in adding to the body of knowledge it takes in order to practice medicine responsibly today.

    • shiprocklck

      I REALLY REALLY hope that business is not 50% of what it takes to be a successful physician. Ava Marie Wensko George, I think you as the MBA/CHDS/AFDI-F, and I as the lowly MD, probably have very different ideas of what it is to be a successful physician. The sad part is that your idea seems to be winning out.

      • Ava Marie Wensko George

        No disrespect to your credential doctor, but living in a family full of physicians (who are incredibly dedicated and I am honored to call them family) if the business side is not run properly (either by an exceptional office manager or by the physician him or herself), the doctor cannot continue to practice. So, perhaps the 50% was a little high (it was an average), a physician must be aware of the business side of taking care of patients. I’m sure you are a very successful physician – Financially and in your practice. If I were you, would not discount what it is that I know about healthcare based on my credentials, however.

  • http://www.doccallum.com Martina P Callum MD

    I practice primary care medicine 100% of the time and stand in line to get my paycheck. Just what we need…more docs with business degrees and scant clinical experience pimping me about the number of patients I see in an hour ..examining only the bottom line..little or no regard for the reason(s) the patient presented. We need more hands on docs taking care of patients. Urgent Care centers are fast becoming the PCP for many families….the concept of continunity of care is a joke..it doesn’t exist anymore…if you have a PCP you can’t reach them after certain hours…the hospitals are owned by corporations and have manged to squeeze the Primary Care doc out…so you have to fight for the privilege of taking care of your own patient in the hospital..heaven forbid if your patient shows up in an ER the doc might and more often not call to let you know…so your pateint gets assigned to a hospitalist…We need those MBAs and not doctors to figure out how to drastically decrease the cost of a medical education..No wonder these young docs want fat paychecks..they need them! Their debt after school is astromonical..and let’s not forget big Pharma…they encourage this maddness..why…because they can no longer send a drug rep in to talk to a doc about an off label use of a drug…but they can sure a doc in to do it…I think the new title is “Medical Liasion” fancy name for a drug rep with a MD or DO degree..it’s disgrace.

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