Board certifications in four medical fields testify to the clinical skills of Frank Byrne, M.D. But what the 47-year-old hospital president says he really needs to perform his job at a higher level are business concepts that all the medical degrees in the world can't give him.
So, after sampling business courses at the University of Michigan, Byrne, head of Parkview Memorial Hospital in Fort Wayne, Ind., immersed himself in an executive degree program offered jointly by the American College of Physician Executives and Pittsburgh's Carnegie Mellon University. He received a master's in medical management earlier this fall.
Byrne is part of a new and rising trend in healthcare: With the increasing demand for physician leaders, many doctors are seeking management degrees and business acumen to supplement their clinical experience. Some, like Byrne, are already leaders or intend to be. In other cases, practicing doctors just want a better understanding of the business issues their organizations face.
Universities say physicians' interest in business degrees is skyrocketing, particularly for executive-type programs that let them continue working.
One sign of that interest is the burgeoning number of executive programs concentrating on healthcare. Of the 24 programs with a healthcare focus identified in the accompanying chart, just eight are at least 10 years old.
For example, the University of Missouri has offered a master's of health administration since the 1960s but in an executive format only since 1991. "The executive mode is where the demand is," says Keith Boles, associate professor in the program.
Physician interest is well-founded. "There's a lot of value in combining a clinical background with an understanding of managed care, negotiating and the business side," Boles says.
Executive programs require physicians to be on campus only at certain times during the year. Typically, this might be every other weekend or for a handful of 10-day sessions throughout the course of the program. As a general rule, programs with shorter and less frequent on-campus sessions will involve more distance learning, which can take a variety of forms, including video-conferencing and online lectures.
Another option for working physicians is evening classes. While that reduces travel costs, it can require an increased time commitment and limit their choices to local programs.
Attaining an advanced degree while working full time isn't easy. During the last year of his program, which is the most intense, Byrne spent five to 10 hours a week listening to lectures on CD-ROM and completing assignments for distance-learning classes. He also attended a three-week session at Carnegie Mellon.
Despite the burden, Byrne says he would do it all over again. "I use the tools I learned in this program virtually all day, every day," he says.
For example, a class on negotiations has helped Byrne work on contract issues in a more collaborative manner with physicians and health plans. He used analysis techniques taught in a markets and competition course to decide to go ahead with a satellite hospital.
Charles Hankins, M.D., who recently completed the executive program in business administration for physicians at the University of Tennessee, says he is making good use of his new education, too. Hankins still practices neonatology full time in Memphis, Tenn., but he also has done some consulting work for hospitals since completing the degree. Hankins says queuing programs, used by Disney World to control the flow of visitors through lines, have applications in healthcare.
"These programs have real use in predicting the peaks and valleys in patient care," he says. "Knowing average lengths of stay and knowing admission rates in a population, you could use a queuing program to adjust your staffing."
Now that he has an MBA, Hankins says he someday might step into a full-time administrative role. For the meantime, he is happy taking care of patients.
For most physicians, the purpose of getting a management degree is to advance their administrative careers, says Roger Schenke, ACPE executive vice president. "In management, it matters what you have built, created or managed before," Schenke says. "What education does is help you build a track record."
At $10,000 to $54,000, degrees don't come cheap. Schenke suggests doctors take a few business courses or seminars first to make sure a degree is what they want.
Some may find they don't need to go on to get degrees, while others might consider a degree essential.
Boles of the University of Missouri advises physicians to talk to graduates of a program they're considering and check out at least three before applying.
The array is mind-boggling. Even when the ACPE concentrated on listing only programs with a healthcare focus, it still found an array of different degree names. But often, the specific name of the degree awarded doesn't reflect significant differences in course work, Schenke says. The quality of courses will vary program by program anyway. Course descriptions are generally available on the university's Web site.
Programs will emphasize the distinct advantages of their format. For example, Michael Stahl, program director at the University of Tennessee, argues only an accredited MBA really equips physicians for the variety of leadership positions they may accept.
Other program directors say the degree name doesn't matter. "Our MHA equates to an MBA," says Gary Palmer, associate director of the executive master's programs at the University of North Carolina-Chapel Hill.
The accompanying chart, based on ACPE and Modern Physician research, lists several executive and part-time degree programs that have a healthcare focus.
Many universities also offer standard MBAs in an executive or part-time format, and some physicians choose those over healthcare-specific programs. The "Official MBA Guide," at www.mba.us.com, provides links to MBA programs nationwide.
Generally, experts recommend that physicians select programs with a healthcare focus if they plan to continue working in the field. Professors will use healthcare case studies to illustrate the concepts they teach, as well as examples from other industries.
Byrne has taken both healthcare-focused and general business classes. He says he found value in each. In the general business classes, Byrne said it was enlightening to study other industries' solutions, particularly for service. At Carnegie Mellon, he felt the all-physician class introduced him to a peer group with a deeper understanding of his own problems, and, perhaps, solutions.
Physicians also must decide whether to enroll in programs designed specifically for physicians or programs that draw from a variety of healthcare backgrounds.
Advocates of the physician-only model say they can structure programs with physicians' needs in mind. Programs with the opposite philosophy say they provide a richer education because of the diversity of participants' backgrounds.
Other factors to consider are:
- How quickly do they want to complete a program? Most programs range from 2 to 2 1/2 years, but some allow physicians to take up to 10 years to finish their degrees.
- How often can they travel? Programs vary considerably in their use of distance learning. Most, however, are likely to incorporate more distance learning, using the Web or video-conferencing, as technology advances.
- Are their business partners and family prepared to support them? "Don't underestimate the commitment of time and intellectual energy," Byrne advises. "It will have an impact on other areas of your life. That said, the return on investment is outstanding."
Lisa Scott is a Chicago-based freelance writer who contributes frequently to Modern Physician.