The rise of the MD/MBA: Should spine surgeons go for it?

MDs spend years in medical school, residencies and fellowships focusing on clinical training. They become experts in their specialty and subspecialty — ready to provide excellent clinical care — but in today's changing healthcare environment, opening an independent practice isn't easy; keeping it open is even harder.

The "pros" for entering an MBA program include:

•    Acquiring business strategy that could help with career advancement and money management;
•    Applying customer-driven techniques for patients to grow your business;
•    Opening up new opportunities to engage with healthcare companies, policy and innovation.

The "cons" for entering into an MBA program include:

•    Additional time spent away from clinical practice, family and research;
•    The programs come at a steep cost when you're already taking time out of your practice to attend;
•    Business school isn't a silver bullet; just having the degree doesn't mean you'll succeed.

A growing number of surgeons are looking toward MBA programs to give them the tools they need to run an effective business. But, after spending so much time and resources in medical training, is another degree worth the effort? Especially as healthcare trends toward consolidation and physician employment, does it make sense to pursue a business degree? Or would it be better to hire outside experts to manage the business-side of the practice?

"Three years after I graduated from medical school I went back to school and got a business degree," said Michelle Mudge-Riley, DO, in a KevinMD post she penned. "However, going back to school requires a huge investment of time and resources that many of us are already short on. Most of the skills needed to succeed in the corporate world are already inherent in a doctor or cultivated by the discipline, dedication, drive and desire it takes to become a doctor. The business degree alone isn't going to put you on the fast track to success."

But the Patient Protection and Affordable Care Act has prompted many physicians to flee toward executive MBA programs to prepare for new regulations, leadership roles and building a business that can stand apart from large hospitals and health systems. The business training may also help physicians provide a better patient experience. Patient satisfaction is increasingly important with payers paying more attention and physician rating websites on the rise.

"Entrepreneurs have to know how to navigate with the desire of payers to hold down prices and control uses in healthcare," said Maria Y. Chandler, MD, MBA, in a New York Times report. "They have to know how to please pointy-headed bureaucrats. This is going to be one of the survival skills in the future in healthcare."

Physicians can complete the part-time executive MBA programs designed for working professionals and managers, including MIT's Sloan School of Management program — mentioned in a Kaiser Health News report. Some medical schools are now offering seminars on healthcare business and policy principles as electives, which fill up quickly. Around 50 percent of medical schools now offer joint MD/MBA programs and healthcare-specific executive MBAs.

At UC Irvine, the number of healthcare executive MBA program enrollees increased from 35 percent to 50 percent in recent years, but only 5 percent of physicians enroll in the school's general executive MBA program, according to the KHN report.

There are other reasons physicians are flocking to the business programs, too. Physicians may want to advance their careers with leadership positions, look for opportunities outside of clinical medicine and make strategic investments. Surgeons interested in research enter programs to help write grant proposals or find other ways to fund their projects and manage money, according to the Times report.

Additionally, healthcare is becoming more consumer-driven, with patients paying more and seeking the best value for their care. Business schools can help physicians make the leap from clinical excellence to providing customer service by applying lessons from other industries — such as the airline, restaurant or tech fields.

Business expertise can also help spine surgeons interested in device innovation and invention. With increased regulation on medical devices and huge oversight on the relationship between device companies and spine surgeons, bringing a good idea to fruition is increasingly difficult without business expertise.

However, not every surgeon needs, or desires, to be good at business, and even those with MBAs aren't guaranteed success. In fact, for someone who just wants to run their practice better, an MBA may not be a good strategy.

Short business programs can give overall guidance on business principles, but the real "how to" of navigating business leadership roles is much more complex, according to a Physician Leadership blog post. Alternatives to the full MBA program include short college courses focused on one principle — such as cash flow or rate of returns — can give the required expertise without taking up too much time and money.

Distance learning with online courses provide insight, and hiring a business executive or coach can help surgeons cut through to the core of what they need in focused business strategy. In her post, Francine Gaillour, MD, wrote, "For all physicians, your ability to enter the business world — whether in pharmaceuticals, biotechnology, information technology and numerous other fields — depends more on your specific accomplishments that demonstrate business acumen or ability to solve specific business problems. The MBA is not your ticket."

So, should surgeons enter MBA programs? It depends on their goals and desired input to select the right path for their career trajectory.

More articles on spine surgery:
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Looking back: 4 spine surgeons discuss important professional lessons
First spine surgery with 3D-printed vertebral body—Will this change everything?