Two people shaking hands with stethoscope in forefront
November 9, 2016

Alan Reed: The business of medicine

Managerial accounting, human resources, and negotiations might seem like odd topics for the medical school curriculum. Yet these are three of the courses offered to University of Iowa Carver College of Medicine students who select to participate in a new distinction track in health care delivery science and management. Alan Reed, MD, MBA, director of the UI Organ Transplant Center and adjunct professor of accounting in the UI Tippie College of Business, talked with Medicine Iowa about this unique collaboration between the two colleges.

Q: Why do physicians need training in business?

A: Physicians have abdicated leadership roles over the years, perhaps because medicine became more complicated and we were focusing on patient care issues. Other people have stepped into these leadership roles and are making decisions about how medicine is delivered and paid for and how policy is created.

Only physicians and others who practice on the front lines really understand the implications of policies and payment models and how they affect patients, but these concepts have never been taught well or taught at all in medical school. We send students out of here largely not knowing how they are paid and who pays, the legal ramifications of issues like medical errors, how to build and work in teams, how to run a business, how to negotiate a contract, or much at all about population health, health care delivery, or the business of health care in this country. The time has come to educate them in health care policy, business, leadership, and all of these important things because this next generation of physicians has to be engaged.

Q: How did the distinction track develop?

A: We had a very motivated donor, dermatologist Marilyn Kwolek (’81 MD), who said if she knew then what she knows now about running her practice she might have made different choices. She wants to help residents and students understand those issues. Separately, five medical students asked if I would mentor them in developing a distinction track. So the students—Joe Nellis, Mike McHugh, David Demik, Charles Paul, Sebastian Sciegienka—and I, along with colleagues from the Tippie College of Business, organized a weekend seminar in leadership and business skills for medical students, with support from Marilyn’s gift. We had 125 students apply for the 50 slots. It spoke volumes to us about the interest and need for this type of training.

Q: What happened following the seminar?

A: We decided this had legs and we ought to push it a little bit. With support from Deans Debra Schwinn (medicine) and Sarah Fisher Gardial (business), we developed a memorandum of understanding. The Office of the Provost approved the distinction track as an elective adjunct to the medical degree and we launched it in January. We are also planning a daylong seminar on relevant topics and business skills that are more practically focused for senior residents.

Q: How does the distinction track work?

A: In any given year there are four blocks of courses, two taught by medicine faculty and two taught by business faculty. The topics, spread over 12 blocks total, include human resource management, marketing, law, managerial accounting, data analytics, teamwork, and quality and safety. Students need to participate in at least nine of the 12 blocks. Each student also will do a capstone project, guided by a physician mentor, and take an elective rotation in leadership for future health care professionals.

Q: How does this differ from an MD/MBA program?

A: It’s a matter of depth and understanding. These block courses are introductions to topics, as opposed to spending 12 weeks immersed in a single topic, as you do in a dual-degree program. Students who finish the distinction track will earn a doctor of medicine degree with distinction in health care delivery science and management and a certificate of completion from the Tippie College of Business.

Q: Why did you pursue an MBA?

A: I earned it later in my career, here at Iowa. When I came here to run the transplant program in 2007, I recognized— and health care leadership recognized— that it would be worthwhile to invest in training me in leadership and financial skills. They sent me to a two-week leadership development course at Harvard, which whet my appetite. When I learned there was a science behind management, finance, and business, I said, ‘This is incredible! I have to learn more.’ The skills I developed during my MBA program I now use every day.