In an evolving healthcare industry, prominent surgeons are choosing to pursue graduate business education—a trend that continues to grow nationally.
(Editor’s note: A version of this story first appeared in the Spring 2015 edition of Fox Focus, the school’s alumni magazine.)
It’s 4:30 a.m., and Alexander Vaccaro reaches for his alarm clock.
Soon after, he’s reading lectures and watching transcribed videos from the seat of a recumbent bike. The piece of exercise equipment doubles as Vaccaro’s classroom desk as he completes coursework during his daily workout.
An orthopaedic surgeon and spinal specialist, Vaccaro maintains a tightly organized schedule. He’s the Richard H. Rothman Chair of Orthopaedic Surgery at Jefferson University Hospitals and president of the Rothman Institute, an international leader in orthopaedic science, research, treatment, and technology. And he completed his Online Master’s of Business Administration through Temple University’s Fox School of Business.
Vaccaro estimated that he committed at least two hours daily to his Fox Online MBA. Often, it was more.
“I’m being honest when I say this: It’s one of the hardest and one of the most-rewarding things I’ve ever done,” said Vaccaro, who’s also a professor of neurosurgery and orthopaedic surgery. “You know what you do for a living. Getting your MBA helps you figure out why you do what you do, and you’re able to do it better.”
Vaccaro is one in a growing number of accomplished medical professionals, with a slew of letters following their surnames, who supplemented their clinical educations with a business education at the Fox School.
The reason? As the landscape in American healthcare continues to evolve, medical professionals like Vaccaro are learning that one of the greatest issues in their field is a business-related one.
“I was brought up thinking about care for the individual. Now I have to care for the system that cares for the people,” Vaccaro said. “I almost think an MBA should be mandatory for clinicians. When you get into medicine, you need courses on how to run a program, and you need background skills in operations, marketing, law, ethics, and communication. Those in medicine who plan to lead need an MBA.”
Healthcare spending in the United States reached $3.3 trillion in 2016, or 17.9 percent of its gross domestic product. And that figure is expected to continue climbing. Physicians equipped to tackle the challenges of operating a medical facility, in relation to both patient treatment and business management, are in high demand.
According to a 2011 U.S. News & World Report study, hospitals run by trained physicians earned quality scores that were 25 percent stronger than hospitals run by management. Having a physician who is capable of balancing a budget and managing personnel “is more than valuable. It’s indispensable,” said Dr. Steven Szebenyi, the former chief medical officer and senior vice president of healthcare management with Health Partners Plans, a not-for-profit health insurance organization in the Philadelphia region.
Szebenyi, in his former role, oversaw all clinical aspects of Health Partners Plans, reporting to the company’s chief executive officer and senior team, managing a staff of nearly 200, and overseeing its budget, among other duties. The push for a business education among the nation’s top healthcare workers can influence hiring practices, Szebenyi said.
“I look for someone with more than clinical experience,” Szebenyi said. “I look for someone with administrative training, additional training, or both. That need is only going to continue to grow. With this shift from volume-driven healthcare to value-driven healthcare, you see more and more physicians taking more prominent roles and leadership positions.”
A gathering of more than 700 of the nation’s preeminent business and healthcare executives at the University of Miami’s “The Business of Healthcare: Bending the Cost Curve” conference in January 2014 concluded that the challenge of lowering overall costs while raising the quality of care remains. And in November 2014, Todd Kislak, who boasts a decade of healthcare management experience, told Bloomberg Businessweek that the issue boils down to “the coats vs. the suits. What you need is people who can wear both.”
Temple’s Fox School of Business is preparing physicians to do that. A number of high-ranking surgeons have completed the Fox Online MBA program, which combines technology, collaboration, and real-world experience, so professionals in any industry can balance the rigors of continued education, full-time employment, and family.
Like Vaccaro, Dr. Cataldo Doria earned his Online MBA at the Fox School.
For years, Doria, the director of the Jefferson Transplant Institute and the Division of Transplantation at Jefferson University Hospitals, said he had considered a graduate degree in business administration, before choosing Fox for its “top-notch reputation,” he said. “Medicine is changing so much and so fast, and unless you really understand the economics and the business of it, you’re going to be left behind,” said Doria, the Nicoletti Family Professor of Transplant Surgery.
Three other physicians who earned their Online MBAs from the Fox School have noted immediate gains professionally as a result of their recently attained business credentials.
When Dr. Vani Dandolu had elected to pursue her Online MBA, clinical colleagues said she had swayed “to the dark side,” said the chair of the Department of Obstetrics and Gynecology at University of Nevada School of Medicine. Instead, Dandolu viewed the program as an opportunity to learn business-world language without having to give up her stake in academic medicine.
“I get more credibility, my opinions are taken more seriously and, really, I would not have been a serious candidate for my current position if not for my additional degrees,” said Dandolu, also the ObGyn residency program director and a professor of obstetrics and gynecology at the University of Nevada. “I was very clear on what I wanted to get out of my MBA and I believe that focus is critical when you are pursuing any new venture.”
