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December 9, 2020

Does MD + MBA = happiness and success?

Dr. Christine Guico-Pabia, MD, MBA, MPH, the director of neuroscience global medical affairs for Wyeth Pharmaceuticals, was in the vanguard of physicians adding formal management training to their MDs when she obtained an MBA degree at Temple University 16 years ago. She sought the degree to complement her background in public service and saw an MBA (master of business administration) as the next step in the evolution of her career. In a 15-year career in the pharmaceutical industry since earning her MBA, she credits her degree with "shifting the way I thought which allowed me to bring in fresh ideas" combining medical and business perspectives and adding credibility with non-physician business colleagues. She singles out the value of her business training in teaching her how to position her point of view for her special interest - developing and delivering health-care technologies.

Lauren M., a 35-year old emergency room physician, wanted to return to medicine in a new role after four years as a stay-at-home mother. Two colleagues’ suggestions of getting an MBA led her to seek the opinion of an independent adviser. Discussions quickly clarified that she had no clear rationale behind obtaining an MBA, though she undoubtedly would have been accepted and prospered in such a program. Rather, she nursed a private wish to be a psychiatrist, a career option she had rejected earlier as it was her father’s field of practice. She entered a second residency in psychiatry at a .8 FTE basis to allow her meet her family responsibilities and is now thriving in the second year of her program.

Reasons to get an MBA

Whether it’s for career advancement or greater variety, many physicians consider opportunities to expand their professional roles. Daily life at the hospital or clinic exposes us to some or all of the following:

  • We are part of the health-care industry, surrounded by layers of bureaucracy and a strict regulatory environment.
  • Our institutions may employ large numbers of younger administrative persons with MBA degrees who claim to have all the answers.
  • We note that the MD/MBA combination, while uncommon, is certainly no longer rare.

Quite reasonably, therefore, many physicians ask whether formal training in business and management would open up new career options.

In mid-career, at age 47, and while serving as a chair of a neurology department, I obtained an MBA. I’ve been actively involved in physician management both before and since receiving the MBA, and after the degree in the development of startup companies and as an adviser to industry. When asked by physician colleagues about the merits and practicalities of heading back to the classroom, I say that background research falls under three main considerations:

  • Critical examination of your rationale for acquiring an MBA
  • Knowing the range of program options available to you
  • Knowing what you should expect once the program is under way

Working through these considerations will help ensure that your decision to proceed is a thoughtful, well-researched one with the greatest likelihood that this new qualification will add real value to your professional life and future career opportunities.

Examine your rationale

Drill down into your reasons to pursue an MBA:

  • What’s driving your desire for career change and development? Are these influences more a move away from some feature of your professional life or a move toward some particular goal?
  • How do you envision an MBA degree will open up new career avenues, and are there alternate routes to consider?
  • Will you be open to unanticipated "byproducts" of your MBA education?

If you elect to get an MBA degree as a way around feeling stuck or disillusioned with clinical medicine, you are short-circuiting the process of putting your career under the microscope. You would do better to examine your professional and personal options thoroughly, focus on a limited number of target choices, then decide whether or how an additional degree would be helpful. Don’t expect novel ideas about how to spend the second half of your medical career to emerge in an accounting class. Keep in mind that it is part of our professional culture as physicians to place a high value on formal qualifications. Classrooms are familiar, comfortable environments where we have already displayed the ability to succeed.

Kent Bottles agrees there is nothing automatically transforming about adding the letters "MBA" to your credentials. "There’s a tendency for physicians disenchanted with medical practice to think there’ll be a magic to getting an MBA" says Bottles, the vice-president and the chief medical officer of the Iowa Health System. Bottles has worked as an academic pathologist, a biotechnology company executive, and a CEO of a medical education and research consortium. He proposes that if you want to reinvent yourself, you would do better to take stock of what you don’t like about your current situation rather than head to the classroom.

Kevin Ruggles, MD, the chief physician executive of Rockford Health Physicians in Rockford, Illinois, holds a master’s of medical management (MMM). "Practices with strong physician-centric cultures are places where you have to prove yourself with years of clinical experience before you can ascend to management or executive roles, and where that background counts for more than an additional degree."
Kevin Ruggles, MD, the chief physician executive of Rockford Health Physicians in Rockford, Illinois, holds a master’s of medical management (MMM). “Practices with strong physician-centric cultures are places where you have to prove yourself with years of clinical experience before you can ascend to management or executive roles, and where that background counts for more than an additional degree.”

