Medical workers learn the language of business
A growing number of professionals pursue master's degrees to better navigate a complex health system
By Davis Bushnell, Globe Correspondent, 9/28/03
Strategic planning and number crunching know-how are just two of the skills now prescribed for healthcare professionals seeking to advance their careers in a managed-care world.
As a result, the number of doctors, nurses, and other medical workers pursuing master's degrees in business administration, health administration, and similar disciplines is growing.
The complexities of the nation's healthcare system are spurring this phenomenon, particularly at teaching hospitals in large cities like Boston, specialists say. At a time when these hospitals are battling to keep costs in line with revenue, physicians and nurses in managerial positions need to know how to read business charts, develop strategies, and manage subordinates more effectively.
Physicians in senior administrative positions are expected to increase their business knowledge as part of their jobs, while many other doctors and nurses on lower rungs of the organizational ladder also are boning up on business to try to advance their careers, according to healthcare executives.
Business topics are not covered in-depth in medical school or nursing school. Sometimes clinician-managers are able to acquire this knowledge on their own, but often business school is the prescribed venue for what Dr. Timothy Babineau and others call ''learning how to speak the language of business.''
Babineau, a gastrointestinal surgeon at Boston Medical Center and chief of surgery at Quincy Medical Center, went through an accelerated 17-month program at Boston University's School of Management. He received his MBA degree in 2001.
''I now can have a dialogue with bean counters,'' Babineau said.
Tufts University School of Medicine, Northeastern University's College of Business Administration, and Brandeis University offer a program leading to combined medical and MBA degrees. And Harvard Medical School and Harvard Business School are now considering their own joint program.
The University of Massachusetts-Amherst has an online MBA program for doctors, and the Simmons College School for Health Studies has a master's program in health administration geared to nurses, social workers, physical therapists, and other healthcare workers.
While the number of doctors and other healthcare professionals who have received advanced management degrees from these Boston institutions in the last 10 years is relatively small - a total of 500 or so - according to program administrators, a significant momentum is underway, these administrators say.
Data is unavailable on the number of doctors and nurses who have received MBA degrees nationally. But it is believed that the number of doctors in MBA classes across the US has doubled or tripled in the last decade, the American College of Physician Executives says.
Clearly there is an increasing interest among healthcare professionals about the business of healthcare, said Ira Weiss, dean of Northeastern's College of Business Administration.
After all, business and healthcare go hand in hand, and those preparing to enter the health profession ''may end up running hospitals and HMOs,'' he said.
Doctors who have taken part in the 7-year-old Northeastern-Tufts-Brandeis program ''have been some very smart people,'' said Deeb Salem, chairman of the department of medicine at Tufts New England Medical Center. ''Obviously, the skills they learn are useful for analyzing balance sheets, negotiating contracts, and other things.''
However, he said there is a lingering question of how many of these graduates ''will be using their MBA skills a lot. I don't know.''
In the last 10 years, though, the number of doctors signing up for advanced business courses has been ''dramatic,'' said Howard Horwitz , vice president of professional development for the Tampa-based American College of Physician Executives.
The feedback he's getting is that ''doctors want to increase their business knowledge so that they can make sense, for example, of healthcare financing, and can better understand payers and consumers,'' Horwitz said.
The American College of Physician Executives is partnering with UMass-Amherst for the university's online MBA program, which was started 2 years ago.
Doctors who pursue MBA degrees do have a head start, suggested Dr. Peter Slavin, president of Massachusetts General Hospital, who received his MBA from Harvard Business School in 1990. He is a member of a task force studying a joint program at Harvard's medical and business schools.
There's a certain ''logic,'' he said, that spills over from the medical to the business side of the ledger. In business matters, ''you also diagnose a problem and come up with a treatment plan.''
Among the biggest benefits gained from his BU experience are financing and organizational skills, Babineau said.
He said he can now articulate his thoughts about financing issues. ''Also, I don't think I could have done things in Quincy'' without organizational know-how, he added.
Business knowledge is also a must ''for increasing one's managerial responsibilities,'' said Dr. Robert Bernasek , medical director of the primary care center at Bridgeport Hospital in Connecticut, which is affiliated with Yale Medical School. He began taking two UMass online courses last spring.
Meantime, he's improved his ability to discuss what to him had once been arcane business issues with ''hospital administrators and the physicians I work with,'' said Bernasek, who hopes to get his MBA degree in three years.
Thirty-seven doctors from all over the country are currently enrolled in the UMass program, according to Heather Miller, director of admissions for the online program. The first graduating class will be next spring. Twelve courses are offered for $600 per credit, she said, noting that doctors usually start off by taking courses in accounting and statistics. As is the case with programs at other schools, some of the costs are borne by a student's employer.
''More and more, we're seeing doctors who want the skills to deal with managing budgets and making financial projections,'' Miller said.
Other healthcare workers, such as nurses, are motivated a bit differently when it comes to going back to school, said Bill Behrendt, senior vice president of human resources at Beth Israel Deaconess Medical Center in Boston. He also teaches a graduate course in health administration at Simmons.
While higher pay is obviously a motivator, ''these are people who have frequently done their clinical thing and want to move into administration,'' he said.
Kirsten Boyd, a new nurse manager at Beth Israel Deaconess, said she received a master's degree from Simmons last May. ''I had been in critical-care nursing but wanted to be part of management,'' said Boyd.
More money wasn't a factor, she said, adding, ''It was a passion for nursing and improving the operational flow on the floor I'm working.''
She is now assigned to the neurosurgery and neuromedicine floor, responsible for supervising the duties of 40 nurses and support staffers, she said.
The Simmons graduate program attracts many clinicians like Boyd who work for hospitals in the Longwood Medical Area, said John Lowe, director of the Simmons graduate program in healthcare administration.
Although course offerings such as statistics, advanced financial management, and strategic planning are similar to what's covered in an MBA program, ''we like to tailor some courses to students' needs, depending on their healthcare specialty,'' he said.
Babineau said he tailors his business education every day to running the surgical operation at Quincy Medical Center. But he's proudest, he said, of being part of a new culture.
''In the past, too many doctors abdicated their [managerial] responsibilities to non-clinicians,'' he said.
Davis Bushnell is a freelance writer and can be reached at davisbushnell@compuserve.com.
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