MD/MBA program provides new health care perspectives

UB’s MD/MBA dual degree program offers medical students looking to enhance their clinical training with the advanced management education needed to become leaders in the business of health care.

The collaborative program is a partnership between the School of Management and the Jacobs School of Medicine and Biomedical Sciences.

The benefits of the program are enormous, according to Philip L. Glick, professor of surgery in the Jacobs School and liaison for MBA programs for the health sciences schools and the School of Management.

“The arc of my career is about 40 years long, and throughout medical school and all of my residency training, everything was focused on patient care and there was very little during my training to teach me about the business of medicine,” Glick says.

He notes that the health care policy of the United States changed in the late 1990s, and medicine began being treated like a business.

“In 2023, we are judged on our outcomes. We are in an environment with scarce resources and reimbursement is no longer fee for service,” he says. “Reimbursement is based on the outcomes, so you can do a lot of cases and if you do not have good outcomes, you are not going to be successful.”

Glick says the business of medicine is more than just spreadsheets and bottom lines — it is human resources, operations and negotiations.

“Successful academics in the past — if you were good at patient care and you were good at teaching and you were good at research — you were considered successful,” he adds. “But there is now a fourth leg, which is how good are you at leading?”

Glick earned an MBA from the Kellogg School of Business at Northwestern University in 2005, 26 years after earning his medical degree.

“I thought I had set up a really perfect academic environment for myself, but there were things going on outside surgical academics that I really didn’t understand,” he recalls. “So, I decided mid-career to go back and get an MBA. It changed my life. It exposed me to things that I had never really thought about before.

“There is a lot to running a business besides making the balance sheet look good,” Glick adds. “You learn how to manage people, how to be a good leader, how to improve operations so that not only is it more economic, but you also have better outcomes. Doctors were previously just not prepared on how to do that.”

After Glick finished his MBA, he began talking with Michael E. Cain, then-dean of the Jacobs School, and Paul Tesluk, who was dean of the School of Management at the time.

“We had a dual degree sitting on the books, approved by the New York State Department of Education, for MD/MBA degrees and no one was using it,” he says.

A survey of 100 employers across Western New York, including hospitals, insurance companies and multispecialty groups, asked the question: “If you were going to hire a doctor that had one additional degree to be a leader in your institution, what would it be?”

More than 80% of the respondents replied: “We want doctors with MBAs,” Glick says.

With that knowledge, the School of Management created a concentration in health care management.

“It was the same degree that was on the books, but we now offered medical students a standard MBA with a health care concentration,” Glick says.

The MD/MBA program is a five-year program: seven semesters at the medical school and three semesters at the School of Management, reducing by a year the usual four-year MD program and two-year MBA program.

Students take regular classes just like any other MBA student, but most of their electives are in health care policy and health care management, Glick says.

Students may aspire to be a CEO of a hospital, as well as a primary care doctor. “That MBA knowledge will help them take better care of their patients. It will help them run their practices better.”

Nina Valenzuela is one of three recipients of the dual degree in the Jacobs School Class of 2023. She is entering her residency in obstetrics and gynecology at Hackensack University Medical Center in Hackensack, New Jersey, this summer.

She says she has always had an organizational mindset due to the fact that both of her parents are medical technologists who work in hospital laboratories.

“I knew early on that health care goes beyond clinicians and nurses and patients,” Valenzuela says. “How systems are designed, how you get all of these different people organized to accomplish incredible things, how work culture can impact performance and learning — I found these questions fascinating”

During her clinical rotations, Valenzuela made additional observations, noticing that when attendings struggled or expressed grievances, they were usually systems-based, rather than medical.

“Many had to fight with insurance companies to help their patients get care covered, some had to limit the amount of time they could spend with their patients and, overall, it seemed that there were other forces at play that were restraining how providers were delivering care,” she says.

“I realized there was a need for doctors and aspiring doctors to learn more about these forces — health care system design, market dynamics, reimbursement structure — so that we could better advocate for each other, as well as our patients.” 

Valenzuela says the MBA coursework has strengthened her understanding of how the business side of medicine works, as well as the different building blocks that make up the health care system.

“What might also be surprising to many is that during business school, I’d have weekly discussions about social determinants of health in my health care management courses,” she says. “At the end of the day, people there were trying to answer the same question I often ask myself: How do we build it better for our patients and providers, while reducing health care costs?”

Glick points out that Allison Brashear, vice president for health sciences and dean of the Jacobs School, is a perfect example of the benefits of getting an MBA, as well as an MD.

“While getting my MBA was a large time investment, it was worth every minute,” Brashear says. “Already well into my career as a physician-scientist, it put me on a different trajectory and provided me with the strategic insight and executive mindset needed to advance in the world of health care leadership.”

Glick says Cain’s tagline about the new Jacobs School building — “Making Tomorrow’s Leaders Today” — is especially apropos for the MD/MBA program.

“That’s what the collaboration between the School of Management and Jacobs School does,” he says. “It helps make our graduates in medicine tomorrow’s leaders today.”