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Getting a business degree can be highly rewarding, but planning and foresight are essential

By Bonnie Darves, a Seattle-based freelance health care writer

Physicians pursue formal business education for a whole host of reasons, but there are some common threads. For many, it’s a desire to effect change within their organizations or even health care delivery as a whole. For others, a master of business administration (MBA) or master of medical management degree (MMM), or the Certified Physician Executive (CPE) credential, is viewed as a way to better position them as credible participants in big-picture discussions about organizational direction or in decisions that affect their professional lives or their specialty’s future.

Increasingly, especially in large organizations, the business degree may be a requirement for seeking a senior leadership position. Some physicians have a specific reason for getting an MBA or MMM, such as launching a new clinical service. A final subset of physicians obtains formal business education as a first step toward exiting clinical medicine and moving wholesale into a nonclinical leadership role.

For internist Pamela Sullivan, MD, MBA, the driver was twofold. She needed a better understanding of the business world to help her perform more effectively in the leadership realm in which she was already functioning as a medical director. She also wanted to make a better-informed decision about how to focus the rest of her career.

“I realized that I needed to know more, and that I needed to be able to speak the [business] language whether I was in a clinical meeting or a business meeting,” said Dr. Sullivan, who is chief clinical officer of implementation for Landmark Health, which partners with health plans and uses a “house calls” model to care for patients with multiple chronic conditions. “The MBA program gave me the confidence I needed to do that.”

Dr. Sullivan opted for the one-year physician executive MBA program at the University of Tennessee’s Haslam School of Business. In part, she chose it because it was shorter than some MBA programs, but also because she wanted a practical curriculum and the face-to-face experience of the four weeks of onsite residence. “I learn by doing, and this program was not about taking exams — we got real-life practical assignments. It was so energizing,” Dr. Sullivan said.

Andrew Furman, MD, MMM, took a more stepwise, protracted approach to getting his master’s in medical management. The emergency medicine physician started by taking courses through the American College of Healthcare Executives and the American Association for Physician Leadership (AAPL) over a few years. He then carried those credits into the MMM program at University of Southern California (USC) in Los Angeles, which he completed in 2017. Today, after stints at Geisinger Health System, and Salem Health in Oregon, he is medical director for Accolade, Inc., an innovative private care-delivery and benefits company serving self-insured employers.

The slower approach enabled Dr. Furman to initially select courses on topics that related to issues he was encountering in his work, while allowing him to accrue credits toward an eventual master’s degree. “I started piecemeal when I was three years out of residency and was doing committee work. The AAPL courses were fantastic because they set me on a path to a one-year USC program,” Dr. Furman said.

From the outset, Dr. Furman was clear about his motivation for learning about business: “I wanted to be part of the change in health care, and any change that occurs affects physicians,” he said. “If you just want the three letters after your name, you might not get much out of it. If you want to shake up the mess we’re in in health care, you will.” For Anil Singh, MD, MPH, MMM, executive medical director of clinical transformation at Highmark Health and system division director of Critical Care at Allegheny Health Network in Pittsburgh, Pennsylvania, the decision to obtain a business degree arose in part out of frustration. “I was being asked increasingly to do things that did not involve patient care, and to help fix issues,” said Dr. Singh, who obtained his MMM from Carnegie Mellon University. Business people sometimes asked him to write a pro forma or show ROI [return on investment] when he proposed a solution.

“I had no idea what they were talking about and decided I needed to understand the jargon. Being in the program opened up a different side of my brain that I’d never used before,” Dr. Singh said. “Now, when I speak to businesspeople in their own language, I’ve got immediate ‘street cred’.”

Benefits of business education: professional and personal
Like Dr. Singh, other physicians interviewed for this article were unanimous on one key benefit of formal business education: becoming conversant in the language spoken in board rooms and management meetings.

“I knew that if I was going to be communicating with CEOs and CFOs, and marketing directors, I needed to understand their language — and I needed the credentials and knowledge to participate effectively. The MBA gave me that confidence,” said anesthesiologist Talal Ghazal, MD, MBA, co-director of the Holy Cross Hospital Pain Center in Wheaton, Maryland. “I also wanted to learn about something I wasn’t trained in. I found that business is no big mystery — it’s a matter of understanding the fundamentals and concepts.”
Physicians who pursued MMM and MBA degrees that included an onsite component also cited interactions and continued networking with their cohort members as a major benefit.

