Are MDs More Effective At Running Hospitals Than MBAs?

[HuckleB]

http://getbetterhealth.com/are-mds-more-effective-at-running-hospitals-than-mbas/2011.10.07#more-53216

"...

‘Social Science and Medicine’ published in its August issue a very interesting work by Amanda Godall, professor at the IZA Institute for the Study of Labor in Bonn, Germany. Godall’s is the first empirical research on the correlation between hospital results and having MDs in their top managerial positions.
The work reviewed results from top 100 American hospitals in the areas of Cancer, Gastroenterology and Cardiovascular Disease. Godall used the Index of Hospital Quality, which takes into account several measures of infastructure, processes and results, and compared figures with the background of the board of directors that rule each hospital. In 2009, Gunderman & Kanter published in ‘Academic Medicine’ a study on 6,500 U.S. hospitals and found that only 235 were run by MDs.

Godall classed 300 hospital CEOs in two categories: professional managers with no clinical experience (often MBAs), and managers with a medical practice background. And she found a significant association between better IHQ results and having an MD running the hospital. As she points out, this doesn’t mean that people with a medical background are more effective managers. It could be that better hospitals tend to appoint MDs as CEOs, maybe as a way of improving carreer opportunities inside the organization.

Anyway, even if we need to acknowledge the limitations of this kind of research, Godall’s article is the first one to provide empirical data that not only open an interesting research field but also challenge HR policy in the healthcare sector. In public-funded healthcare systems with universal coverage such as the Spanish one, it also raises questions about Government policies over the last 30 years, in which it has been common practice to give important posts to people with no previous knowledge of the healthcare sector. The list of the latest Ministers of Health is the biggest proof: most of them, including current minister Leire Pajín, came to office without the slightest clue about the complexity inbuilt in healthcare management."



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Yet another layer to so many of the discussions at DU.

[hifiguy]

1. I have met a lot of MBAs I wouldn't want

organizing a two-car funeral on a one-way street much less running a hospital.

[bananas]

2. Cancer patients would be best

with only six months to live, they aren't building empires or setting aside nest-eggs.

[bemildred]

3. MBAs have not shown much ability to run anything, except perhaps into the ground.

Narrow gage intellects don't do well in the messy chaos of the real world.

[SharonAnn]

12. It depends on what the goal of the hospital is. To treat the sick or to make money?

Hopefully an MD will stay focused on the "treat the sick" goal while they try to balance the need to stay financially solvent.

An MBA might focus on the "make money" part and perhaps only incidentally "treat the sick."

[bemildred]

20. "You cannot serve both God and Mammon".

But that is the problem with MBA-think in any enterprise. it measures everything by money, and money is not the measure of all things. It's a deliberately simplified (i.e. dumbed down) view of the world.

[TygrBright]

4. It shouldn't be either/or.

I've met MBAs who couldn't manage their way out of a paper bag with a scissors and a flashlight. I've met MDs with cases of MDPD so severe they'd likely touch off a riot and provoke mass resignations among their staff. And I've met MDs and MBAs both who are excellent managers, multitaskers, and have an intuitive grasp of priorities and resource deployment that would make them stellar hospital managers.

There is no single credential that guarantees someone will be competent at the phenomenally complex and difficult job of managing a large hospital.

If the point here is to emphasize that hospital managers should be selected on the basis of competence rather than credentials, whether they be MDs or MBAs, bravo. I'm all for it.

But if it's all about "This should be the credential required, not that," forget it.

opinionatedly,
Bright

[muriel_volestrangler]

8. That sounds very sensible

Running a hospital is something much more than either an MBA or MD shows you have the knowledge for. I'd look for people who have shown a good track record at running departments, holding a senior hospital-wide position, or, just possibly, an organisation you think is similar - but I'd say there aren't many of those.

[MedicalAdmin]

13. Good point.

My background is varied but the one credential I don't bring to my current job is that business management or medical degrees. ANd yet I run a clinic and despite the bad times economically we are doing better now that I am in charge than at any time in the clinics past.

It is about the person and not the degree.

However, I must admit that as a class, there seems to be a high percentage of dumbasses who think their shit don't stink among the MBA crowd. Just my experience.

[HuckleB]

26. I think it's about looking at what credentials seem to prepare people better.

It's not either/or, but it's also a worthy question.

[AngryAmish]

5. I have met a lot of MDs who are really shitty businessmen

THat said, the really shitty ones would not aspire to run hospital, methinks.

