A few years ago, I was sitting in my office at the Medical College of Georgia when the telephone rang. The caller was a neurosurgeon who had recently finished training at MCG and was now in private practice. He felt overwhelmed in his new practice and had a thousand questions about the business aspects of his new career. Of particular concern to him was the interpretation of his employment contract that he had signed a couple of years before. I heard his concerns and offered some sage advice (such as never to sign anything without reading or understanding the document).
Upon later reflection, I felt that as a department we were failing our residents. While we provided our residents the requisite training to complete a complex spine case or craniotomy, we failed to provide them with any tools to analyze an employment contract or understand a practice’s balance sheet.
This experience and others like it inspired a course designed to introduce young doctors to business concepts and practices. Aptly titled Health Care Management 101, the course became a required core competency for successful completion of MCG neurosurgery and neurology residency training.
The objectives of HC 101 are simple and threefold. They are to provide:
• core competencies in non-clinical healthcare management;
• baseline knowledge for business decision making; and
• tools to keep MDs from getting MBA blindsided.
Initially, the course was given on monthly basis during a luncheon lecture. Because it was next to impossible to gain residents’ attention and attendance for an hour-long session given their busy clinical loads, after the first year the course was delivered in an online, interactive format. The Web-based application is familiar to students because it is used for other medical courses at MCG. Students must have access to high-speed Internet and a password for the Web site. Students merely direct their browsers to a secure Web site, enter a password, and begin the course.
The Web-based course consists of seven consecutive audiovisual lectures, each synchronized with a PowerPoint lecture. Each lecture is a separate module, enabling the students to work at their own pace. The students must take a pretest before viewing the lectures to determine their knowledge level of the subject. The subsequent sessions fill in the knowledge gaps, and learning is assessed by a short quiz following each lecture.
Residents are able to complete the course during the year, at their leisure. Additionally, program administrators and I can track their progress and provide residents who are not working on the course with the necessary motivation.
The content of the course was designed to expose the residents to some basic healthcare business topics that they will be faced with when they enter the “real world.” The course content was developed to apply to academic as well as private practice environments.
The seven sessions range from about 10 to 45 minutes in length and begin with current issues in the U.S. healthcare delivery system before moving on to intensive study of coding, reimbursement, and healthcare regulations and laws. The course concludes with an MBA “in 30 minutes.”
The response to the course has been very positive, and other MCG residency programs including general surgery, internal medicine, psychiatry, and pediatrics now are requiring it for their residency programs.
Measuring Success
The experience over the past two years shows that the course objectives are
being met, based on the post-quiz score improvements. However, the true value
of the course is its ability to expose young doctors to the business side of
medicine during their training. The real test of the course’s success
is whether young doctors areprepared to make proper business decisions, ask
knowledgeable questions and succeed in the business of healthcare.
I know the course is really sinking in when the residents start to come by my office in the last six months of their training and bombard me with questions, concerns, and requests to help them review contracts, salary offers, and a practice’s finances. In the past, residents didn’t even know which questions to ask.
While HC 101 has been successful and similar business courses are being done very well across the country through various organizations, the courses often are fragmented or not well administered. Medical schools and training programs at academic medical centers have an obligation to establish business training curricula for residents that help them prepare for the rigors of the business side of medicine.
William B. Hamilton, MBA, is the administrative director of the Department of Neurosurgery and Neurology and the Neuroscience Center at the Medical College of Georgia in Augusta.