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Once a Practice, Now a Business

Spurred by changes in the American healthcare system over the past five years, medical professionals are flocking to executive education programs to learn business skills
Oct 27, 2015 — Emily Cataneo
Susan Moffatt-Bruce is a cardiothoracic surgeon at Ohio State University's Wexner Medical Center who studied medicine for nine and a half years to get where she is today.
 
But when the sweeping changes wrought by the Affordable Care Act hit the medical industry, she was stuck.
 
"None of those skills I needed to transform healthcare were part of my training," Moffatt-Bruce says. 
 
Since its passage in 2010, the Affordable Care Act, often referred to as Obamacare, has transformed many aspects of the American healthcare system. One change has been an increased impetus for physicians, nurses and healthcare administrators to run practices, hospitals and other institutions with an eye towards best business practices. 
 
But many physicians are in the same boat as Moffatt-Bruce: accomplished doctors with no head for business. 
 
"These folks have often got to to the top of their professions by being good physicians or good surgeons, and suddenly they're being asked to run complex organizations where the business model is changing,” says Simon Peck, associate dean at the Weatherhead School of Management at Case Western Reserve University. 
 
That's why schools like Weatherhead are reporting soaring interest in executive education programs that focus on healthcare. Weatherhead has seen so much interest generated by these industry changes that it developed a new healthcare-focused Executive MBA in conjunction with the Cleveland Clinic.
 
Officials at Ohio State University's Fisher College of Business say the school's EMBA has drawn an increasing number of healthcare professionals in the past five years, and that more and more hospitals are asking for custom healthcare programs where employees can learn to navigate this new business world. And the University of Minnesota’s Carlson School of Management
also reports an increased interest from physicians in its EMBA and part-time MBA, so much so that the school is considering developing a physician-specific MBA. 
 
But business wasn't always an important aspect of the healthcare industry.
 
"Before, healthcare business was succeeding and moving forward without doing everything well. And that wasn't their fault, but other dimensions besides clinical care weren't necessarily done well," says Marty Schwalbe, managing director at Ohio - Fisher.
"Whereas one could have looked at it years ago as a social service that was provided by people who really cared about other people and their health and well-being, it's gotten a lot more complex."
 
Indeed, Obamacare has transformed many aspects of the American healthcare system. It afforded patients more control over health decisions and more rights in terms of dealing with insurance companies. It expanded access to preventative care, changed how physicians receive Medicare bonus payments, and encouraged the use of electronic medical records. It heralded the end of health insurance discrimination based on pre-existing conditions. 
 
These changes have affected nearly every aspect of doctors' practices, including how they operate, how they're compensated or reimbursed, what's expected of them in terms of patient experience, and how they do their work, Schwalbe says.
 
To navigate these changes, one of the most important skills that physicians must learn in these short executive education programs or longer EMBA programs is leadership. 
 
“We need to train physicians as managers, so that can command the respect of nurses, allied health professionals and other technicians,” says Steve Parente, associate dean of MBA programs at Carlson.
 
“It's best to do the whole MBA program," Parente says, but shorter programs like Carlson's Medical Industry Leadership Institute Certificate can help participants get the "education that they need to get them out of the myopic view that they've had of just managing their own practice.”
 
For Ohio State’s Moffatt-Bruce, the dawn of Obamacare meant a new leadership role. Prior to 2010, Moffatt-Bruce's duties revolved around clinical cases and research. But after Obamacare passed, her colleagues at Wexner realized they needed someone dedicated to implementing quality care. 
 
Moffatt-Bruce assumed a new role, Chief Quality and Patient Safety Officer and Associate Dean of Clinical Affairs, but she quickly realized she needed to develop more business skills. She started Fisher’s 12-month long Master of Business Operational Excellence in 2010, and this year enrolled in the school's EMBA program.
 
She says her education has taught her financial acumen, organizational skills and process improvement skills. 
 
"These are focused training efforts that are absolutely key and give us skills that we do not garner during any of our basic science or medical training," Moffatt-Bruce says. 
 
Carlson’s Parente says he sees students at his school who are also interested in learning about strategy, marketing, and communication to consumers—skills that are also not taught in medical school. 
 
Part of the motivation for this business training is to further physicians' medical practices. 
 
“Physicians who come into the executive education program realize tomorrow isn't going to be at all like yesterday, and that they need to be out in front,” Schwalbe says. “They need business expertise and education in order to have them take on that administrative role and to help guide the physicians' group forward." 
 
But although physicians may want to improve their business acumen in order to improve their practices, there's also another distinct advantage to physicians developing business savvy: finding better opportunities and deals for their patients. 
 
“There are gaps in care that could cause more expensive care because people need more complex treatment, especially the elderly,” Parente says. “People with diabetes, for example, could have more complex care management. The short courses could be really helpful in learning to get as much out of the system as we can."
 
Image: "A "refusal of treatment" form from one of our ambulance services" by Jacob Windham from Mobile, USA / Creative Commons (cropped)
 
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