The clinical and business aspects of medicine traditionally have been seen as polar opposites, with MDs monitoring the health of the patient and MBAs taking the fiscal pulse of the institution. More and more, though, cardiologists have turned to additional education to become adept at both—a trend that broadens their opportunities and also may benefit peers and patients.
The second day on the job as chief of cardiology at the medical school at University of North Carolina at Chapel Hill (UNC), Cam Patterson, MD, sat down with an administrator to review the budget. As he recalled, it had a large number at the top, lots of numbers in the middle and glaring red number at the bottom. What he inherited in 2005 was a $2 million deficit. While he was a highly skilled physician—a cardiologist, distinguished professor and director of the Carolina Cardiovascular Biology Center—his medical bag of tricks did not include finesse with finances.
“I realized that I didn’t have the toolset that was necessary to sort out the complexities involved in why a cardiology division, which should be a big money maker, was losing money,” he says.
When he saw an advertisement for the executive MBA program at UNC’s Kenan-Flagler Business School, it spoke to him: Here was an opportunity to learn the business skills needed to steer the program back to solvency. For 28 months, two nights per week, he became a student again, earning an MBA by 2008. “It was one of the smartest things I ever did,” he said. “I would learn something in the evening and apply it the next day at work.”
An MD first
While multiple degrees are not unusual in medicine, they traditionally have involved completing an MD and then tagging on a PhD, or a master’s in public health, public administration or science, additional education that facilitates research in areas such as population studies or epidemiology. But cardiologists appear to be embracing the option of an MBA more often to hone their leadership skills, either by earning degrees sequentially or by enrolling in dual degree programs.
The number of medical and business schools offering dual MD/MBA degrees has burgeoned and is likely to continue on that track, according to Maria Young Chandler, an MD/MBA who heads up the Association of MD/MBA Programs. Based on a 2001 survey of 125 U.S. medical schools, she and her colleagues found that the number of programs had grown from six in 1993 to 33 in 2001 (Acad Med 2003;78:335-340).
Today the count is about 65, “and that is half of all medical schools,” she says. “It is growing every year. I usually get contacted by schools interested in starting programs; there have been about four in the last year and two that have started.”
Chandler founded one of the earliest dual-degree programs at the University of California, Irvine. The program dates back to 1998. The University of Pennsylvania School of Medicine and Wharton Business School may own bragging rights to the oldest program, though, having established a joint MD/MBA in 1970.
Whether a traditional executive MBA or a dual degree, the core curriculum at most business schools likely encompasses similar fundamentals: finance and accounting; teamwork and leadership; management and human resources; economics; leadership development; and marketing. Programs often offer courses in negotiations, communications, innovation and entrepreneurship as well.
“Business education is far more practical than medical education,” Patterson says. “In medical school, you get taught to pass the boards. That is the No. 1 objective.” The skills that he obtained in business school—such as a whole class devoted to how to run a meeting—were immediately applicable. “Those are really practical skills that anyone who is in an administrative or managerial position needs to know.”
He credits his business education for strategies used to turn the cardiology division around. He looked for opportunities to logically integrate and diversify programs, as well as to create efficiencies and growth. That included merging cardiology, adult cardiac surgery, vascular surgery and interventional radiology into a single unit, as well as launching an aggressive practice acquisition campaign to add private practices to their clinical group. The division is now in the black and profitable.
“We now have 60 new [employed] physicians who are part of UNC's heart and vascular clinical program who formerly were in private practice,” he says. “That whole process relied heavily on