Managed care hasn't had much impact in Macon, Ga., but Steve Williams, M.D., is determined to get familiar with the business side of healthcare before it does.
Williams, a pediatric intensive-care physician at the Medical Center of Central Georgia, didn't enroll in a traditional master's of business administration program. Instead, in March he joined 11 other physicians, hospital administrators and professional staff in the University of Alabama-Birmingham's new master's program in health services administration.
"My goal is to remain current in both medicine and the business of medicine," Williams says. "I don't have any problems with an MBA, but that's not going to meet my needs. I am always going to be somewhat dependent on a hospital, so I need to know why the administrators have to make the decisions they make."
Alabama-Birmingham is one of a growing number of schools catering to physicians and other healthcare workers by setting up business and management programs just for them.
Using research gathered by the American College of Physician Executives of Tampa, Fla., Modern Physician found at least 21 other universities offer special business, administrative and management master's programs geared toward healthcare professionals. Most programs were inaugurated within the past three years as managed care loomed as an ever larger presence.
Classes fill up quickly. The graduate program in medical management at New Orleans-based Tulane University has grown to 84 physicians in 1997 from seven in 1995. Physicians taking ACPE courses nationwide earn Tulane graduate degrees by taking 36 hours of classes designed by the ACPE and taught by Tulane's faculty.
ACPE spokesman Chris Platz says his group is trying to get more colleges to link with its program, which currently has 2,600 physicians enrolled in sites across the country.
Boston-based Tufts University annually allows 15 of its medical students to concurrently earn their MBAs; 200 have applied for spots in next year's class.
At the University of North Carolina, Chapel Hill, 25 out of 85 students in the department of health policy and administration master's programs are physicians, up from fewer than five in 1992. "The combination of an M.D. and an administrative degree is very potent now," says James Porto, director of the university's executive master's program, which serves part-time students.
University of North Carolina's 50-year-old health administration program is the oldest such healthcare management master's program in the country. The program has graduated 2,661 students.
Other medical-related graduate degrees are being spun out of existing MBA programs.
"We had a large contingent of physicians in our executive MBA program, and that's what helped inspire this," says spokeswoman Nancy Belt of Washington University in St. Louis, which in August will premiere its 60-student healthcare MBA program. "We've had applicants from 13 states and Canada."
Universities have different ideas about how to make themselves stand out from MBA programs. For example, Washington matches a physician with a nurse, pharmacist and hospital administrator so all can learn what the others' roles are in healthcare delivery. Other universities try to limit on-campus time so physicians don't have to give up their practices to attend class.
"Traditionally, MBA programs are tied to full-time programs, which has been one of the difficulties (for physicians)," Platz says. "That's why we're seeing a lot of new programs tailored to physicians. You can schedule your courses over the course of a year."
Alabama-Birmingham's program consists of seven eight-day sessions spread over 19 months. That makes it accessible for Williams, who must make a 200-mile trip from Macon.
Williams says he spends 80 hours in class during each "intense, grueling" session. "I'm using up my vacation time" to go to class, he says. Between sessions, Williams says he has research assignments that take at least four hours per day.
But that grind isn't stopping physicians from signing up for classes.
Belt says she sees four reasons why physicians are looking at Washington's healthcare MBA and similar programs:
One group wants to learn how to better manage their practices; another group is interested in becoming executives; others wants to know how to evaluate managed-care contracts and buyout offers; and the final group wants to know how to invest in healthcare ventures.
Patrick Noonan, director of the MBA program at Emory University's Goizueta School of Business in Atlanta, isn't so sure specialized programs are necessary for the physicians Belt describes.
Noonan says that despite the business school's location, within a two-block radius of Emory's medical school, the Centers for Disease Control and Prevention, and the American Cancer Society, it has no immediate plans to start a specialized MBA program for physicians.
Atlanta physicians who want to attend a local healthcare MBA program must go to Kennesaw State University, most famous as the host of House Speaker Newt Gingrich's ethics-violating political science class. Kennesaw State, which has no medical school, has offered a healthcare MBA for the past two years.
Noonan says the basic business knowledge physicians need is in the traditional MBA program, and traditional programs also give doctors an opportunity to study with professionals outside healthcare.
"No one would think about setting up a forest products MBA," Noonan says. "I'm not sure there needs to be any tailoring of content. You're already dealing with professionals in all sorts of industries (in the classroom), and that's different from a program that takes 22-year-olds. You don't set up a separate program for the grownups and the kids."
However, Emory has discussed separating the physicians from the rest of the MBA students, Noonan says.
"You're really at the intersection of two professions," he says. "You already have someone trained in a different profession where there's very little overlap (with business) in the training they've received. That's where the argument comes in that physicians need something special."