“Working on an MBA, MMM, or CPE helps you develop a network of colleagues with similar goals or interests, who become an ongoing resource for advice or counsel,” according to John Jurica, MD, MPH, CPE, medical director of an Illinois urgent care network who blogs and delivers podcasts on physician leadership.

For Dr. Furman, the networking was especially gratifying. “The cohort experience was amazing. You learn so much from being in the room with people with varied backgrounds who often are experiencing similar issues,” he said. The diverse specialty and background profiles of a typical MBA cohort enrich the learning experience, notes Kate Atchley, PhD, executive director of the University of Tennessee’s Physician Executive MBA program. “In a typical year, we’ll draw physicians who are entrepreneurial-minded, some who are in mid-career or are already in administrative positions who want business acumen, and younger physicians who know that medicine is changing and want to be part of that change,” she said. “The benefit of the physician-only environment is that the students come in with the same educational background and the same experience of clinical work — they can relate to each other.”

Dr. Singh’s cohort, for example, included hospitalists, internists, cardiologists, a pathologist, and a palliative medicine physician. “Learning from the other physicians was a phenomenal experience,” he said.

Rex Kovacevich, MBA, a professor of clinical marketing in USC’s MMM program, sees those valuable interactions firsthand. He often witnesses physicians sharing their stories and experiences, and in doing so, helping each other deal with situations in their own organizations or professional lives. “That’s one of the key benefits of the cohort model — the physicians become comfortable sharing with each other,” said Mr. Kovacevich. Monique Butler, MD, MBA, chief medical officer for Swedish Medical Center, in Englewood, Colorado, cites those networking benefits and the resulting relationships she built as an important outcome of her participation in the University of Tennessee’s Physician Executive MBA program. “The cohort experience gives you a huge support network. We’re able to just pick up the phone and call each other when we’re working through a challenge,” she said. “It’s been incredibly helpful.”

Weighing the education options
The chief decision physicians face when they decide to pursue business education is choosing which route to take. The formal physician executive MBA, MMM, and CPE programs teach similar content, but their formats differ. The traditional MBA program, offered online or in a hybrid online/on-campus format, or as an immersive on-campus experience, ranges from one to two years and focuses on business theory, concepts, and principles. There are more than two dozen traditional MBA programs that have a health care business or leadership focus. Several universities now offer physician-only executive MBA degrees structured to accommodate the schedule constraints of practicing physicians and to deliver targeted content. Programs developed as part-time offerings often impose a maximum time for completion.

The MMM, a more recent entrant in the business-degree realm, is designed specifically for physicians and typically targets those who are at least three years out of residency. Physicians who pursue an MMM often end up serving as medical directors, department chairs, chief medical officers, or president/vice president of medical affairs. The programs run 12 to 18 months, and prerequisites might be required. These programs incorporate online learning and an onsite residential component several times annually. Common courses include organizational management, health economics, health policy, health finance, health law, and operations management.

Maeleine Mira, director of the MMM program at USC’s Marshall School of Business, said that a key feature of the MMM curriculum is that it’s designed to teach students how the business cases apply in health care. “That’s one of the benefits of the MMM compared to traditional MBA programs,” she said. “Every student graduates with an implementable capstone, so that they’re ready to go back and institute changes.” USC also offers a pre-MMM fellowship option for final-year residents.

When considering any MBA or MMM program, prospective participants should carefully evaluate the content focus to choose a program that suits their individual needs or career objectives, several sources pointed out. Physicians should also keep in mind that some programs require that participants have three to five years of clinical experience post-residency.

The CPE that AAPL offers focuses heavily on both business content and leadership training and is pursued on a course-by-course basis in a 150-credit curriculum consisting of online learning and live events. The focus is on hands-on learning. The CPE offers flexibility for participants who might need to complete the curriculum at an uneven rate or over a longer period, and it requires a final capstone project and audiovisual presentation. A sophisticated technology platform facilitates interaction among learners, and AAPL also provides professional development resources such as career assessment and executive coaching.

Typically, physicians earn their CPE designation in two to 2½ years, according to Peter Angood, MD, AAPL’s president and chief executive officer. AAPL also partners with five universities to enable students to complete prerequisites toward master’s degrees and easily transition into those programs.

Other degrees that include some business content include the master in healthcare quality and safety management (MS-HQSM) and master of science in the science of healthcare delivery (MS-SHCD), as well as clinical informatics degrees. The master of health administration also includes business principles but focuses on applied health care experience.

