More physician MBAs will only worsen healthcare's financial problems

The physician MBA may be the new paradigm for medical education, according to a Kaiser Health News article via The Boston Globe.

Among the adherents are Sree Koka, M.D., chair of dental specialties at the Mayo Clinic. A graduate of the executive MBA program at MIT, he was inspired to create a video to introduce himself to patients.

"I've come to realize that unless that relationship (with patients) is good, almost nothing I do technically is going to work well," Koka said.

Physicians are flooding MBA programs at institutions, such as MIT. Many want to obtain the kind of outside-the-box thinking they believe a management education would afford them that is not provided by their clinical training.

On the surface, a doctor who obtains an MBA makes a lot of sense. Physicians are highly competitive individuals in a profession carrying a lot of prestige and often a lot of compensation. In those ways, the MBA complements a medical degree. And since obtaining one in a part-time executive program is so much easier than completing medical school and a residency, it is likely a no-brainer for those docs who can carve out the time in their schedules.

Doctors can even take the MBA challenge while still in medical school. About half of the programs nationwide are now offering joint programs.

But I do not buy the argument that doctors are obtaining MBAs in order to connect more readily with their patients. Although Dr. Koka's intentions are noble, you achieve such connections in improved face-to-face interactions, not by posting a video on YouTube.

The MBA degree serves three specific purposes: For younger students, it's to secure a well-paying corporate job. For mid-career individuals, it's to help them continue their rise through the corporate ranks. And for those not corporately inclined, it's to allow them to start up and successfully run a business or series of businesses.

And as suggested in the KHN/Globe article, although some doctors are learning algorithms to improve the quality of care they deliver, it appears many are actually using the management tools they obtain to gain leverage against the hospitals they work for.

When Richard Baum, another MIT MBA student, observed that "you're not just sitting in a room full of doctors, but with manufacturers and shipbuilders," it is bad news for hospital finance executives.

Despite their grousing they're beholden to hospitals, doctors still almost entirely call the shots in how care is provided. Add to that the price-per-transaction savvy provided by an MBA degree, this will invariably drive up the costs of delivering care. At a time when both government and commercial payers are looking to reduce reimbursements and patients are responsible for more out-of-pocket costs, this will neither help the bottom line for hospitals nor their relationships with patients.

I'm not suggesting doctors pursue a master's in social work (a public health degree is probably more practical, and likely far more doctors possess one than an MBA). However, there is a serious disconnect between doctors and their patients, amplified by paternalistic relationships that have changed little over the decades. As a result, pricey tests with at best nominal clinical advantages are routinely recommended with little input from patients. Moreover, doctors continue to resist any linkage between price transparency, price controls, and the way they practice medicine.

The Sustainable Growth Rate formula hasn't failed because it was shoddily constructed --doctors didn't like the first payment cut they received a decade ago, and relentlessly lobbied to make sure it never happened again. Ditto to the recent investigation by the Washington Post into how the American Medical Association apparently fudged the time doctors spend on performing procedures such as colonoscopies, driving up costs even further.

Given the way physicians practice medicine in the U.S., is obtaining their MBAs going to help the healthcare system's biggest problem--epically overpriced care? The captains of industry and economists teaching these business-minded doctors would say an unfettered market will eventually decide that question. I've already made up my mind. - Ron (@FierceHealth)

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