There are scores of fine business minds among physicians in every arena of health care who don’t have formal business or management training. The more you stay in the mainstream of health care and particularly with one organization or practice during your career, the less need will there be for additional qualifications. In fact, in some practice cultures, clinical experience counts more. Kevin Ruggles, MD, the chief physician executive of Rockford Health Physicians in Rockford, Illinois, also holds a master’s of medical management (MMM). He was previously a staff neurologist and a physician executive at the Marshfield Clinic in Marshfield, Wisconsin, and he says, "Practices with strong physician-centric cultures are places where you have to prove yourself with years of clinical experience before you can ascend to management or executive roles, and where that background counts for more than an additional degree."

In addition, an MBA - of itself - will not make you an expert in finance, marketing, or accounting. An MBA is a general business degree providing you exposure to a wide range of business disciplines. In this way, it’s like your medical degree. After graduation from med school, you had to pick your specialty and go through residency training, and graduates of full-time MBA programs commonly go through extensive on-the job training in the intricacies of finance or marketing after they start on Wall Street or Madison Avenue.

Physicians considering a career in industries like medical insurance or pharmaceuticals sometimes believe that having an MBA will make them a more attractive job candidate. However, it is your medical degree, specialty training, and clinical experience that remain the cornerstone of your application. If you are employed in these fields and desire the qualification, you may find that senior executives will sponsor your MBA if this is mutually advantageous.

Before enrolling, check your rationale with colleagues who already have had an MBA for several years. Ask about their original purpose for obtaining the degree, how it advanced their career progression, and whether the degree took their career in a different direction than they originally envisioned. The usefulness of an MBA "settles" over several years, making discussions with veteran holders of the degree more valuable.

In my case, I’m much more involved now in human resource issues for physicians rather than the heavily quantitative roles in health economics and finance that initially drew me to the classroom. In another example, Bertrand Liang, a neuro-oncologist by training and now the board chairman of Tracon Pharmaceuticals, Inc. and the vice chairman of Paramount BioSciences, both in San Diego, says his MBA degree "opened up worlds that I’d never have perceived." He developed particular interests in finance and corporate strategy during his training and runs a financial services group that funds biotechnology ventures.

Secure with your rationale as to the added value of an MBA, you must then choose from the wide range of program options available. Your ultimate choice will come down to a set of tradeoffs - though each style of program has its proponents, final choices are driven more by the constraints of your existing personal and professional realities, rather than there being one type of program that is intrinsically superior.Median Compensation of Physician Executives by Post-Graduate Business Management Degree and Position

While full-time MBA programs abound, part-time programs are most popular with physicians because they allow you to continue to practice. Programs may be completed at local educational institutions or at considerable distance. Of course, universities farther away have ancillary costs such as travel and hotel accommodation, and more time away from family and work. All programs include some component of e-learning, and for some (including physician specific programs) the percentage approaches 100 percent. For Liang, who completed his degree at Regis University in Denver, 80 percent of the program was e-based and allowed for flexible course duration. The greater the course duration and flexibility available, the more discipline is required to complete the training.

In addition to general MBAs, there are MBA programs exclusive to physicians as well as MBA-like degrees, such as the MMM. Most full-time MBA and MMM programs take two years to complete. Physician-exclusive programs are designed to be part time. One benefit of physician-exclusive programs is that CME may be earned while enrolled.

Charles Guernsey, DO, MBA, the medical director of Southern Michigan Pain Consultants in Kalamazoo, Michigan and an associate professor at the College of Osteopathic Medicine of Michigan State University, recently completed the one-year-long MBA program for physicians at the University of Tennessee in Knoxville. He favored a physician-exclusive program because he is focused on health care and wanted to contribute to health-care policy. With heavy practice commitments, it was also important for him to be involved in a program with "defined goals and timetables giving me structure and discipline."

The MMM degree has been available through the American College of Physician Executives (ACPE) since 1997 and involves completing programs in medical management through ACPE followed by additional coursework at one of three business schools (Carnegie-Mellon University, Tulane University, or the University of Southern California). Ruggles pursued his MMM degree at USC because "I’d already completed several ACPE courses, so it was logistically easier and less expensive. Also, I knew where I wanted to go with the rest of my career.”

