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MDs seek MBAs as health care gets more complex

Nervous dental patients who make their first visit to Dr. Sree Koka may feel calmer because they have watched his video on YouTube. It answers many of their questions: Is the doctor male or female? Does he speak English? Is he nice?

In the video, Koka introduces himself, cracks a few jokes, and suggests what patients should think about for their first appointment. He created the spot while attending MIT's Executive MBA Program where he learned the benefits of focusing on personal relationships, not just technical expertise.

"I've come to realize that unless that relationship is good," said Koka, chairman of dental specialties at the Mayo Clinic, "almost nothing I do technically is going to work well. It's not just about the teeth but everything the teeth represent: patients' quality of life, social esteem, self-confidence, pain, comfort, and their smile."


Koka is one of a surprising number of senior-level health care professionals seeking an executive master's of business administration from MIT's Sloan School of Management in part because of the federal Affordable Care Act, also known as Obamacare, and other changes in the health marketplace. For the first time, health care has more students in MIT's executive MBA program than any other industry, accounting for about 1 in 5 members of the class of 2014.

Also, more are practicing physicians, including three surgeons, two oncologists, and an anesthesiologist. Whether preparing for new or bigger management roles or seeking to improve their practices, they see the executive MBA as a path toward improving the patient experience.

Executive MBAs are part-time programs aimed at working professionals and managers. At the Massachusetts Institute of Technology's 20-month program, for example, classes meet on weekends, with an occasional weeklong session.

Business training for doctors has been growing since the late 1990s when the University of California, Irvine, became one of the first medical schools to offer a joint MD/MBA program, as well as a health care-specific executive MBA. Now more than 50 percent of medical schools offer the joint degree, said Dr. Maria Chandler, head of Irvine's program and president of the Association of MD/MBA Programs.


The number of practicing physicians taking Irvine's health-care executive MBA program has shot up in the past two years, from 35 percent to more than 50 percent of the incoming class. Still, less than 5 percent of students enrolled in Irvine's general executive MBA program are health care folk. That makes MIT's 19 percent quite striking.

Dr. Richard Baum, chief of interventional radiology at Brigham and Women's Hospital, said he was eager to study "the science of business" and not get a health care-specific executive MBA. He wanted to learn bread-and-butter stuff, like how to pay for a hospital with bonds and government subsidies. But he also wanted to learn new ways of thinking from outside health care.

When studying for the degree, he said, "You're not just sitting in a room full of doctors, but with manufacturers and shipbuilders."

That is true of an increasing number of physicians, said Jonathan Lehrich, director of MIT Sloan's executive program. "Many physicians working in medical centers," Lehrich said, "feel like prisoners of the hospital administration. They're tired of being told, 'Well, you're the physician. You just go off and practice and we'll make all the decisions.' "


Dr. Suma Thomas is a cardiologist who attended MIT while practicing at the Lahey Hospital & Medical Center in Burlington. When working with associations dedicated to improving patient care, she said, she realized that "doctors don't have the tools to improve our health care system."

She took finance courses that taught her to read a balance sheet as well as classes in leadership and communications. In her new position as vice chairman of strategy and operations for the Heart and Vascular Institute at Cleveland Clinic, Suma wants to use her new training "to help make the quality of health care best everywhere in the nation."

The doctors who have earned their executive MBA through MIT are putting their new skills to work in a variety of ways.

Koka, the Mayo clinic dentist, will become executive director of the Foundation for Oral Rehabilitation in Zurich in August. He focused on courses such as strategic management and innovation and entrepreneurship to gain insights that he used while leading the staff in a new clinic for complex cases at Mayo.

For Dr. Ivan Salgo, senior director of global cardiology at Philips Healthcare's ultrasound unit in Andover, the draw was learning how to analyze "big data," to extract meaning from massive sets of data.

Salgo, a cardiothoracic anesthesiologist in the medical device industry for the past 10 years, saw a changed health care system. It's no longer enough to create a useful device, he said. Medical device companies, insurers, and patients now demand results. "So now it's not about getting paid for the antibiotic for your cold," he said, "but for curing your cold."


Using data analysis skills, Salgo created a new way to predict cardiac outcomes. By measuring blood pumped out of the heart, blood flow, and tissue motion, he was able to better evaluate the risk of different cardiac treatments, helping doctors at Philips to better advise patients. His project won an award from the American College of Cardiology this year.

"Doctors can be changed by the system or be part of the change," said Salgo. They can continue to be advocates for the patient and for good care, he said. But they can't leave everything else to legislators and administrators. "Physicians with business training can help lead the change."

Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.