December 2000 Bulletin

Doctors eye MBA to compete

Some say business degree is worthwhile; others disagree

By Sandra Lee Breisch

After years of practicing medicine, many orthopaedic surgeons get the urge to obtain an advanced business degree such as a Master in Business Administration (MBA).

Their reasons: to gain autonomy, better position themselves at the managed care bargaining table, financial rewards, new business opportunities, or simply to maintain status quo in their practice.

And the enormous commitment of time spent away from their practice and family, money and other personal sacrifices doesn’t deter them.

For Laurel D. McGinty, MD, the realization that she needed an MBA came after being in practice for five years. "Although I had all of this science training—a masters in molecular biology, completed an orthopaedic residency, hand fellowship, it just became increasingly obvious that I had no courses in even basic business, accounting or economics," recalls the 45-year-old Albuquerque, N.M. orthopaedist. "And when speaking with people in the business world, well, I didn’t even understand their language and their thought processes. So, professionally and personally, I felt I needed to know about this huge area of the world that I was unfamiliar with."

In the fall of 1996, while practicing full-time, Dr. McGinty dedicated her evenings and weekends to complete a "very costly" MBA in two-and-a-half years at the University of Phoenix.

The payoff: she is chairman of the department of orthopaedic surgery, hand surgery and podiatry at the Lovelace Medical Center, a multi-specialty clinic of 250 physicians in Albuquerque, N.M.

Yet, more credentials didn’t bring Dr. McGinty a fatter paycheck. "We’ve got the lowest reimbursement rate for Medicare in the country," she explains.

Dr. McGinty’s financial situation—in light of her costly MBA—is not an isolated case.

"That’s because there’s no pot of gold there," explains Robert J. Cimasi, a health care expert and president of Health Capital Consultants, St. Louis, Mo. "The vast and overwhelming majority of available jobs that require orthopaedists to get a business degree will probably not bring them the types of professional satisfaction that they went into clinical medicine for in the first place," he says. "I’ve seen many orthopaedists say, ‘I’m fed up with being beaten up with the business end of medicine. I want to get an advanced degree so I can better deal with this or make a change in my career.’ And even if the degree does help them make a change, when they get over to the other side they may find it’s not what they’re suited for or why they went into medicine in the first place."

The job prospects for specialists in their 50s and older who’ve earned an advanced degree aren’t so great. In fact, they’re "complicated," says Gigi Hirsch, MD, founder/chief executive officer, MD IntelliNet, LLC, a Boston, Mass. consulting and placement firm. "Physicians are viewed by the business world as people who are very good at collecting academic degrees, but they have very little real world experience and street smarts," she explains.

Before physicians make any decisions, Dr. Hirsch suggests a career consultation and networking with other physicians who have obtained an MBA and are now working outside of the academic arena. She stresses that "it’s a very, very smart thing to do—not only because it helps you decide whether or not to get one, but it also helps you get more bang for your buck by helping you know how to focus some of your activities as a student."

That’s exactly what Ward S. Oakley Jr., MD, did. He chatted with his colleague, Robert H. Haralson III, MD, who in 1998 completed a one-year Physician Executive MBA Program at the University of Tennessee’s Knoxville Campus. Then, last January, Dr. Oakley enrolled in the same program. The $40,000 program is designed for "physicians only" and emphasizes management skills in a health care context. He will become an MBA graduate this month.

But age also played a factor in Dr. Oakley’s decision. About to turn 50, he felt it was a time when he needed to expose himself to something different—but something not outside medicine. "I don’t really know if I’m looking for a major change in occupation, although you never know what may happen," he says. "But as I age, I look at the next 10 to 15 years when I might be called upon or be obligated to move in the leadership position both in the hospital and in my community. I thought this type of educational exposure would help me in those areas."

Dr. Oakley says, "I learned how bad a business person I’d been in the past." But now he’s says he’s familiar with the financial aspects of running a business, creating business plans for projects and understands the importance of cash flow and net present value. "There’s also these little catch words that business people use and doctors are not always familiar with—that I understand now," he says.

Dr. Oakley noted that the MBA program gave him a better appreciation and understanding of customers and how to satisfy their needs.

And Dr. Haralson sings similar praises about the program.

"Physicians ought to do it [get an MBA]," he says. "I think when physicians deal with policymakers such as government, legislators, insurance companies, managed care organizations, well, we’re speaking a different language. And we don’t understand their language or ethics, which is definitely different from physicians’ ethics. As a result, they’re taking advantage of us. By going through this program, I’m now able to deal with these people better because I understand their language and where they’re coming from."

"Tough—but worth it," says the 62-year-old orthopaedist who since formed a 34-person orthopaedic group in Maryville, Tenn. "I just wish I’d done it 20 years ago."

According to Cimasi, some of the most successful orthopaedists, in terms of business entrepreneurs, "don’t have" any advanced business degrees. "These folks have been able to apply to business the same discipline of learning that it took to become an orthopaedist," he says. "They found that business required the same skill sets, the gathering and careful analysis of data and research; the ability to weigh options and make informed decisions; and the will to act. These skills—so vital in clinical medicine—are universally recognized as respected, powerful and valuable tools in the business world, if they can learn to apply them. I’m not certain if most of these MBA programs out there have found any magic key for doing that."

Perhaps a more tailored advanced degree curriculum for physicians to consider is the Master of Medical Management degree (MMM). It’s designed to build expertise in managerial competence for physicians working in a managed care environment.

So believes Allan D. MacKenzie, MD, who earned a MMM at the Tulane University Medical Center in May of 1999. It took him three years and cost him $35,000. He also found that many of his colleagues who had an MBA were enrolled in this program. "My degree is even better than an MBA because an MBA focuses on all businesses—dry cleaners, garages, grocery stores," he says. "Today, we have to focus on and learn more about managed care, health maintenance organizations, physician practice organizations, medical management corporations—basically, know all of the elements that make up the competitive medical environment, in great detail."

"I learned from 1979 to 1995 that even if you’re going to take on the HMOs, you really need a third degree—you need an MBA, MMM or a Master in Health Policy degree," he says. "That’s the only way to compete because every fraction of every cent in a capitation contract is the difference between success and bankruptcy."

Today, he is executive medical director of the Industrial Medical Council for the State of California.


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