The Business of Medicine

Marcel Tam wants to be a family doctor at a community health center. But he knows that caring for patients, while noble work, gets you only so far. Helping an obese patient strip off weight, for example, doesn’t even dent the obesity epidemic, so Tam (MED’12, GSM’12) is thinking that he should really be fighting a broader war aimed at forces like junk-food mass marketing.

Perhaps running a grocery affiliated with his health center could help combat obesity by making available nutritious food. Honing his business instincts is what drew Tam to BU’s joint MD/MBA program. The University is hosting a national conference of such programs April 9 through 11.

“I plan to utilize business practices to more aggressively tackle the upstream causes of disease,” Tam says.

The five-year-old MD/MBA program, run by N. Stephen Ober (CAS’82, MED’86) at the School of Medicine and Mark Allan (GSM’93) at the Graduate School of Management, has been drawing one medical student a year, but that number shot up to nine this year. Tam is wrapping up his third year at MED; next year, he’ll attend GSM for accelerated MBA study, then return to the Medical Campus for his fifth and final year. (MED students can apply for the program until February of their third year.)

Welcome to the world of medi-biz, fueled by our ongoing national spasm over health-care reform and turbocharged by the new Obamacare law. Ober, director of the MD/MBA program, attributes the surge in applicants partly to better promotion: two years ago, the student-run Medicine and Business Association was formed at MED to host workshops, speakers, and other activities. But the spike in joint degree seekers is not confined to BU. There are now about 60 MD/MBA programs, at almost half the nation’s medical schools, up from a half dozen programs in 1993, Ober says. The growth reflects creeping evidence that doctors in private practice no longer can punt paperwork and all financial matters to their office manager.

“Saying ‘That’s the business stuff, leave me alone’ — those days are over,” says Ober. “Do you know how much paperwork a doctor has to do just to do a hernia repair?”

He believes a joint degree also can help to address widespread job unhappiness among doctors. From plunging Medicare reimbursements to infringements on physicians’ autonomy, he says, “it’s a recipe for ‘why the hell did I do this?’” Having a business background, he goes on, “opens your eyes to other career objectives” like health-care management. Indeed, the New York Times reports a doc-flock out of private practice and into salaried jobs at hospitals and health delivery organizations, lured by steady pay and better hours.

Joint-degree students cite various benefits. Sohini Stone (MED’08, GSM’08) says she’s had many opportunities to tap her business training in her pediatric residency, working on quality and safety issues at New Hampshire’s Dartmouth-Hitchcock Medical Center.

Prospective doctor Sunil Nair (MED’13, GSM’13) seeks management acumen to thread what he calls a coming career squeeze: 30 million newly insured people from the health-care reform bill will mean plenty of patients, but payers are demanding cheaper care. “I see myself as a future clinician first,” says Nair. “But I want the business and management skills of a dual degree to engage with nonclinician leaders in quality improvement, cost and operational efficiency, and the like.”

Nair is part of a MED group planning a new elective course about “nonclinical forces that will shape the future of medicine and the skills future physicians will need” beyond stethoscope and scalpel. Karen Antman, dean of MED and provost of the Medical Campus, envisions a monthlong elective on management for fourth-year students. It wouldn’t supplant MD/MBA study, which is “substantially longer and best suits those who would like to do academic or health policy administration, new drug or device development, or medical policy,” she says.

Careers are a focus of this weekend’s eighth annual Association of MD/MBA Programs conference, with talks scheduled by executives from Boston Medical Center, Brigham and Women’s and Massachusetts General Hospitals, Caritas Christi Health Care, and Blue Cross Blue Shield of Massachusetts, as well as academics from joint-degree programs.

The Association of MD/MBA Programs Eighth Annual Conference runs April 9 to 11 at the Hyatt Regency, 575 Memorial Drive, Cambridge. Register here.

Rich Barlow can be reached at barlowr@bu.edu.