A distinct plus of physician-exclusive MBA programs is the networking opportunities they present. Guernsey saw great benefit from networking, feeling he’d developed "professional friends for life" and was delighted that his program had active alumni group meetings. Other dual-degreed physicians say there are also benefits to being in programs with non-medical MBA students. Bottles says physicians "have much to learn from industries like airlines and hotels." Case studies from these industries are more frequently discussed in general MBA programs than those that are physician exclusive.

Once you have identified one or two educational programs to which you feel most suited, you must consider several practical hurdles. Evaluation of these potential roadblocks will allow you to complete your degree while sustaining your personal and current professional activities and avoid any of those "well, I never thought about that" moments.

Advanced testing and preparation

GMATs, the business school equivalent of the MCATs, will usually be waived. Program directors feel the demands of your undergraduate and graduate medical training already indicate you possess the intellectual capacity and self-discipline to successfully complete the course requirements. As a prospective MBA student you should be comfortable with e-learning and Internet usage. Knowledge of statistics, and an understanding of software programs like Excel and PowerPoint are also prerequisites. If you fail to master Excel or brush up on statistics before starting the MBA in the belief that you’ll "wing it," you’ll be sorry. The pace of learning is fast, the assignments come week after unceasing week. Don’t expect sympathy for your life as a busy physician

Cost

You should anticipate tuition costs of $40,000 to $90,000 spread over the duration of the program. This includes books and special software programs, but not the cost of particular features of some programs. Remember to factor other costs like travel, lodging, and meals, and the cost of lost income while you are not at your practice. Tuition support may be available from your employer - clarify the tax implications with an accountant as this may constitute imputed income.

Course duration and commitments

Course durations vary from one to two years, most requiring some on-campus class time. I completed the Weekend MBA program at Michigan State University’s Broad Graduate School of Management. On campus time commitments were three full weeks and 35 weekends (with 12 hours of classes from 4pm Friday to 5pm Saturday) over 17 months. Most weeks required about an additional 20 hours of self study, assignment completion and a three- to four-hour face-to-face meeting with three teammates who lived nearby. This is representative of the time commitments required at many programs around the country for students trying to get maximum value from their experience.

Intellectual challenge

While you’ll be well up to the intellectual demands of a graduate business degree, you should anticipate that some course work, especially the quantitatively intense material, will prove challenging - there may be more than one reason for economics being called the dismal science. "I was able to gain mastery of finance, statistics, and the online marketplace simulation, but only with a significant time penalty," says Guernsey. Other physician colleagues describe the challenging courses as "humbling."

Reactions of colleagues

Annual expenditures on health care within the United States may be at $1.7 trillion, but the culture of the medical profession is one still uneasy at accepting the business dimension to our patient care work.

Physicians are almost reflexively skeptical of colleagues who choose to acquire formal business or management training. I encourage meeting that skepticism head on-the best interests of both our patients and professional colleagues can be a primary driver for a physician to acquire an MBA. What’s more, the qualifications do complement one another. Your colleagues will feel affected even if their actual workload does not change. They, like our families, are entitled to know what we are embarking on, and the legitimacy of their opinions should be acknowledged. Transient discomfort in a collegial relationship is preferable to being perceived as a deceitful.

Minding friends and family

Your MBA program, however demanding, will end, but life with your spouse/partner, children, and other family and friends continues. When considering an MBA, reflect on how to integrate such a sizeable time commitment into your professional and family lives. You should seek and obtain the willing support of your loved ones before you commence the program, allow time for them throughout the course, and celebrate your completing the degree by rewarding them in some particular way.

Overall, formal business and management training offers opportunities to expand your professional role, interact more effectively with senior non-physician administrators in their practice, and advance your career in ways you may or may not anticipate. Positive returns from acquiring the degree are most likely to occur when you critically assess your rationale with the aid of seasoned colleagues and know what you (and your family) are committing to before you cross the threshold of an MBA classroom.

Ivo Drury, MD, MBA advises physicians considering career transitions. A board-certified neurologist, he practiced at academic medical centers for 26 years and has experience as a physician executive in multiple capacities.



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