Johns Hopkins experts propose business training requirement for med students

Health care increasingly requires business management acumen, authors say

Modern health care increasingly demands that people working at all levels of the industry—from community physicians to hospital CEOs—possess strong business management skills to go along with their medical know-how.

By and large, however, they don't possess those skills, and in order to remedy that shortcoming, a "Management 101" course should be embedded into the curriculum of every medical school, say two Johns Hopkins University professors in an invited commentary for Academic Medicine.

Christopher Myers (left) and Peter Pronovost

Image caption: Christopher Myers (left) and Peter Pronovost

Christopher Myers, an assistant professor at the Johns Hopkins Carey Business School and co-author of the commentary, says many medical professionals have received some management or leadership training, but it has tended to come through a widely varied and unsystematic approach that has had little impact on broader practices and behaviors.

"What's needed are more methodical efforts at the outset of medical education, drawing on research-based theory from psychology, sociology, and the organizational sciences," says Myers, an expert in management and organization. "The med schools could partner with business school faculty and other management scholars to bring MBA-style training to the health care context—Management 101 for med students."

Myers and co-author Peter Pronovost, a professor at the Johns Hopkins School of Medicine, note that many U.S. universities have been introducing joint MD/MBA programs, though enrollment in these programs has lagged expectations.

According to the Association of American Medical Colleges Medical School Graduation Questionnaire, only 0.7 percent of 2016 medical school graduates completed an MD/MBA program. More than 90 percent earned a standard MD degree, which the authors point to as an indication of the need to include management skills in the "core" medical curriculum.

And often, the writers say, physicians are promoted to management positions based on their clinical or research prowess, resulting in a "double loss"—the removal of a skilled doctor from a clinical role, and the installation of a manager who may be unprepared to lead.

Topics of management training that are familiar to business students, and which Myers and Pronovost suggest should become equally known among medical students, include:

  • Individual and interpersonal dynamics (judgment, decision making, motivation, communication, negotiation, and conflict management)
  • Team and unit dynamics (leadership, information management, and team processes)
  • Organizational dynamics (organizational culture, interorganizational networks, and managing change)

Prior research has established a link between the quality of management in a hospital and the quality of care patients receive there, and the authors say the overarching goal of their proposal is averting the potential patient harm that can result from ineffective management. This is familiar territory for Pronovost, a medical doctor and the director of the Armstrong Institute for Patient Safety and Quality at Johns Hopkins Medicine. Myers, in addition to his position at the Carey Business School, serves on the core faculty of the Armstrong Institute.

"We are not naïve enough to believe that instituting 'Management 101' in medical education will completely resolve the leadership challenges facing physicians," they write at the conclusion of their commentary. "Still, it is a necessary first step toward elevating management abilities onto more equal footing with clinical knowledge for the majority of medical school graduates, and more adequately preparing these graduates to lead and manage the delivery of high-quality, safe care in the modern medical enterprise."