When an M.D. is not enough, add an MBA

The rise of the business-savvy doctor.

For some, it’s a hedge against an uncertain healthcare landscape. For others further into their career, it might be a reaction to burnout. Others still may cite the entrepreneur-physician earning big money in the biotech industry. Regarless of the reason, though, more and more doctors are looking to add some more capitalized letters to the ends of their already prestigious titles.

At the Rothman Institute, spine surgeon Alexander Vaccaro has patients prepped and waiting for him in four different exam rooms all before 8:00 a.m. Hovering, a little like an entourage, are medical assistants getting what he needs and younger doctors watching him work. Vaccaro is a sought-after specialist. And, at age 53, he has a 2-month-old baby at home.

What else could he possibly want?

Vaccaro wants a master of business administration. So he spends an extra 15 or 20 hours each week doing homework.

“There’s this sort of subtle insecurity most physicians have when we go into practice where we really don’t understand basic business models,” said Vaccaro, chairman of the Department of Orthopaedic Surgery at Thomas Jefferson University.

Doctors get tired, he says, of going hat-in-hand to hospital managers and begging them to buy the big equipment, or make the investments that physicians think they need to give good care or improve safety.

You can’t just go to the local Walmart and buy a $1-million MRI machine.

“I have to come up with a business model and a business plan,” Vaccaro said. “Not just because I think it could be a good idea or I think it would be convenient, now it has to make sense from a financial perspective.”

Ten years ago, that wasn’t his strategy, but Vaccaro says at mid-career he changed his approach.

He enrolled in a business program, and even before he finished the degree, last year, Rothman tapped him to be president of the practice.

“Now I become creative and am no longer responsible as a child looking to the parent, which is the institution I work at, to look for money,” he said. “Now I can control the dollar. Chairmen historically were not good at that.”

Vaccaro is earning his MBA at the Fox School of Business at Temple University and he’s doing it online.

Associate dean Bill Aaronson says busy doctors like having the flexibility to do required reading on their own time, then meet-up online.

“Every Thursday [from] 8:00 [p.m.] to 10:00 p.m., you know you are going to be in your virtual classroom,” Aaronson said.

At least one doctor has logged into class—straight out of surgery and still in his blue scrubs, he said.

Aaronson says weekend executive programs and online classes work for physicians in their 30s and 40s who are just beginning to take on leadership roles at work.

Three physicians enrolled in Fox’s online MBA program in 2009. There are 12 in the program today.

“They get frustrated and they get angry. They don’t understand the business side of the enterprise. Then all of a sudden: ‘Well, what do you mean I can’t use that test? I need that test,’ they go into an MBA program,” he said.

There is an Association of MD MBA Programs but no data yet on whether doctors with an MBA get promoted faster or end up earning more money.

But a business degree from a top school can cost more than a hundred thousand dollars, so lots of students invest in an MBA with hopes of cashing-in later.

“Being that I got my MBA, I can pay myself more,” Vaccaro said. “You have the ability to negotiate better.”

“Healthcare today is what we affectionately call a hot mess. If you were down south you’d be hearing that,” said James Dockins, a healthcare management professor at Rockhurst University in Kansas City, Mo.

“Any time you’ve got all the different problems and issues, there’s also lots of opportunities,” Dockins said.

Rockhurst partners with the Kansas City University of Medicine and Biosciences to offer a D.O./MBA degree—doctor of osteopathic medicine and a master of business administration.

Four years ago, there were 14 students were in the dual degree program; now there are 42, Dockins said.

Health spending accounts for nearly 18 percent of the U.S. economy, or $2.9 trillion. And, that Dockins says makes medicine big business. Some of the healthcare sector’s toughest problems, or opportunities, are actually customer service issues.

At The Wharton School at the University of Pennsylvania in Philadelphia, Professor June Kinney says those are problems that business people know how to fix.

“There’s the whole front-office aspects of it,” Kinney said. “Sometimes, I think most of people’s complaints about their physician office are more about the support staff than it is about the physician. It’s about things like wait times or efficiency of follow-up.”

Kinney thinks companies, like Starbucks, train workers to give shoppers a customer-friendly experience, but doctors often don’t learn those skills in school.

Though, medical students can get that training in a dual MD-MBA program.

In the early 1990s there were fewer than 10 programs, today there are more than 65 across the country. And now, about 500 people graduate with that dual degree each year.

Kinney says Wharton’s program with the University of Pennsylvania Medical School attracts ambitious, young people who are thinking ahead.

“They are looking in some ways to hedge at their future,” she said.

Many of them went to medical school straight from undergrad, and they’ve always been top students.

“In the midst of their medical-school years, they look around at their peers who are in other parallel careers and wonder: Is this the right track for me? Is medicine as it’s traditionally defined how I really want to spend my career, or do I want more options?” Kinney said.

“Perhaps to change directions but still use my medical background and interests,” she said.

Frank Brodie graduated from Wharton with a dual degree last spring. Before entering medical school he worked in marketing for General Mills selling Fruit Roll-Ups.

“I think that being an M.D. MBA helps me bridge that gap,” he said.

Now he’s an intern—a physician fresh out of medical school—at Harbor UCLA Medical Center in Torrance, California.

Recently, he suggested a new way to do things when he noticed that some people in the urgent care clinic wait hours to get a 10-minute consult and a referral to a specialist.

“Kind of thinking about supply-chain management, ways I learned to think at Wharton,” he said. “We have started trying to triage those patients really quickly to the front.”

Brodie is also using his degrees as a physician-entrepreneur. The 32 year old launched two startup companies while he was a still a graduate student at Wharton.

Those businesses are struggling right now.

“Unfortunately I’m not the next Mark Zuckerberg…yet,” Brodie said. “But it was a really great learning experience.”

Brodie is already working on his next business project. This time it’s a medical device that could be used by eye doctors.

“We don’t even have a sexy name yet,” he said. “Right now I’m collaborating with some folks at CalTech as well as some clinicians at UCSF to see how we can design some studies to test it.”

For now, he has no expectations that he’ll get rich from his business endeavors. And actually, Brodie says it’s his work-a-day doctor’s salary that gives him financial stability to be an entrepreneur.

“So, hopefully, I can pull it off,” Brodie said. “Hopefully I can have that kind of hybrid life where I get to stay a clinician and in this business world. We’ll see.”