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From MD to MBA: The Next Step in Patient Care? by Faye Goolrick 
Financial Times survey  Goizueta ranked eighteenth Case competition win Four Goizueta MBAs win National Society of Hispanic MBAs case competition Kudos News & accomplishments New faculty J. Douglas Bowman and Joseph F. Porac join Goizueta 
Real estate in 2000 Panelists assemble at the business school to discuss issues of market dynamics 
Andrew Serwer '84MBA A Fortune writer hits the Street Class Notes Learn what Goizueta alums are up to Goizueta Alumni Association News Alumni reception and awards; new alumni board president |
Mastering the Business of Medicine by Sharla A. Paul The problem with the health-care business is that it isn't like other businesses. The consumer rarely-if ever-pays for the services, the physicians and lab technicians who provide the services aren't always the direct employees of the hospital or clinical service provider, and the product-human life-defies quantifying. "I can tell you how much it costs to take out your appendix, but how can I quantify the quality of your care?" says Robbin Moore '00EMBA, administrator of Emory's Center for Rehabilitation Medicine and associate administrator at Emory and Crawford Long hospitals. Such are the issues that Moore and nineteen other professionals are tackling in the inaugural sessions of the newly launched Executive MBA Health Care Track at Goizueta Business School. The track
"For most of this century, no one had the incentive to manage health-care costs," says Rick Gilkey, director of the Center for Healthcare Leadership at Emory's School of Medicine and one of three professors teaching the track. "The turning point, I think, occurred in the late 1980s when Ford Motor Company discovered they were spending more on health care than on steel. This was a shocking realization. Companies at that time began looking for ways to contain costs, which set in motion the battle we now see." For better or for worse The battle against escalating costs gave rise to the almost ubiquitous managed care plan, which now covers more than 85 percent of the insured U.S. workforce, according to the Health Care Financing Administration (HCFA). Business meets medicine. Match made in heaven or shotgun wedding? Perhaps a more accurate depiction is one of a partnership, the two joined for better or for worse, in sickness and in health. Weighing in at $1.1 trillion in 1997 and projected to grow to $2.1 trillion by 2007, according to HCFA, the health-care industry represents between 12 and 16 percent of the nation's gross domestic product. As the population ages, health care promises to remain among the largest service businesses in the United States. "The health-care marketplace has changed dramatically in just a few short years," says Michael Johns, director of Emory's Robert W. Woodruff Health Sciences Center and chief executive officer of the Emory Healthcare managed care system. "Where once there was more of a cottage-industry style marketplace with a few large regional health centers, there is now a large-scale, nationwide health-care industry. This new industry is as complex and
The learning curve is steep but not insurmountable. First and foremost, clinicians and administrators must learn to collaborate to compete as integrated health-care delivery systems in a rapidly consolidating industry. "The formula is value. Value equals quality plus cost," says Gilkey. "The revolution in health care has forced organizations to operate as cost-effective businesses, whether they are for profit or not for profit. Health-care providers must function as cohesive organizations, rather than as a collection of clinics and departments." This collaboration is shaping up to be a difficult process, considering that most clinicians are trained to be tacticians, to respond to acute clinical episodes using the "command and control" model, Gilkey says. In this terra incognita, the players do not necessarily speak the same language, much less use the same tools. "[Clinicians] need to understand the lexicon of business," says Gilkey. "They need to understand the drivers and economics of the health-care industry. They need to understand the basic business concepts-finance, accounting, marketing, and management. Physicians need to understand spreadsheets and the effects on their practices. They must be able to use business tools to balance quality of care with cost and efficiency." To that end, the new Health Care Track aims to provide a "ramp" for clinicians to join other EMBA participants from a wide range of industries, according to Edgar W. Leonard, director of the EMBA program. "There's a lot of horsepower in that Executive MBA classroom. You have fifty students with an average of sixteen years' experience in business. That's eight hundred years of experience," says Leonard. "We launched the Health Care Track to better service an important EMBA market. [Clinicians] have some significant differences from the other EMBA students. They're well trained, but not in business. Our goal is to get them to come out of the program better managers of the business of health care." Geriatrician meets pharmaceutical executive The first run of the Health Care Track has proven to be much more than a place for doctors to pick up the lingo. Enrollees represent a wide range of health-care factions that would not necessarily interact otherwise. In addition to primary-care physicians and specialists, the roster includes a pharmaceutical executive, hospital