Philadelphia-area surgeons Dr. Aron Wahrman and Dr. Daniel Dempsey, who attained their Online MBAs at Fox, agree. As clinical assistant professor of surgery at Penn Medicine, Wahrman sees a benefit to giving the program’s top medical students and residents a taste of business education.
“I think traditional curriculum, which mainly focuses on scientific and clinical curriculum, does them a disservice,” said Wahrman, who earned his Fox Online MBA in 2011. “With everything that’s going on in healthcare, the patient is expecting quality and value, and an MBA gives you a broader perspective on topics pertaining to that. Moreover, you can’t just give (administrative duties) to people in healthcare who aren’t as vested in taking care of patients or in making decisions at the individual and community level. That’s why I think pursuing a Fox Online MBA was a good fit.”
Dempsey is professor of surgery, chief of gastrointestinal surgery, and assistant director of perioperative services at the Hospital at the University of Pennsylvania. Prior to commencing his Fox Online MBA studies, he said he possessed a basic knowledge of a hospital’s business operations, but “by no means was I an expert.” He said he’s since been able to complete financial analyses on greater returns on how his hospital spends, and better understand profit loss and cash flow, as a result of his most-recent degree.
Like Dandolu and Wahrman, Dempsey said he faced vilification from his colleagues in medicine.
“The common reaction was, ‘What’re you doing that for? You’ve been doing aspects of administration for years,” he said.
And Dempsey’s reply?
“I have one foot in each camp now,” said Dempsey, who earned his Fox Online MBA in 2011. “Having an MBA, especially one from Fox, trains you to be a more-effective messenger between these two large arenas. Suddenly, you’re able to help non-clinical administrators understand a surgeon’s point of view, and you also are more able to help the clinicians understand how an administrator sees something.
“Overall, that business education facilitates greater communication between the two sides.”
The responses Dempsey received are somewhat commonplace. In a 2005 research paper written by Dr. Windsor Westbrook Sherrill, professor in public health sciences at Clemson University, students reported uncomfortable exchanges with doctors who saw them as “traitors” for having enrolled in a joint MD/MBA program. Sherrill, whose research has concentrated in medical education, identified a critical “gap in training,” when it comes to clinical leaders who lack business education.
“The real driver is the financial constraints of healthcare today,” she said. “In fee-for- service medicine, there wasn’t a push for cost efficiencies. Reimbursement services have changed. There was a time when you didn’t have to worry about cost. You’d be reimbursed no matter what you charged. It’s gotten more important in healthcare to be cost-conscious. There’s more regularity around quality and accountability measurement, from payers and policymakers.”
Dr. Maria Chandler, the president of the Association of MD/MBA Programs (AMMP), said nearly 70 dual-degree programs exist in the United States. One of them is housed at the Fox School, through which dual-degree students pursue the Fox Online MBA. The program, which can be completed in less than two years, employs a flipped-classroom model.
The program features what Fox has coined “a curriculum carousel,” which provides multiple entry points throughout the calendar year. Students can pursue the degree at their pace, and can register for one or up to three courses per semester. Each course is delivered one at a time over four weeks, and the program can be completed in as quickly as 20 months.
The program-opening residency features a leadership course, networking and team building opportunities, professional development workshops, and special events.
As Chandler sees it, the overlap between the two industries is “larger than people think,” and necessitates a foundational business education.
“I’ve seen surgeons without business training stand up in meetings, and say they need new equipment for one reason or another,” Chandler said. “And when they are asked, ‘How do you suggest we pay for that,’ the surgeon can’t make a business argument.
“Then, I’ve seen others who say, ‘If you double throughput through our department, the piece of equipment would pay for itself in X amount of months.’ Now, all of a sudden, the surgeon has the CEO’s ear and can get what he or she wants. And that’s just a small sampling of what a business education can do for a medical professional.”
A dual-degree program, according to Chandler, gives students the skills, vocabulary and applicable training to succeed in both arenas following attainment of their degrees. In her leadership position with AAMP, Chandler said she has come into contact with a wide array of scholars who were thankful for the joint education, executives who wished they’d had it, and a small subset of those who don’t see the value in it.
“I once met a surgeon who was in charge of a $6 billion budget and had absolutely no business training,” she said. “In what other industry would someone be tasked with managing a budget of that size and have no business training? That’s the current state of the healthcare industry.”
Vaccaro, the orthopaedic surgeon and Rothman Institute president, said he did not want to be left behind within his evolving field. Pursuing an Online MBA at Fox allowed him to supplement his medical know-how with the ability to, in his words, “speak the language” of the business community.”
“I’m a much-better leader today because of Fox’s program,” Vaccaro said. He earned an MBA, he said, “to run a healthcare system, to improve its quality, and to make it more accessible and affordable. We have to start to control the healthcare system, and that’s what a business education can do for someone like me.”