I have also met a lot of MBAs who are really shitty businessmen.

[Warpy]

6. Uh, YES

My nursing career spanned the transition from physician run hospitals to MBA run hospitals and the changes were all negative ones.

While physicians were just as quick to try to balance the books on the backs of nursing staff, the MBA types brought retail management style philosophy into the mix, demeaning professional staff and completely misunderstanding the nature of the job and the nature of the institution, itself.

Even the ones who did the "health care management" route to the MBA fell flat, writing ridiculous mission statements that had nothing to do with the purpose of a hospital: to treat the sick and comfort the dying.

The first step to reforming hospitals has got to be to eliminate the MBAs from their management. Yes, it's that bad. They are utterly incapable of dealing with an institution that is labor intensive.

[MedicalAdmin]

14. MBA's are wholly unprepared for service industries.

Their educations don't cover this area, they are not interested in it, and they just don't seem to get it.

Most of them seem to want to bring "the lessons" of whatever industry they did their thesis on, or where they worked as a busboy (or whatever) while tugging on their bootstraps.

ANd that has nothing to do with service organizations like schools, hospitals, etc....



These statements are, of course, generalizations. I'm sure they are out there, but I've never met them in my long and varied career.

[cbayer]

7. Great work on her part.

In my experience, MD administrators often do run better hospitals. One of the main reasons for this is that the usual animosity between the clinical MD staff and the administration is decreased. When admin and medical staff are able to work together and not be adversaries, overall quality of care often improves.

thanks for posting this.

[Ikonoklast]

9. A close friend of our family is a very-highly paid MBA hospital administrator.

It is a very long story, but he got canned from a high-profilr position because he had the impudence to want his hospital to cure sick people as the first priority.

[Skittles]

10. EVERYONE more effective than MBAs

[virgogal]

25. Nonsense.

[Skittles]

27. too many of them SUCK

over-educated out-of-touch people who think they know everything

[Scuba]

11. I'll put my money on MSN's.

[MedicalAdmin]

15. Microsoft Networks?

What?:wtf:

[Scuba]

16. Master of Science, Nursing....

... nurses know more about running hospitals than MD's and MBA's together.


I base this opinion on 30+ years as a hospital administrator.

[MedicalAdmin]

19. Oh. I could get on board with that...

Far too many MD are stuck in thinking they are god (although many are not) and MBA's are, well, the same assholes who almost destroyed the world economy last time and might still get away with it.

Nurses are, by and large, pretty good. Although my next door neighbor is a nurse and she is one of the biggest *****'s I've even met and she is someone I wouldn't trust to tie a pair of shoelaces without an instruction manual and a coach. There a stinkers in every pot.

[Maine_Nurse]

24. I have worked for two places run by RN's. Seems to work well.

I know one CEO was BSN/MPH and I think the other was BSN/MPA.

[saras]

17. I have yet to see an MBA be successful at ANYTHING whose success wasn't defined by MBAs

[valerief]

18. MBAs run their own portfolios best. Everything else? Meh, doesn't matter. nt

[nichomachus]

21. MBA = Managed by Assholes

The destruction of American business began when we created the management class. Companies used to be run by people who worked their way up through the ranks and knew what the business was about.

Now, most businesses are run by people who know how to look at a spread sheet and negotiate for more and more money in their pockets. They don't have a clue as to what the people under them do for a living or how they do it.

[Dawson Leery]

22. MBA's are experts at enhancing their financial portfolios and nothing else.

Yes, hospitals should be run by MD's, not MBA's.

[ProfessorGAC]

23. This Seems Like A "Well, Duh!"

I've got an MBA. I know i wouldn't run a hospital as well as an MD with a proven track record.

Geez, lots of physicians run their own businesses anyway.

I've got an extensive techncial background, and that still doesn't mean i could run a hospital.

Maybe a doctor with an MBA is the ideal. Don't know.
GAC

[JI7]

28. I'm not very impressed with MBAs running things just because they have an MBA

i have found out those who run businesses better tend to be ones with some knowledge and interest in that business itself.

in fact i find just bringing in anyone because they have an MBA even if they know nothing about the business always hurts it.

this is why our economy is a mess.

in fact if you want to run a business i would recommend researching the type of business you want to run and learning about that. like if you are into restaurant business learn about food, cooking etc.

[mod mom]

29. Many CEOs are MHAs.