At one time, MDs who pursued advanced degrees in business, public health, or another field did so only to attain leadership roles in the public or private sector. However, as changing demographics, medical science breakthroughs, advanced technology, and new business trends begin to challenge healthcare providers to expand their knowledge base and skill sets, more residents and MDs are choosing to pursue non-medical advanced degrees, largely in business administration (MBA) and public health (MPH).
Explore This IssueSeptember 2019
The choice to pursue an advanced degree is not to be made lightly—degree programs are notoriously costly and time-consuming, and perhaps overwhelming for the typical overstretched resident or MD. Still, forgoing that additional education degree may come at a cost in today’s increasingly complex and competitive healthcare environment.
The decision a physician makes about additional education comes down to the available program options and to what extent the experience, knowledge, and skills gained in any one program can be applied to a healthcare practice.
MBA: The Business of Medicine
Business education is of particular value to physicians and residents who wish to serve as hospital administrators, financial managers, or consultants. However, MBAs have also become more commonplace among MDs in general, partially due to an increase in larger group practices, for which business acumen is essential.
Ron Kuppersmith, MD, MBA, an otolaryngologist and a clinical associate professor of surgery at the Texas A&M Health Science Center College of Medicine in College Station, Texas, enrolled in an MBA program at the University of Washington one year after completing his residency at Virginia Mason Medical Center in Seattle. Although the program was not focused on healthcare and Dr. Kuppersmith was the only physician in his classes, he believes that he has benefitted from that foundational business education. “The additional knowledge [I received] has been helpful when participating in the management of our practice, interacting with other entities that affect our practice, and when participating in leadership roles within other organizations,” he said.
“Interacting with other entities” is an especially salient point at a time when more consumers are demanding not only cutting-edge medical care, but also a more personalized and integrative healthcare approach, packaged in a convenient and streamlined care experience. In an effort to meet those expectations, more healthcare providers are partnering with private-sector businesses in technology, wellness, and marketing/branding, just to name a few. The ability to partner with other businesses tends to give medical practices a competitive edge.
Does an MD need to go so far as to earn a separate master’s degree to gain the understanding and knowledge required to maintain a successful medical practice? Not necessarily, said Dr. Kuppersmith, who added, “Whether or not you pursue an MBA, performance in business comes from ability and motivation. Ability is a function of aptitude and training and must be developed through self-study, mentoring, and experience. I would recommend obtaining an MBA if you are truly interested, motivated, and have the support to complete a rigorous program.”
To optimize their time and money, many medical students and residents are opting for dual MD/MBA programs, designed to focus specifically on the managerial, financial, and technical aspects of healthcare. There are a growing number of such programs in the United States—65 at last count, according to the Association of MD/MBA Programs.
On its face and certainly to the public, an MD/MBA combination might seem odd or inappropriate. Maria Chandler, MD, MBA, founder and president of the Association of MD/MBA Programs and faculty advisor of the dual-degree program at the University of California at Irvine, believes that the differences between the two worlds are what make these programs so valuable. “[As physicians] we’ve been set up to think that we know more than we do,” Dr. Chandler told Medical Economics in a 2017 interview (available at medicaleconomics.com/med-ec-blog/dissecting-value-mba-private-practice-
physicians). She cited the positive influence of the business world’s staff-focused “team culture” on the more hierarchical environment of medicine. “I would argue that an MBA makes you a better physician, because you’re using your resources to treat patients more efficiently.”
We’re actually trying to lay the groundwork for a healthcare world and jobs that don’t even exist yet…. There’s nothing wrong with the traditional, but we want our students to prepare themselves for the future. —Roland Eavey, MD
Degrees in Public Health
Current and future challenges to public health are real—and massive. The World Health Organization has identified 10 current threats to global health, including widespread antimicrobial
resistance, vaccine hesitancy, and air pollution/climate change. Breakthroughs in medical science push the edge of the moral envelope, raising new questions about ethics, privacy rights, and religion. Meanwhile, the United Nations predicts that there will be 300 million people 65 years of age and older worldwide by 2025.
Tackling such sweeping and complex challenges requires a broad understanding of how health systems work at every level, and an overall population point of view that is developed through the targeted education and training provided by a public health degree program. Professional degrees in public health include the MPH (Master of Public Health), the more academic and research-oriented MSPH (Master of Science in Public Health), MMSPH (Master of Medical Science in Public Health), and DrPH (Doctor of Public Health).
Like an MBA, an MPH is available in a dual MD/MPH degree program. Most students undergo the MPH portion of the program after completing their first or second year of medical school, at which point they select a specialization or concentration that enables them to direct their careers accordingly. Physicians with degrees in public health enter fields such as epidemiology, biostatistics, environmental health, health policy, and health administration, and social and behavioral sciences. The Association of American Medical Colleges lists more than 80 MD/MPH programs in the United States today.
Stacey Ishman, MD, MPH, is a pediatric otolaryngologist at Cincinnati Children’s Hospital Medical Center. She started her MPH program at Johns Hopkins Bloomberg School of Public Health in Baltimore just two weeks before the end of her fellowship at that institution, and did her coursework over the next two years while working as an attending physician. “My decision was made to help jumpstart my academic career,” she said. “I wanted to be better at designing studies and understanding the epidemiology and the biostatistical side of the research.”
For Dr. Ishman, the program has delivered in multiple ways. “On a day-to-day basis, it has helped facilitate my research career because I became better able to design and interpret the studies and the data I collected, which was my original goal,” she said. “The unexpected benefit is that I really understood the value of a systems- or population-level approach. And so, while my original goal was to take better care of each individual patient in my clinic, I began to realize that, by creating an evidence base to create best practices for my area of interest, my research could have far broader implications if we could create something that was a best practice for a population.” Indeed, she and her colleagues were able to create standardized algorithms to help aid and
target their treatment of pediatric sleep apnea, an area of medicine for which there is little in the way of evidence or best practice.
Recognizing the need for healthcare professionals who are prepared for a rapidly changing world, some universities have created business-related programs customized for physicians. Both Carnegie Mellon University and the University of Southern California offer an MMM (Master of Medical Management), a degree program for physicians that incorporates courses related to health policy, organizational and operational management, healthcare law, healthcare economics, and more, provided in a combination of onsite and distance-learning courses. The leadership training program in the department of otolaryngology at Vanderbilt University Medical School is another unique example (see “Building Leaders by Degree,” below). The University of Tennessee (Knoxville) has a 12-month Physician Executive MBA program, also designed with a focus on leadership.
Healthcare industry analysts predict that the U.S. population will continue to age and, as the demand for healthcare grows, so will the need for healthcare providers to handle the daily avalanche of data produced by the industry’s increasingly sophisticated information systems. The ability to analyze, interpret, manage, and apply that copious data has become an essential “hard skill” in healthcare. In this regard, a degree in health informatics gives health providers a true step up.
A master’s program in health informatics (MHI) is designed for healthcare professionals who want to learn how to optimize this incoming healthcare data, and make the best use of current healthcare management information systems to aid in clinical, administrative, and research strategy, as well as decision making. For physicians who plan to stay in clinical practice, the informatics focus provides the most direct applications, as they become able to better use data to formulate solutions for their organization and improve outcomes for their patients.
A health informatics curriculum is not to be confused with that of health information technology (IT)—a technical discipline that ventures into areas such as computer networks and processing algorithms. That said, universities do often combine the two in an overarching program. Tufts University’s master’s program enables the participant to choose between informatics and information technology tracks. George Mason University’s program offers three areas of concentration: health informatics management, health data analytics, and population health informatics.
Linda Kossoff is a freelance medical writer based in California.