Are business skills the ticket to reclaiming physician autonomy?

Physicians are interested in leadership roles, but many do not have the business skills to support that ambition. 

According to a new survey by Jackson Physician Search and the Medical Group Management Association, 67% of physicians expressed interest in pursuing leadership roles. Among them, 69% were motivated by the desire to have a voice in organizational decisions. 

Michael Gomez, MD, NICU medical director of Orlando, Fla.-based Pediatrix Medical Group, told Becker's the key to physicians reclaiming autonomy is to "find time and resources to develop all the other skills needed to perform well in healthcare."

Most medical schools do not provide business acumen. Despite interest, only 18% of physicians receive executive or business training during medical school, and just 21% of healthcare organizations offer formal leadership development programs for physicians, according to the Jackson Physician Search and MGMA survey. 

And while some people can intuitively understand how to operate within the business side of healthcare, Dr. Gomez said some physicians, like himself, are hyper focused on clinical care. 

"This became more challenging early in my career in the early '90s," he said. "Administrators would ask us to create business plans for new proposals or provide budgets and resource needs. We weren't trained for that; we learned to diagnose and treat, not to think systemically. I quickly realized I needed to learn how to speak their language."

Learning the nomenclature of healthcare management proved difficult. An unexpected resource was a guide in the back of the phone book that summarized how to create a business plan for small businesses, he said. 

Dr. Gomez also decided to go to graduate school to get a degree in healthcare administration. 

"These studies equipped me to communicate effectively with administrators and get the resources I needed," he said. "Many administrators appreciated my understanding of both medicine and business, which helped me gain their attention and support."

While the sacrifices involved with two more years of school were tricky, it proved worth it for Dr. Gomez. 

"No one anticipates that after 10 years of training — medical school and residency — you'll need another two to three years of graduate study," he said. "It's a calculated risk, especially when working alongside brilliant individuals who excelled in politics, business and medicine. We all aspired to their level of competence, but many of us needed additional training."

Business school is also where he learned "the hard lesson of never promising to deliver anything without understanding how to achieve it," he said, particularly when it comes to resources. 

"As a hospital-based specialist, I rely on hospitals for resources," he said. "Understanding how the hospital acquires these resources and how they can recoup their investment is crucial. When I was first learning this, most of us were independent contractors, trying to convince hospitals that we shared their vision and could be valuable partners."

Other leaders echo these sentiments, saying a lack of understanding of business has escalated the "marginalization" of physicians. 

"Most physicians, for too long, have abrogated the business and political side of healthcare to others — trusting that these others would do the right thing for patients and the healthcare system — (I'll just see the patients and you manage the shop)," Harry Severance, MD, adjunct assistant professor at Durham, N.C.-based Duke University School of Medicine, told Becker's. "This abrogation has led to marginalization of physicians as healthcare decision-makers and leaders while significantly contributing to disintegrating conditions within healthcare workplaces, leading to worsening patient outcomes, increasing worker departures from healthcare as well as other cascading workplace problems."

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