administrators within and outside the Emory Healthcare system, several international students, and a Deloitte consultant working toward a joint degree in business and public health. "This [mix] helps students to understand the others' perspectives," says Leonard. "If I understand your viewpoint, I can better communicate and propose solutions that work for all parties." Moore, who has worked in health care for eighteen years, initially as a bedside nurse and for the last eleven years in hospital administration, is thrilled to be among a diverse group of students with such a clear purpose. "The strength of the program is that it's a collaborative business environment for health-care people," she says. "I hear their perspectives, and when I go back to work during the week and make a decision, I remember what they said. It helps me better position my decision." Moore is using the EMBA Health Care Track to get a handle on the distinct challenges facing Emory as an academic health-care provider. "In the Emory Healthcare system, people assume they're getting a certain level of quality because of who we are," she says. "They walk in our door, and they know we're good. They want to know they'll get a fair price. Quality isn't negotiable. We have to give them value. Factoring in the cost of teaching is a big challenge. We have to make sure that Emory is known as being cost-effective with excellent business capability and excellent quality of care. The EMBA helps me help the hospitals stay competitive and ensure our future is secure." Bob Zorowitz '00EMBA, a geriatrician at DeKalb Regional Health Care System, is using the track to establish a foundation in business as he launches a line of services for an expanding elderly market. "Health care is changing so quickly, particularly in the realm of geriatrics and senior services. The population is getting older," he says. "We don't have a lot of experience developing products in managed care for seniors. Medicare managed care is in trouble in a huge part of the country. There will be a real problem trying to reconcile the reality of shrinking reimbursements and a fixed pool of resources with the health-care needs of this population. To take disparate groups of physicians, hospitals, and other health-care service [providers] and make them work in concert
For Bob Yoder '00EMBA, manager of planning and support at Merck Pharmaceuticals, the track offers a broader perspective of health care than his twelve years in pharmaceutical sales has afforded him. "Until now, I've had a narrow focus," he says. "My view of the playing field has been purely from the pharmaceuticals side. This is my opportunity to get a view of the other side of the equation." Like Moore and Zorowitz, Yoder faces complex changes in the way he conducts business.
Participants in the Health Care Track also benefit from the perspectives and experiences of the other thirty-eight EMBA students, who represent a wide range of industries and companies, including BMW, Southern Company, Kraft Foods, Fidelity, Pitney Bowes, and Delta Air Lines. "We in health care tend to be rather provincial," says Zorowitz. "Health care as an industry is largely local and very fragmented. We tend to be sheltered from some of the best business practices that are taken for granted in some other industries. Coming into contact with people who deal with businesses of varying sizes gives us a global perspective that we wouldn't get otherwise. The perspective of being with people from global companies is invaluable, even if my business doesn't ever take me outside of Decatur." Learning how these non-health-care companies anticipate market changes and new market dynamics is invaluable as competition increases in all areas of health care. "In pharmaceuticals, we face new barriers to entry into the marketplace," says Yoder. "It used to be that we could launch a product, obtain a patent, and basically own that area for a good twelve months. That window has been cut down to about four months. It's not the same old game. I see the EMBA degree and the Health Care Track as a way for me to anticipate what's happening in the marketplace. It's a way for me to become a leader in my organization." A new generation Leadership is a notion that comes up repeatedly in discussions about the new health-care environment. "The most critical shortage is nurse and physician leaders," says Gilkey. "The changes in health care call for a new generation of leaders to emerge. The heroes will be the people who are committed to clinical excellence and who are willing to take a broader, more strategic role. It won't be a generation of General Pattons. It will be a group of quiet leaders who are willing to live by well-defined values." He describes a leader as someone who has "the ability to inspire, to provide a sense of purpose and direction, an enabler who creates a climate where others can be successful, who creates collaborative networks." Moore and the other EMBA Health Care Track participants take the concept of leadership very seriously. "I get the sense that we're creating a new business model," she says. "Health care has elements of other service businesses, but there's so much we can't quantify. So many businesses must try to put a number on the quality of service they provide. I think we're going to solve that. I think health-care professionals will be the leaders in figuring out how to factor in those slippery but important nonquantifiables. |
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various accounting practices.
