MBAs vs MDs

[eridani]

http://hcrenewal.blogspot.com/2014/07/money-vs-mission-how-generic-managers.html

On Health Care Renewal, we emphasize problems in leadership and governance in large health care organizations, and how they affect health care professionals' attempts to carry out their mission, and ultimately how they affect patients' and the public's health. Large health care organizations are increasingly led by people trained in business, not health care professionals, thus generic managers. The stewards of these organizations, the members of their boards of directors or boards of trustees, are also increasingly current or former managers without direct health care experience. Yet all too often, health care leadership is ill-informed, incompetent, unsympathetic or hostile to health care professionals' values, self-interested, conflicted, dishonest, or even corrupt.

Recently, in an effort to "bridge the gap" between physicians and MBAs, a new article in Becker's Hospital Review by Todd Kislak discussed differences in the thinking and values among business trained health care managers and physicians. The author, an MBA, listed nine issues on which MDs and MBAs have different views. I have summarized below what appear to me to be the main points, somewhat reorganized from how he did it. Whether he meant to or not, Mr Kislak showed why physicians may have reason not to trust their new generic managers.

1. Making Widgets vs Treating Patients Mr Kislak wrote that MBAs see health care in terms of orderly, uniform and standardized processes, while physicians see it in terms of the complexity and variability of patients, the ambiguity of diagnosis, and the unpredictability of outcomes.

2. Scalability. As a rule, MBAs tend to seek solutions to problems in a way that they perceive to be scalable and replicable, trained in the belief that the capacity to perform repetitively and consistently leads to better efficiency and quality. One-off situations are by definition outliers, and as such their importance tends to be downplayed.

[winter is coming]

1. MBAs are about this quarter's profits.

MDs are about solving the current crisis, but also thinking of long-term outcomes.

[Ex Lurker]

2. I have an MBA

It's an overrated degree. I didn't learn anything I didn't already know from undergrad or couldn't have picked up on the job. It was a waste of my time, but my employer paid for it, so at least it didn't cost me anything out of pocket.

[eridani]

3. I think it's one of those things that you need for career purposes

Like MSWs and education masters. I imagine programs vary a lot in how helpful they actually are.

[Donald Ian Rankin]

4. This strikes me as dubious.

A major goal in UK hospital care is to make as much as possible of it standardised, algorithmic and process-driven, not to cut costs or make life easier for doctors, but *because you get better results that way*.

If you see symptom X, you perform test Y; depending on what results come back you sent the patient home or prescribe treatment Z; and that way fewer people slip through the cracks.

The "House" picture of individual diagnostic genius saving lives is appealing, but not accurate.