Friday, March 18, 2005

HealthLeaders Magazine: Do MDs or MBAs Make Better Leaders?

My belief is that physicians with appropriate cross-disciplinary expertise make better leaders than MBA's (in informatics, computer personnel) with unidisciplinary backgrounds.

Excerpts from the article:

When David B. Nash was applying to medical schools back in 1976, he informed admissions officers that he was interested in pursuing a business degree as well as a medical education. Big mistake.

Most scoffed at the idea. His colleagues ostracized him, and Nash eventually learned to keep his mouth shut when it came to the topic of business. More than 25 years later, much has changed for Nash and other physicians. No longer a pariah, Nash holds both an MD and an MBA, and is a leading advocate for combining medical and business education as chair of the Department of Health Policy at Thomas Jefferson University in Philadelphia.

The concept of the physician executive, meanwhile, has migrated from the fringe of healthcare to its core. Today's physician leaders are seen as key players in the ongoing effort to reinvent the struggling healthcare system.

This transformation of the physician executive from outcast to savior reflects a widespread belief that doctors bring vital skills to the executive suite. For one, physician leaders are more connected to the daily grind of healthcare. From a clinical perspective, they know what needs to happen. And perhaps most importantly, they have an automatic "in" with the prime moneymakers: their fellow physicians.

That being said, are physicians better suited for the corner office? Or is the MBA, whose sole career has been focused on the business side of healthcare, better positioned to run a healthcare organization in today's complex financial environment?

"Physicians have blood under their fingernails," says Roger Schenke, executive vice president with the American College of Physician Executives, an organization focused on physician-executive education. "They understand the product, they understand its delivery and they know what it's like sitting across the table from the customer. They also understand the way other physicians think. Do these attributes make them good leaders? Not necessarily. But they certainly can help."

Many industry insiders agree that physicians who receive rigorous financial and leadership training, either via an MBA program or through any of the myriad other educational opportunities available today, are just as qualified to lead healthcare organizations as their gray-suited brethren.

... there has been a substantial increase in the number of physician executives in hospital positions other than the CEO, from the chief medical officer down to the senior managerial level. "What's happening is that there is a building-up of physician executives who will be qualified to lead the hospital, so I would expect we'll see the overall number of physician CEOs trend up from here ...

... Hands-on clinical experience also is a major asset, according to Cropp of Independent Health. "Knowing what takes place in the interaction between the patient and the physician, having an understanding of what happens in a microsystem like a physician's office and what happens within the have a better feel for where the opportunities for improvement really do lie."

... the best physician leaders understand what all good leaders come to realize: Leadership is a "team sport." This is particularly true in healthcare, given the exponentially increasing complexity of the industry, he says. "Physicians can bring value to leadership roles, but we also need to be cognizant of and understand the skills that other members of the team bring," he says. "Just as I wouldn't think of practicing medicine without competent nurses and other clinicians, I also wouldn't think of fulfilling the role I'm in now without a talented financial staff or human resources team."

Schenke, with the American College of Physician Executives, says he's not aware of any studies that have attempted to quantify the performance of physician executives. Nonetheless, 30 years in the industry has given him a few insights. "If you think of the most respected, trusted healthcare organizations in the country-Mayo, Cleveland Clinic, Mass General, Johns Hopkins-you find a physician leader at the heads of those organizations," he says. "That doesn't mean that one necessarily has to be a physician to be a good leader of a respected institution. But there is ample evidence that physicians are doing a good job."
Message to healthcare MBA's without scientific or medical backgrounds regarding this growing trend: if you want to play doctor, you need to go to medical school.
-- SS

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