To earn a seat at the table and have the opportunity to self-advocate, however, physicians must not only be clinically well-versed, but also proficient in leadership, care delivery, and practice management.
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September 2021
The following discussion expands on available resources for medical students and physicians interested in understanding and developing business perspectives and skills through an asynchronous learning format, including a new offering we’ve developed (see “Business of Medicine Curriculum and Suggested Resources”).
Business of Medicine Domains
A focused study of the business of medicine for physicians should include at least three practical domains: leadership, healthcare delivery, and practice management. In addition to content learning in these three domains, experiential learning and practical application are critical in skillset development. Similar to traditional classroom settings, asynchronous learning platforms are complemented by the application of knowledge in the real world through reflective writing and exercises and the implementation of changes and experiments in practice.
Leadership. The onset of the COVID-19 pandemic reaffirmed the need for clinical leadership in both the hospital and public policy settings (Six Tests for Physicians and Their Leaders for the Decade Ahead. NEJM Catalyst Innovations in Care Delivery. 2020). In the near future, physicians will be expected to lead diverse groups to improve patient outcomes through multidisciplinary teamwork, coordinated care, and alternative healthcare delivery models, all while reducing healthcare costs.
Developing leadership skills is a continual process that requires thoughtful and deliberate practice with constructive coaching. Experiential learning allows for an evolving and dynamic skillset that defines effective leadership. Business of medicine training provides foundational knowledge in the fields of behavioral science, communication, and sales, with a focus on three practical topics: influence, networking, and career development.
Care Delivery. With the passage of the Medicare Access and CHIP Reauthorization Act (MACRA) in 2015, the U.S. healthcare system began a fundamental shift away from rewarding volume (fee-for-service models) and toward rewarding value (value-based and bundled models). Since then, physicians have been held increasingly responsible for high-quality, low-cost outcomes in an effort to maximize value for patients and reduce systemic waste (Otolaryngol Head Neck Surg. 2020;163:397-399; Arch Intern Med. 2001;161:1261-1266). Physician leadership and input in the restructuring of care delivery is critical in improving the patient experience, designing sustainable systems for both patients and clinicians, and advocating for physicians’ needs.
Business of medicine education should emphasize an understanding of the past, current, and future state of the U.S. healthcare system, with discussions on healthcare spending, metrics, and value-based healthcare delivery and payment models. Design, implementation, and behavioral economic principles that emphasize human-centered solutions are vital instruments in developing solutions for patients within the evolving healthcare system.
With foundational knowledge in care delivery, physicians will have the ability not only to advocate for their patients, but to do so in a way that uses a patient-centered design to better understand the underlying motivations that determine their experiences and actions. Physicians who understand these underpinnings can develop more effective care delivery models that drive superior patient outcomes.
Practice Management. Finally, the practice management domain rounds out the broader concepts of leadership and care delivery with realistic tactics for building a successful practice that optimizes both patient care and physician career satisfaction.
Practice management begins with the development of a strong referral system, which is driven by physician communication, outreach, and networking. While the discussion of practice financials in medical training has traditionally been taboo, financial stability is a prerequisite for providing excellent patient care. Financial insecurity limits a physician’s time, resources, career satisfaction, and opportunities for innovation, which can cause downstream effects in patient care.
Education in the business of medicine for physicians should discuss strategies used to achieve a financially successful practice; this provides foundational support for innovation in healthcare delivery and the patient experience. Approaches to developing a financially successful practice include expanding referrals and patient reach, providing patient-centered and profitable services, optimizing reimbursements through effective billing, and expanding clinical services using in-office procedures, testing services, electronic commerce, and social media. Taken together, these factors play a critical role in the development of a thriving practice and provide the groundwork for the improvement of delivery and outcomes.
The well-rounded physician with both clinical expertise and a business perspective will be best poised to navigate the evolving U.S. healthcare system in the years to come. As asynchronous learning opportunities become more prevalent as a result of the COVID-19 pandemic, physicians have a tremendous opportunity to fill in medical education gaps with practical teachings from the business sector.