Program Weds Medical and Business Studies for Doctor
of Tomorrow
The joint degree plan at UCLA grew out of recognition
that medicine is not practiced in a vacuum.
By Rhonda Hillbery
When he first decided on a career in pathology and laboratory
medicine, Adrian Correa thought he would spend 90% of his
time working with patients and doing clinical tasks. But in
medical school he was surprised to learn that about half the
work of a pathologist involves decidedly nonmedical matters.
"I started to find a lot of what I would do as a practicing
pathologist would be managing not only patients but also lab
staff, equipment purchases, contracting, all these things
that fall under the realm of business," says Correa,
30, now in his residency at the UCLA Center for Health Sciences.
Deciding he had to become business-savvy, he looked around
and discovered that a joint degree program was being planned
between UCLA's medical school and the Anderson School, its
graduate business school. In June, Correa and a classmate
were the first graduates of a new MBA/MD program that marries
medicine to management studies.
He is one in a new generation of doctors who hope to gain
financial tools that will give them perspective--and some
control--over how health-care resources are managed and spent.
"There's a valid concern that few physicians are trained
or equipped to make financial decisions that affect the whole
health-care system, because that's just not what we're taught
in medical schools," Correa says. "Because of that,
it's come to the businesspeople to make those tough financially
based decisions."
The program allowed him to graduate in just five years,
shaving a year off the time it would have taken to complete
the programs separately. The abbreviated timetable required
him to complete medical "clerkships" over two summers.
The new program is one of several at UCLA that combine MBA
studies with another discipline, such as engineering, law
or public health. This program and a few like it around the
country reflect the recognition that medicine is not practiced
in a vacuum, but is inexorably tied to other forces, especially
financial ones. Correa considered similar programs offered
at other universities including Northwestern, Dartmouth and
the University of Pennsylvania.
Given the unrelenting demands of today's managed health-care
world, Correa expects to spend even more time managing and
supervising when he enters private practice in a few years.
He hopes to build a group practice and perhaps become its
chief executive.
He's already learned that the definition of "maximizing
results" transcends mere profit. "It can be profit,
but it can also be patient care, which you can maximize by
running an organization well."
Designed to allow students to tailor their business studies
to their medical specialties, the UCLA program requires students
to complete three years of medical school before applying
to the MBA program. Their fourth year is spent in MBA courses;
the fifth is half-and-half.
While some students plan to become administrators, others
intend to practice medicine or perhaps combine the two, says
John Mamer, the Anderson School's interim dean. Opportunities
also exist in the pharmaceutical industry, biotechnology and
medical equipment companies.
"It's pretty clear that management issues surrounding
health care have become pretty significant issues, so it's
not hard to imagine how someone might think of this,"
Mamer says of the program. One measure of interest in MBA
studies is that practicing doctors comprise 14% of the part-time
executive MBA class of 1999.
Given the challenges inherent in health-care delivery and
administration today, interest is not likely to wane any time
soon. "This is sort of an important new arena for us
in the business school," Mamer says.
One of seven students making up the first "official"
MBA/MD class this year at UCLA, Jeannine Rahimian, 23, plans
to work in a field where she can mix patient work with administration
in a group practice. She is considering obstetrics-gynecology
and internal medicine as her specialties.
"When I was in medical school I realized we had no
background in business," says Rahimian, engrossed in
her first-year MBA classes. "Now to be a really good
physician, you have to understand the economics behind health-care
delivery."
Her MBA studies will span accounting, economics, statistics,
human relations, finance, marketing and operations, and electives
such as health-care management. So far, applying those disciplines
to medicine seems more than plausible. "I'm surprised
how everything makes sense. It's very logical and applicable
to everyday life," she says.
It's too bad that the doctor-patient alliance can't be like
it used to be, Rahimian says. "With cost constraints,
it's difficult to have the same relationship with patients.
That's the downside, but it's necessary because we are able
to treat more patients with good management."
A classmate, 25-year-old Jabari Reeves, says he wants to
make a difference "on a larger scale," and thinks
his business studies will help. The inescapable rules of managed
care mean that "in order to make changes, you need to
be able to speak to both sides," he says.
Planning to practice emergency medicine, which he says suits
his personality and interests, Reeves may eventually try to
work in policy or administration at an agency such as the
World Health Organization. He sees himself "not necessarily
just working for an HMO behind a desk, but doing something
to really make a difference."
Reeves is serving a clerkship this year at Martin Luther
King Jr. Hospital in Watts, which offers a sobering look at
the challenges of delivering health care in inner-city Los
Angeles.
"Working there really puts things in perspective,"
he says. "In the county system, the shortage of resources
has made me realize what it means not to have health care
or health insurance. I want to work toward a place in time
where everyone has basic health care."
Reeves says he realizes that he cannot single-handedly change
the way health care is delivered, but he thinks business training
will at least better equip him to try.
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