Like many of his fellow physician-executives, Michael Perry, M.D., moved into a management role almost by accident about five years ago, when he was recruited in May 1999 for a job as chief physician officer at Freeport Health Network in northwestern Illinois. At the time, Perry's admittedly slim background in management consisted of "a single summer business course my entire career."
Since then he's made up for lost time, earning more than 150 hours of continuing medical education in subjects such as accounting, human resources, finance and marketing through the Tampa, Fla.-based American College of Physician Executives. He topped off that business background in March 2002 with an intensive, 4?-day educational and testing program designed to replicate the rigorous process that physicians undergo when they seek board certification as specialists.
For Perry, his status as a certified physician-executive highlights a "very steep learning curve" that began with that first managerial role six years ago this month and culminated in a rapid ascent at Freeport Health, where his comparatively modest beginnings as chief physician officer ultimately led to his recent appointment as the system's chief executive officer. Perry, who opted for the ACPE's management-training program and certification plan rather than the more traditional route of a master's degree in healthcare administration or MBA, will take the network's top job on Jan 1.
"I liked the idea of being taught by physicians," says Perry, who is now the system's executive vice president. "An MBA is a more generalized degree, more theory. The certified physician-executive program is more practical, more down-to-earth. The CPE is pretty much the capstone of everything you've ever learned -- it puts it all together."
Perry, a 53-year-old family-practice physician, is one of only about 980 doctors who have earned their official stripes as certified physician-executives, a program the ACPE launched eight years ago. Along with identifying rising stars among physicians and verifying their skills and knowledge, it was intended to provide some impetus to the idea of eventually creating a medical specialty in physician management.
"We'd like to think it's an elite group," says Marvin Kolb, M.D., a CPE who is vice president of medical affairs at St. Michael Hospital in Milwaukee and president of the ACPE. "I would think that as recruiters and organizations look increasingly to physicians for leadership roles, this (certification process) demonstrates their commitment to education, training, experience and competence. It's a way of saying this individual is really committed to education but also has a track record of results and experience."
For now, the titles are bestowed by the Certifying Commission in Medical Management, a not-for-profit ACPE affiliate. Down the road, if the ACPE has its way, the certificate will one day be the equivalent of a board certification for doctors in management, essentially a new medical specialty for doctor-administrators.
Whether that happens -- and it's a long shot -- the CPE designation has definitely developed a newfound status along with some signs of increased interest from would-be doctor-executives. The ACPE says it was approached about the program by U.S. Surgeon General Richard Carmona, M.D., who has extensive experience in management and administration. His resume includes stints as a chief medical officer; CEO of Kino Community Hospital in Tucson, Ariz.; and director of the public health system in Pima County, Ariz.-a job from which he was forced to resign in 1999, about 18 months before his contract ended, after criticism from government officials about a mountain of debt.
But Carmona did not have to attend the CPE sessions to win his latest accolade-he was granted a certificate based upon his background alone. It was presented to him when the ACPE gathered in late May for its annual meeting in Boston, where Carmona spoke at an induction ceremony for fellow CPEs. "He was already so experienced in this field that we told him we would be honored for him to be a CPE," says Barbara Linney, vice president of career development at the ACPE and the administrator of the trade group's Certifying Commission in Medical Management.
Physician-executives have come a long way in recent years. It once was a term used to describe doctors who somehow -- often as a result of coincidence, inertia or factors far beyond their own control -- found themselves thrust into a managerial role at a hospital, medical group or clinic. The narrow definition has expanded in recent years, encompassing an array of positions -- including president and CEO -- as more and more physicians gravitate toward managerial posts in response to the hassles of managed care, stepped-up government regulation, lifestyle issues and decreased reimbursements.
Considering the heightened interest in advanced degrees, certificates and the prestige that comes with an alphabet soup of titles after a surname, a diploma in physician management was almost inevitable. It's also a solid source of revenue for the ACPE, which charges $2,200 in tuition for a program that lasts for just more than four days.
Of course, it's sometimes difficult to gauge the true impact, or prestige, of this kind of a certificate program, no matter what the prerequisites. In other words, what is the true value of a program of this type? Is it just window dressing, another official-looking piece of paper to frame and place on the office wall with all the rest of the plaques, honors and awards?
"It's like going to any continuing education program," says Errol Biggs, director of graduate programs in health administration at the University of Colorado at Denver. "It's obviously not a degree but a certificate."
On its Web site, the ACPE says, "For the physician-executive, board certification in medical management can be the key to success in today's competitive healthcare environment. CPE certification can be a valuable credential that can help you advance your career, enhance your credibility and attain the satisfaction of reaching a major achievement."
The promotional material on the Web site suggests that the Certifying Commission in Medical Management is identifying and certifying physician-executives who "have reached a level of excellence within the medical management profession." It also points out that the program focuses on tutorials that allow participants to "practice management techniques in front of a video camera" to evaluate communication skills.
Linney acknowledges that the real learning by these newly minted physician-executives occurs long before they kick off the certification program on a Sunday afternoon with a discussion of communications strategies and a seminar on "career assessments." Each participant, she says, must be a licensed M.D. or D.O., hold a board certification in a clinical specialty and have either a graduate management degree or 150 hours of management education, including courses in health law, financial decisionmaking and marketing.
She says about 60% of all CPEs have some type of a master's degree in management -- such as a master's in public health, business administration, medical management or hospital administration. The rest have accumulated the 150 hours necessary for admission into the program. A credentials committee must approve the individual for participation.
Not all of the sessions are intellectually demanding. In some ways, the program seems more like career counseling for ambitious executives, with seminars on topics such as negotiating salary and networking.
On the final day, each candidate makes a five-minute presentation to an assessment panel, describing "their medical management skills and accomplishments" and demonstrating their "effective presentation skills," according to the ACPE's Web site. After the videotaped session, panel members judge the candidates based on their communication skills, presentation, responses to questions and knowledge of "medical management education resources."
Linney says "5% or less" of the candidates are deferred, or fail to receive their certificate. Those individuals are given the opportunity to resubmit a video or re-take the written test that covers nine core healthcare management courses.