When choosing a degree program, especially an MBA, physicians should be fairly clear about what they want to achieve, Dr. Jurica advises, in part because of the financial investment. That might range from under $10,000 for an online-only program to $100,000 for a big-name university MBA. The CPE path is generally less expensive than the traditional MBA or MMM program, he added. “It might be worth waiting to start a program, if there’s a way to get your employer to help with the costs,” Dr. Jurica said. He also advised physicians who aren’t ready to commit to a program to consider taking business courses through the AAPL, specialty organizations, online programs, or local education institutions.

“It’s important to decide whether you need the name recognition — which might be the case for those who will compete for a senior management position at a large organization — or just the degree and the core business knowledge,” Dr. Jurica said. In the latter case, an economical online program might suffice.

What to expect
The prospect of continuing clinical practice while obtaining a business degree can be daunting, but it’s doable for physicians who organize their time efficiently and strategically, sources agreed. The MBA and MMM programs typically carry a workload of 12 to 25 hours weekly, in addition to the onsite periods.

Physicians who want to get a business degree should plan well in advance, all sources said, and should ensure they will have support from their families, colleagues, and organizations before they start. Ideally, they should also try to either reduce or reconfigure their clinical hours to accommodate program demands. “The most important aspects of preparing for a graduate business degree are figuring out how you’ll arrange your time when you add the program to your other responsibilities and making sure that those close to you – your spouse, your coworkers, your children – are onboard,” said Mr. Kovacevich.

That’s one reason that Dr. Ghazal, who obtained his health care MBA from George Washington University in Washington, D.C., encourages physicians who are eyeing a specific role to consider getting a degree earlier in their careers. “By the time you get to mid-career, and have a demanding practice and a family, it can be a challenge to fit it in because of the time requirements — you basically have a deadline every week.”

Deborah Vinton, MD, medical director of the emergency department at the University of Virginia in Charlottesville, found herself on a crash course path when she began the University of Tennessee Physician Executive MBA, five years after finishing residency. She started the program just six weeks after delivering her third child. Despite the logistical challenges, the timing was important: she had an opportunity to participate in planning the UVA’s new emergency department and needed business credentials to be effective.

“I wanted to be a physician leader at this academic center, and I knew I needed this education,” Dr. Vinton said. The school and her cohort were “amazingly supportive,” she said, and she was able to bring her infant daughter with her for the onsite residency portions. “I was surprised by how accommodating everyone was — I didn’t expect that,” she said.

For Jamie Eng, MD, MMM, who completed her MMM at USC as a continuation of the administrative emergency fellowship that program offers, the degree better equipped her for the administrative work she was already doing at USC-Los Angeles County Medical Center. “It was fortuitous because the fellowship actually required me do the MMM. I looked at other administration fellowships, but this was such a good fit that I decided I might as well get the degree,” said Dr. Eng, who is associate medical director of emergency medicine at Providence Tarzana Medical Center in Tarzana, California, and director of the USC Administrative Emergency Medicine Fellowship program.

“The cohort was fantastic,” Dr. Eng said. “I feel like my administrative experience was sped up by a decade learning from the experiences of others.”

Tips for choosing a program and planning the journey
Physicians interviewed for this article offered the following additional guidance for their colleagues planning to pursue formal business education:

When you’re evaluating programs, look at how the curriculum and the schedule can intersect with your job. If you’re not able to merge your work with the requirements, you might have to consider other options.” — Deborah Vinton, MD, MBA

I think it’s important to get awareness of the various learning opportunities, so that you have a better sense of what you want for your professional growth.” — Peter Angood, MD, AAPL president and CEO

When you’re looking at programs, be clear about your career and where you want to be in five years — and how a particular program or fellowship is going to get you there.” — Jamie Eng, MD, MMM

You must be able to make the commitment before you start a program. You need a game plan, the financial resources, and the buy-in from family and colleagues. I ended up devoting two full days a week to my studies.” — Pamela Sullivan, MD, MBA

Truly understand the time commitment. Programs might cite a certain number of hours per week but assume that that’s the minimum. It might take more time to meet your requirements.” — Talal Ghazal, MD, MBA

Do the degree at the right time in your career. It’s important to be a good doctor first and to have that credibility. I think five years in practice is the minimum, and that seven to 10 might be the sweet spot.” — Anil Singh, MD, MPH, MMM