Learning the business of medicine
Learning the business of medicine
Practices benefit when docs take courses
It's been said that doctors make the worst patients, and some would apply that same analogy to a physician's business acumen. But a growing number of physicians are going back to school to supplement, rather than take over, their practice's financial and management results.
One example is Glenn Lux, MD. As president of the 22-physician Pediatric Associates in Bellevue, WA, he felt that regardless of the capabilities of his administrator, he needed to have "a foot in the business world."
Lux knew that he needed to acquire some knowledge in areas that medical school and his career had not prepared him for. His goal when he started taking business courses was general - to get a sense of what was going on in medicine.
But the end results have been far greater. His new-found knowledge helped Lux form a 200-physician independent practice association, Cascade Healthcare Alliance. Those courses also led to changes within his own practice,enabling Lux to create a decentralized decision-making structure, to hold more efficient meetings, and to focus on customer care.
Advanced courses make the difference
Lux's story is not unusual. According to Howard Kirz, MD, MBA, chairman of the Seattle-based consulting firm The Clearwater Group, business learning can have a profound impact on group practices. "A lot of practices are struggling with a complex environment, trying to figure out where to steer their ships, where to find capital, who to partner with." Kirz says. "But most physicians who participate in group practice boards don't have the training they need. Those who get that training find the going much easier."
Along with courses on finances, Kirz says physicians also find courses on team building and leadership helpful to their practices. "It used to be that to have a great orthopedics department, you just needed people who could cut straight and wanted high earnings. But now, you need to have someone in charge of that department who can build a team - who knows about small group management."
Another area many physicians are concentrating on is information systems. Kirz says that much of the business of health care is, or is becoming, data driven, and the more information a physician leader has about systems and data processing, the better off the practice will be.
The best method to determine what courses you need most is to look at your own practice, Kirz says.
You can also cover topics of broader interest in this manner - for instance, patient satisfaction surveys might be a good topic for a two-hour seminar scheduled after hours. "If you want physicians to grow into management learning, it's best to use naturally occurring circumstances to get it done."
As interest grows in management learning, the largest group practices can offer longer courses in-house. For instance, Group Health Cooperative in Puget Sound, WA, offers some 30 courses per year to physicians and clinical leaders. For practices of fewer than 100 physicians, though, longer and more advanced learning will have to come from outside the practice.
Those courses should be reserved, advises Kirz, for those physicians that either have a management role now, or are expected to take on such a role in the near future.
Lux didn't start his business learning in-house, but rather went right to outside seminars, attending the Physician in Management courses put on by the American College of Physician Executives (ACPE) in Tampa, FL. (For more information, see sources, p. 121.) The college offers three such classes, each lasting a week. Lux then went on to take other courses on topics including financial decision making, management of change, and quality. "Eventually, I'll take courses on computers, health law, and negotiation,"says Lux.
Dale Miyauchi, MD, a family practitioner at Totem Lake Family Medicine in Kirkland, WA, has taken about 10 courses through the ACPE. "I just always had a personal interest in management," Miyauchi says. Plus he has still taken what he has learned and applied it to his small group practice. For instance, employee incentive programs are related to results of internal and external customer satisfaction surveys. Information he gleaned from technology courses led the practice to make a large investment in the last two years on computerization.
Miyauchi says the most valuable course he has taken is one the ACPE holds on "Legendary Customer Service." Indeed, customer service ideals permeate his practice. (For more on some of the innovations at Totem Lake Family Medicine, see next month's issue of Practice Marketing and Management.)
While some of his colleagues have been skeptical of his interest and the ideas that come from the classes, since his practice was formed in 1987, it has grown. "I think they value the experience I have gained," Miyauchi says. "They never say no to innovative ideas or something I want to try."
Kirz says that specialty societies, such as the American College of Family Practice, are another resource for courses. And for those physicians who show a great deal of promise and have the interest, there are certificate and degree programs.
Certificate programs usually take one to two years and are available at many universities, explains Kirz. University of Washington in Seattle has a program that takes nine months and accepts 35 physicians per year. The ACPE also has a certificate program and a program which merges into a master's program at Carnegie Mellon and Tulane universities.
Taking a bit longer are the advanced degree programs. There are about a dozen medical master's programs at various universities, including the University of Wisconsin at Madison, Kirz says.
"But very few physicians really need this formal training," he adds. "They should be physicians with substantial leadership experience who have done a fair amount of continuing education and see some value in learning about business. They should be physicians with a long career in front of them, with a number of years in which to use the knowledge that will cost you so much time or money."
But even though Kirz says not every physician - or even every physician leader - needs a master's degree, every physician needs an "expanded set of skills to deal with an increasingly complex health care world. You have to do more than just be able to see patients."
· Howard Kirz, MD, MBA, Chairman, The Clearwater Group, Seattle. Telephone: (206) 624-5757.
· Glenn Lux, MD, President, Pediatric Associates, Bellevue, WA. Telephone: (425) 827-4600.
· Dale Miyauchi, MD, Family Practitioner, Totem Lake Family Medicine, Kirkland, WA. Telephone: (425) 899-5200.
· American College of Physician Executives, Tampa, FL. Telephone: (800) 562-8088.
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