Thursday, March 22, 2007

Students, it is your turn

A comment from CK on a blog called Marketing Profs: Daily Fix,

I'd love to see a CEO run a blog that solicits questions from students (college or MBA) and then he/she answers one a week.

Let's try it out, but expand it to all schools. Students out there, do you have a question you would like me to answer? It is OK to be anonymous if you want, but please indicate what school you attend, your degree program, and your year.


Anonymous said...

Glad the idea is of value for you, Paul and bravo (!) for blogging. You're setting a tremendous model for all CEOs.

The era of democratized media and two-way communication exhanges are upon us--as a result it's never been a more exciting time to innovate and share our expertise.

As a professional I see it as our responsibility to "give back" to tomorrow's leaders and these students--be they at the undergrad or grad level--will receive tremendous value from your teachings (as will all your readers, of which I am now one).

Anonymous said...

Mr. Levy,

As a new member of the health care administration field, I find your blog both informative and interesting as I prepare for my future career in hospital administration. I am completing the MHSA program at Xavier University and currently doing my administrative residency at a non-profit hospital. I have only been on site for a few months now, but I have a question to address to you that has recently came up at our facility and it deals with management empowerment.
What innovative ways or thoughts do you have on motivating/ encouraging your management team to take on bigger projects and plan for the future success of the facility? As with most hospital, our director/ manager level staff often times feel over-worked and barely meeting the demands of their position, but do rank high in their readiness to effect change. I feel that these employees are just about at that point to effectively change our organization, but just need that extra little push to get them to see what our senior management envisions for the future of our hospital. If you could share any insight on your philosophy of empowerment that would great.

Anonymous said...

Paul, This is going to be interesting. I am planning on sitting back, with a great glass of Cab' and watching.

This blog may just turn into the best teaching tool for Healthcare Admins.

I'm still very proud of what you are doing for our profession.

Anonymous said...

An up and coming degree in many medical schools is the combined MD MBA. I am currently a third year medical student with a business background weighing the benefits of an MBA.

Do you see a combined understanding of medicine and business as a great benefit in a hospital administration setting? Is there a disconnect between physicians and administration when this understanding is not there?


Anonymous said...

Dear anon 10:47,

It is VERY helpful when MDs have the kind of business background that an MBA brings, but that adds a lot of extra schooling (and cost)on top of your medical training. An alternative is to take in-service training on business issues during your medical career. That way, you can be more focused in your coursework and make sure it is relevant to your practice.

On the other hand, if you really know you want to prusue hospital administration or tilt your career to managemenment consulting or investment banking, an MBA will be extremely valuable.

Dear anon 5:19,

Ohmygosh, that is a BIG question. The best way to see my answer is to review a bunch of the postings I have made, e.g., the "What Works" ones, and "Change must come from within". The underlying answer to your question, though, is that I don't need to motivate folks here. Instead my job is to try to encourage analytically rigorous review of new project ideas and to help create and environment in which they are more likely to thrive.

Anonymous said...

Thanks mary lu and ck!

Andrew Calvin said...

Mr. Levy,
Thank you for this opportunity to ask you some questions. I'm a fourth year medical student who interviewed at BID's internal medicine residency this winter, and I was very impressed with the program. I felt the same kind of forward-thinking that you demonstrate in your blog was also permeated the internal medicine residency in addition to a very strong commitment to medical education and training future educators. I wanted to stay in Minnesota and I'm thrilled to be heading to the Mayo Clinic in June, but I thought very highly of the program at BID.

Before medical school I did an MPH in epidemiology. During medical school I was involved in a clinical epidemiology research project that also touched on systems improvement that I really enjoyed. I have a number of questions stemming off of that experience.

I know residencies are increasingly incorporating systems improvement curricula, and it seems some academic medical centers are starting to recognize systems improvement work as a valid career path (in addition to the clinician-researcher and clinician-educator). In terms of university faculty promotion the clinician-educators have struggled to quantify and prove their worth to their departments (vs. the more easily quantifiable publication record for the clinician-scientist), and I'm wondering how the "clinician-systems improvers" (not even sure if that's the right term) can get fully recognized for their contribution and justify their academic promotion to their university department. Perhaps that's outside your area of expertise but I'm curious to your take given your unique vantage point. How do these people get recognized/promoted/etc by the hospital, whether it's an academic hospital or not?

Are you noticing an increased activity level in SI work from your clinical staff, in particular from MDs? From your persepctive, do you think there is a large or growing demand in both the academic and private sector for those SI-focused clinicians?

Do you see an increasingly diverse group of clinicians getting involved in this type of hospital administration (MDs, PharmDs, RNs, RTs, etc)?

How does an SI project work between a hospital administration and a university department that staffs it - who typically is in charge? What sorts of backgrounds/training/experience have you seen that seems to help these individuals?

Andrew Calvin

Anonymous said...

Stay tuned, Andrew, I'll get to this soon.

Anonymous said...

I'm an MD/MBA and current medicine resident who has spent time at a top management consulting firm. My long term career goal had been to lead a medical center. However, since being in "the trenches" I've come to realize that working through the hierarchy of a hospital would be incredibly painful given the way I've been trained to approach problems. Decision making among physicians and many hospital managers when it comes to general management, capital expenditure, strategy, even team leadership is frequently unrefined (even amateurish?). Pushing against this cultural divide seems like a Sisyphean task.

Can you offer some advice? Are their ways to leapfrog the hierarchy to prove my leadership mettle? Should I consider exiting health care delivery and re-entering after gaining experience / positions in a horizontal move or in another industry ? I know I'm ready to push an institution to excel, but I don't want to spend 10 years trying to prove it (and picking up bad management habits in the meantime).

Anonymous said...


