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.
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