The Gap in Medicine
I mentioned in another post, the reasons for getting a dual degree. Many of those reasons stem from the fact that we need more physician leadership to help bridge the gap in medicine that exists between clinicians and managers.
However, I think the changing landscape of healthcare will force all of us (if it hasn’t already), as physicians, to take on bigger roles in management and administration. For instance, there is a trend towards hiring mid level providers to complete basic and simple patient related visits and tasks with one MD overseeing them. In the operating room, it is commonplace now to have one or two physicians manage several CRNA’s.
While we know the medicine, we are not trained in the leadership and management aspects of these new roles. Obtaining another degree such as an MBA, MHA, MPH, MMM is certainly helpful, though not a practical solution for many.
Medicine is no longer an isolated topic that is removed from all other aspects of life. The entire business of medicine is, well, a business. To work in a hospital or as part of a private practice group, you are joining a complicated, multi layered business venture. Imagine working at Starbucks and knowing how to make the coffee, but not knowing how to work the cash register. Think of what its like to work as a teacher, yet not speak the same language as your students.
Can you imagine not learning basic medicine before becoming a resident? Or what if you never learned how to perform a complete history and physical until becoming an attending?
Physicians know their craft, but are unaware of the financial and managerial aspects of their jobs. We don’t learn what is involved in billing and coding until we become attendings. We aren’t taught the language of business until we are forced to learn on the job after graduating residency.
Is anyone else confused by this?
Basic business concepts of leadership, management, finance and accounting need to be treated as another core subject, if not approached in medical school then taught during residency. Exposure to these topics from the beginning, will allow trainees to incorporate them into their vocabulary and day-to-day duties, much like they do with medical concepts.
My fellow recently asked me, because I was lamenting over the political nonsense that I deal with on a regular basis, “why do you do this then?”
Me: “Because not enough physicians are present at the table. Our voice and opinion, likely the most important and most relevant, is never, or rarely, heard.”
Either we choose not to take part in administrative discussions because we don’t see the importance of it, or we don’t know how to converse on that level or we want to take part but it is assumed that we don’t know anything.
At least with some basic training and exposure we can send people out into the world with one less reason to not be present. Rather than administration and management being a foreign entity, it becomes an expected part of the job. A part they will be familiar with and better prepared for as they graduate through the ranks and finally become attending physicians.
A sample of topics and how they may be incorporated into training programs can be found here.
Do you feel the same way? Thoughts and ideas welcome!