Let me be a bit direct. You say: "I've come to realize that working through the hierarchy of a hospital would be incredibly painful given the way I've been trained to approach problems." Get over it! Your comment is elitist and self-centered. Your job as a highly trained MBA/MD is to help "the hierarchy of the hospital" learn how to do things better. Do you think the lessons you learn in business school amount to a hill of beans if you don't dive in and figure out how to get people to execute improvements? What happened to those OD and process improvement courses you took as part of your MBA?

Get an administrative job -- virtually any administrative job -- in a hospital. Show your stuff. If you are good at it, you will rise, either at that hospital or at others in the community, because people will hear about you. With an MBA and an MD, you should have more luck helping both MDs and administrators do better.

If you leave the field to get experience elsewhere, it will not help you much in the hospital setting. The only way to do it is to jump in and do it.

Anonymous said...

Thanks for the amazing feedback. You are absolutely correct in calling attention to my comment as being elitist (something I'm working on). I think my frustration comes from a desire to be a change agent and to truly improve patient care. As a very low person on the totem pole, I see incredible institutional and professional resistance to change which seems daunting, making private equity and consulting enticing.

Have you thought about starting a "rotational" program for aspiring clinician-managers similar to many fortune 500 companies? Work on performance improvement issues is easy to come by and is the usual track for physicians, but feels limiting from a professional growth perspective. The opportunity to get P&L, marketing, IT, and general management experience would be very interesting to many in my situation. It would allow CEOs to identify stars and plug them into an organization early in their development. MD/MBAs are a relatively new breed, and I wonder if there can be new opportunities to leverage our interests and skill sets.

Anonymous said...

We have thought about it, but instead have created a different kind of program that recognizes our "stars" and gives them a chance to grow and shine -- with extra training, assignments, and mentorship. But, meanwhile, we need them to keep doing their day jobs as well. I think most hospitals don't have the financial flexibility to create the kind of fortune 500 program you mention. Others may want to comment on that, though.

Anonymous said...

Also, Chandler, some comments on your point: "As a very low person on the totem pole, I see incredible institutional and professional resistance to change which seems daunting, making private equity and consulting enticing."

Go into private equity if money motivates you.

Go into consulting if you want to learn about a broad range of businesses and situations, but not if you want to see your recomendations and proposals carried through execution.

But, you seem motivated by deeper causes. Don't give up. Use your time at the low end of the totem pole to watch and learn why you see "incredible institutional and professional resistance to change." Test out approaches for dealing with that inertia and see if you can make small differences. Learn from those.

Remember, the people in a hospital are the most well-intentioned people in the world. They are not TRYING to be recalcitrant and obstructionist. Something is making that behavior become dominant. Figure it out and try to change it.

You will never find a more satisfying -- or difficult -- job. Don't give up before you have tried it out for real.

Unknown said...

I posted a comment on employee empowerment the other day, but your recent response to the MD/ MBA questions really stuck with me. You mentioned that everyone that works in health care is well-intended and if they are doing something to cause distraction they must be doing it for a reason. Your statement, "Figure it out and try to change it" can apply to almost any situation and I plan on using it as my mantra as I continue with my career. Thanks for reminding me to see the world from other's eyes.

Anonymous said...

This is a great post. You should consider making a Q&A part of a weekly post or something like that.

Anonymous said...

Thank you for inviting these questions. A few weeks ago I posted asking you what advice you have for young professionals trying to work their way up as non-MDs in academic medicine.

Many of the topics you speak about in this blog are precisely the type of work I'd love to do, but I never know WHO exactly does it, or what the actual job title would be within a large academic hospital. It can be so difficult to navigate all the departments, units, etc within these large institutions.

For example, your blog about the "mystery shoppers" was particularly fascinating to me. I'd love to work on that type of project - but how do I go about doing that? I have an MPH, and designed my own curriculum to focus on Health Care Marketing along with Health Policy & Administration. I've often wondered if I should have done the combined MBA/MPH program? Do you need an MBA today to move up in health care?

When I took a job in a large teaching hospital in Boston that wasn't exactly my dream job, I figured I'd get my foot in the door, meet people and be able to move around within the organization and eventually end up in a job more related to my specific interests. However, 4 years later, I've realized that this does not happen easily. Everyone is doing their own thing, stuck in their silo or ivory tower, and there is very little opportunity for young professionals to learn, explore and network in these huge academic health centers.

I've learned more from reading your blog than I have from any mentors I've had in my career. So, thank you for that!

Any advice for people like me?

Anonymous said...

Your second reply to my second post ("Don't give up") is, literally, one of the most career-affirming pieces of advice I have ever received. I can see how you have been very successful at BIDMC. During my 30 hr shift yesterday, I felt different about my role (and only half as cranky!). Interactions with the nurses, technicians, attendings and even chief of medicine felt like a training experience to practice "figure it out and try to change it" with regards to understanding others' motivations. I don't know how long it will last, but you have given me a welcome boost. I will be sure to introduce myself in person and thank you a few years from now.

I still think hospitals could do more to attract (and retain) future leaders. MBAs from HBS, Wharton and Duke to name a few are within the ranks of many hospitals, being paid 1/3 the salary of their peers voluntarily (as residents). We are committed to medicine, and we need leaders like you to help us stay and grow.

Anonymous said...

I am so pleased that so many are getting values from your Q&A. Thanks for spreading the wisdom ;-).

Anonymous said...

Chandler, I am so glad it is working. But it takes lots of practice, so don't get frustrated!

Read Getting to Yes, by Fisher and Ury.

Anonymous said...

Andrew and others,

Please see today's post --

Feel free to submit other questions for future posts here or there. Thanks.

Andrew Calvin said...

Wow, thanks!

Anonymous said...

My pleasure. You look pretty happy in that picture!