Interview with Jon Chilingerian, executive director of the Executive MBA for Physicians program at Brandeis University’s Heller School for Social Policy and Management
What current trends in the healthcare industry warrant a physician obtaining an Executive MBA?
It’s critical that we first understand what’s expected of people in healthcare today. We have what I call a new triple performance problem. The first is that healthcare organizations are expected to achieve excellent technical outcomes. This means that the primary providers of care must work together to bring the cutting edge of biomedical science into the practice of medicine. The second performance problem is about outstanding patient experience. When patients enter the health system, they have needs beyond the technical aspects of their care. For example, the emotional needs, the need for information, the need for great relationships with providers, so that overall, they will feel extremely satisfied. The third performance problem, efficient care, is a bit more difficult particularly when you take the first two into consideration. Efficient care does not mean slash-and-burn downsizing, but rather providing the best care possible in a way that allows you to find the quickest way to help the patient – efficiently moving from diagnosis to treatment so that you reach those excellent technical outcomes and improve the overall health status of the patient.
And so the real question is, is it possible to do all three of these well? Unfortunately, there is growing evidence that there are very few places in the U.S. and around the world that do. I’ve heard from countless physicians who are struggling. They’re struggling to maintain a financially viable practice because of falling reimbursements and rising overhead costs, and because of things like malpractice insurance, new technologies and electronic health records. Physicians are also struggling with converting to a value based approach and with a new international classification of disease code. What we’re seeing is horrible physician burnout. So you put all this together and what we see is that the weight of the regulatory environment is negatively impacting the triple performance problem and thus, the practice of medicine and the experience of caregivers.
My new mantra is that every physician needs this kind of training in the blossoming science at the intersection of biomedical and management science. Physicians are the principal co-owners in the care process. They are the entrepreneurs that decide what new technologies and new methodologies ought to be adopted and assimilated. And they’re also the general managers of these care processes. There has been a large gap between medical decision-making in clinical operation and healthcare management. So I see the future very strongly around the idea that every physician is a leader and every leader is a collaborative team player.
How do you know if you’re ready for an Executive MBA program? What does an ideal candidate look like?
If you feel you were trained to help people and the job doesn’t give you the resources and support to do that, then you’re ready to consider an Executive MBA. If you’re an MD and you’re in a private practice, you’re working in a department, you are a clinical director, you’re a chair or chief, or you’re in the executive suite and you don’t have management training, then you would be an ideal candidate for our program. If you look at the motivating environment and you feel the incentives aren’t there to do the right thing, or you feel that people are not deeply engaged in the work that they do around you, or you see that coordination is lacking and the organization isn’t designed correctly, you are likely experiencing challenges. If you have difficulty understanding the cost of what you do, you need a more sophisticated understanding of cost.
It is essential that we understand the critical role of leadership within healthcare, and that just merely adopting new technology and trying to assimilate it into the organization doesn’t necessarily create value. We understand physicians must successfully navigate new regulatory requirements, new reimbursement requirements and the new value based approach, and our program can help. We provide not only the training but also the education and the skills from expert executive leadership coaches so that medical leaders can translate ideas and desire into helping people in a well-designed organization.
Generally speaking, what do most Executive MBA physicians aspire to accomplish upon finishing the degree? What are their future goals?
When you’re operating within the context we discussed earlier (the crushing overhead, the falling reimbursements, and the physician burnout), it can be hard to develop a personal strategy or path to successfully navigate the environment. So the first thing physicians should accomplish is to have a deeper and more clinical understanding of the situation in which they are embedded. An Executive MBA program allows you to reenergize and recommit yourself to the work that you originally vowed to do. Reenergizing and recommitting is a large part of coming back and doing this advanced graduate study. It’s ultimately a sense-making process that people go through, and as you begin to better understand the unfolding events that occur around you, you are then able to diagnose the situation in a much more lucid way.
The goal is that you come out and achieve aims for the 21st century: we want to produce safe care (avoiding injuries to patients); effective care (making sure that the best biomedical science knowledge is applied and through management science, effectively implemented); we want to achieve those triple aims (outstanding technical outcomes, outstanding patient experience, and efficient care); and finally, we want to produce equitable care (providing care that does not vary in quality because of the personal characteristics of gender, ethnicity, geography and so forth). We train you so that you can comfortably run a practice, but also become a chair of a department, a clinical director, a medical director, a chief operating officer and a chief executive of any size healthcare organization, including a hospital, accountable care organization, primary care organization, nursing home or rehabilitation center. Physicians leave with the confidence to alter their career trajectory, and the derivative is going to be much greater than it was before they started the program. You’ll be able to create and lead institutions that are safe, effective, achieve the triple aims and are equitable.