Every Saturday morning, 27 physicians from around the country grab a cup of coffee, find a comfortable chair and settle down in front of their computers. They're not checking their e-mail or reading a recent journal article--they're earning their MBAs online.
As participants in the Physician Executive MBA program offered through the University of Tennessee at Knoxville, they are among a growing number of physicians earning business-related degrees via the Internet.
According to the American College of Physician Executives, about 25 graduate programs across the country offer business degrees specifically geared for healthcare professionals. Though no one tracks the exact number, at least six function, for the most part, online.
But other than sharing online status, the programs vary widely in price, time, credits required, degrees offered and forms of online or "distance" education.
The UTK program was established in 1998 in response to feedback from physician focus groups. Director Michael Stahl, who refers to the program as the most stimulating of his career, says physician executives were very clear about their needs. Stahl is distinguished professor of management at the school.
"The physicians wanted an accredited MBA (program) that didn't take longer than one year, was for physicians only and required no more than four weeks on campus," he says.
As Stahl and other professors tried to figure out how, given those restraints, students could accrue the 600 contact hours necessary to complete the class work, they realized the answer was distance education.
"We did not decide to emphasize distance education because we're technology geeks," Stahl says, "but because distance education provides the value the physicians said they wanted."
The foundation of the program is the three-hour Saturday online class, which provides real-time two-way audio, video and data transmission.
Students can ask questions during class, and, often, professors break the class into small groups, sending students to private areas on the Web site to work together on different problems. There, they can talk to one another and develop presentations that they later deliver to the rest of the class.
Assignments are posted on a Web site and can be accessed 24 hours a day.
Students spend four weeklong residency periods on campus, one before each quarter. The in-residence time is important, Stahl says, because the opportunity for students to meet one another and work face to face enhances their learning.
While they're on campus, physicians spend at least eight hours a day in class, hours that provide an introduction to the work they will cover in the coming quarter. There also are optional evening sessions that address problems associated with distance education, such as the need for better computer skills.
Tuition for the program including classes on campus and meals, but not lodging, is $40,000.
Alan Lassiter, M.D., CEO of Cook Children's Physician Network in Arlington, Texas, says the UTK program is giving him a working knowledge of business principles and the credentials he needs to fulfill some of the unexpected demands of his job.
"From the fifth grade on, I always wanted to be a physician at the bedside of a patient," he says. "But when I (became) medical director at East Tennessee Children's Hospital, I found I loved the administrative work."
Though the children's hospital is in Knoxville, the physician MBA program was not up and running until after Lassiter moved to Texas. In lieu of an MBA, he took more than 300 hours of continuing education courses in Knoxville in an attempt to get up to speed in the business world.
"I've found that you have to be able to speak their language when you go into a room of businessmen, (and the UTK program has offered an opportunity) for me to get the formal training I need to do that."
Lassiter, who views the program as a combination MHA and MBA, says he spends an average of 30 to 35 hours a week participating in class and completing the homework.
Initially he was skeptical about whether distance education could be effective, but he found his focus and concentration increased as a result of the need to keep his eyes glued to the computer screen during class.
As for the many hours he puts in, he says there's no question that it's time well spent.
One of the oldest executive master's programs geared for physicians is the two-year master's degree in administrative medicine at the University of Wisconsin at Madison. It was established in 1977. Beginning in 1988, the degree was first offered via distance education in the form of videotaped lectures. Since then, the distance component has evolved to include teleconferencing and the Internet.
The program is housed in the university's medical school rather than the business school to ensure it retains a clinical emphasis, says Brent Nelson, assistant director. Students are required to come to campus for one week at the beginning and end of each of the program's four semesters.
Nelson says much of the distance learning for the program is conducted through a weekly teleconference during which the discussions center on topics first introduced on the program's Web site. The site houses the reading syllabus for each course and files that students can download. The university is in the process of evaluating the use of audio and video over the Internet.
Tuition for the program is $31,200. Like tuition at UTK, it covers all but lodging while students are on campus. Forty-five students are enrolled in the program.
Lee Newcomer, M.D., chief medical officer and senior vice president for health policy of United HealthCare Group, Minneapolis, is a 1990 graduate of the Wisconsin program. His interest in the program was sparked by the frustration he was feeling in the late 1980s about the lack of coordination and communication among doctors, hospitals and payers. His lofty goal was "to improve the entire healthcare system.
"I realize that medicine has become a business," he says, "but we have to understand the unique elements (involved) in delivering medical care. I didn't think I'd get that from a regular MBA." Newcomer sees the degree as a hybrid of an MBA and an MPH.
Like Lassiter, he found the commitment of time, and also money, to be a potential obstacle to participating in the program, though a "good screen for intensity of commitment."
One solution he recommended to the university is that it offer a nondegree "light" version of the program for physicians who are unable to participate now but want to develop better business skills.
Another option for healthcare professionals who are looking to build skills but have less time and money to commit is the distance education program offered by Regis University in Denver. To earn an MBA, students complete 10 eight-week, three-credit courses, which are offered online six times a year. There is no on-campus requirement, nor is the program geared specifically toward healthcare.
In addition to the online interaction between professors and students, the courses are supplemented by lectures on videotape and audiotape. Though students are given a year to complete the program, because each course is offered repeatedly, they can choose to interrupt their studies for a couple of months and still meet the year deadline.
Tuition for the Regis program is $10,350. Of 800 students currently in the program, about 20 are physicians.
Aaron Levine, M.D., a Regis graduate, is medical director of the rehabilitation program at Houston's Memorial Hospital. He says that while he missed the direct contact with students and faculty that a residency program would have offered, he was willing to forgo it in exchange for not having to spend time out of town, away from his four children.
Despite his own enthusiasm for the program, he says distance education may not be a good fit for everyone. "Some people don't do their best work in writing," Levine says. "Plus you miss the spontaneity that's possible (in a classroom setting) and the opportunity to read body language."
Levine has mixed feelings about the fact that the program draws candidates from a variety of professions: "In the hospital dining room I only talk with people like myself and I miss what's going on in the real world. This (program) gave me an idea of what people in other situations have to face, and it allowed me to learn the language of business."
Yet he admits he wishes the program had focused more on healthcare issues, such as managed care, and less on finance and accounting. It would have been useful, he says, to have had access to electives that would have filled those gaps.
Apparently his response is not unusual; a physician-only MBA program is now in development at Regis.
John G. Hope is an Oakland, Calif.-based writer who specializes in healthcare business topics.