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Knowledge is power

Dr Fatih Mehmen Gul is a Saudi-based physician. His MBA has equipped him for an executive career that has included setting up air ambulance projects in Saudi Arabia and coordinating domestic and international healthcare projects.

Commenting on his degree, he says; "I gained an overall understanding of the business of healthcare. I became an effective member of the game, rather than just a member of staff."

And for those in the trenches, business training provides hands-on practical skills that can be utilised in daily clinical practice. Schulman uses the example of a physician hoping to pitch a new outpatient clinic.

"If you had an idea of how to improve a process, or a new service to offer to patients, how would you go about it? How would you formulate a business plan, and how would you attract management attention or outside investment in order to go forward and bring your idea to your patients?

"With general management skills, you can answer those questions."

The pay-off can be immediate, says Ouriel. One of his first lectures at Columbia dealt with organisational charts. Ouriel used the information he was given to overhaul SKMC's organisational structure, and improve operational efficiency.

"Almost immediately, I was able to talk the issue over with colleagues and come up with a plan that improved how staff reported to each other, and how we divided up departments and divisions," he explains.

Business school is also credited with helping to break down the barriers between medics and managers. In an industry that pays homage to credentials, physician executives report increased kudos from management colleagues who learn they have an MBA. Stahl relays the story of a chief financial officer who was always dismissive of physicians' involvement in the hospital's financial decisions.

When he discovered the chief operating officer was nearly at the completion of his MBA, his behaviour changed. "The CFO recognised that the MD, soon to become an MBA graduate, was in a position to participate in, and influence, financial discussions," Stahl explains.

"Every discipline has its own language. If the people you are trying to influence know you have a knowledge of business, they will attribute more credibility to your opinion."

Equally, for a profession reputed for its ego, management courses can teach physicians to be better team players. According to Schulman, graduates typically come away with a new appreciation for their colleagues.

"Business is a team culture and so [students] are socialised into that. We deliberately bring in people from other aspects of healthcare, so they get some appreciation for their role with the system; something you never get in formal medical training."

Customised courses

Outlining what you want from an MBA will go a long way towards helping you pick a suitable programme. Standard MBAs typically take two years to complete, but many programmes designed for professionals have been condensed to one year, to allow for career demands.

And they often accommodate students' schedules in other ways, such as by offering classes both in person and online. Tennessee's PEMBA, for example, blends four one-week residency courses, with online classes delivered every Saturday. Students are divided into online groups, based on time zones, so they still benefit from class interaction.

While many courses are tailored specifically to healthcare, a number of physicians opt to enrol in generic business programmes, arguing that medicine is too insular already. For Ouriel, whose MBA focuses on global business, the course offered a more varied experience.

"An MBA programme gives you the opportunity to work closely with someone from a different background," he explains. "You understand they are aiming for the same goals you are."

There are pluses and minuses to both styles of course, Schulman acknowledges.

"One of the benefits of not doing the physician-only programmes, is that it doesn't reinforce the idea that there is something special about physicians as a member of the team," he explains.

"[But] without the healthcare piece, you as an individual find you are accountable for the translation. You can lose the thread of how to apply the concepts you are learning."

Physicians may find they struggle on MBA courses typically designed for accountants or bankers, Stahl warns. "The faculty will teach at the level of financiers, because that is who the course is aimed at, and physicians will be at a profound disadvantage."

The opportunity for peer learning is better in physician-only courses, he adds, because students are on the same page.

"Our students have an average of 18 years experience so people understand the issues and examples. You can broaden the theory or principle and it just clicks."

Investing in the future

MBAs are typically two years of commitment, rigorous coursework, and demanding workload - on top of the trials of daily practice life. But they are increasingly a requirement for the upper reaches of the healthcare sector.

Physician leaders, Stahl notes, are no longer elected on clinical skills alone. "The industry is looking for leaders to have demonstrated competence in management, and the certification to prove it."

With a foot in both camps, physician executives are uniquely placed to influence the changes in healthcare. While he admits his bias, Ouriel firmly believes that, as a clinician, he has an advantage over an executive who is a non-physician.

"I've been through the training, I've been in the trenches with these people," he shrugs. "It is clinicians that take care of patients and health outcomes, and I understand what they do day-to-day."

Clinical leadership is set to have a real impact on the direction of healthcare, Schulman promises, by giving physicians the skills to bring to the bargaining table.

"All the things we think are fixed within healthcare; how we're organised, how we're paid; those all seem very final," he explains. "In truth they are all variables and they are all choices. And understanding that you are empowered to advocate for change in those choices is an incredibly powerful idea."

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