By Benjamin Chartock
Many universities offer programs for mid-career medical professionals and this phenomenon is growing. I was asked to share my experiences teaching in the MBA program jointly run by Bentley University and the leading health system in Boston, Beth Israel Lahey Health. The program is similar in spirit to an executive MBA but exclusive to this hospital system. The degree is not for the C-suite (the top managers, including CEOs, typically already have an MBA) but for doctors and nurses who want to ascend to leadership roles in the organization, as well as for leaders across the health system. Some of my students include the employee who buys large capital equipment, such as MRI and CT scanners, and the employee who runs equipment sterilization across the hospital.-. They are a brilliant bunch and have lots to offer. The rest of this article describes my experience (mostly good!) in order to inform those considering getting involved in similar teaching activities.
I’ve heard Adam Grant once taught a course to Pentagon generals and when receiving his course evaluations he read, “The Professor learned a lot from his students.” The next semester, Grant—a dedicated teacher—came to the generals with more humility; he introduced himself saying, “I’ve never gone to war, never commanded a battalion, but I know a lot about management from an academic perspective because I write papers on the topic.” I relay the same message from day one: I remind them I’ve never sewn up a wound, never gone to medical school, and never worked a night shift at the Emergency Department. But my research in health economics could be helpful to them, nonetheless. This sets the tone for the semester, which is different than an undergraduate course because the students have so much work experience.
I was attracted to teaching in this program because my research relies on data from large medical systems, mostly insurance claims and electronic health records (EHR). Teaching in this program provides an opportunity to form data collaborations, which I first realized during my time as a graduate student at Wharton. At Wharton, it is the norm for health researchers to form collaborations with health-care providers. Cultivating relationships with industry can be incredibly beneficial to research. Not only because direct data-use agreements can arise, but also because medical professionals have a strong sense of what the pressure points are (capacity issues, technology adoption, pay-for-performance, etc.). Understanding these features of the health-care system informs the research questions I ask.
A trick for teaching in such programs is to find synergies and not reinvent the wheel since teaching can be time intensive. I teach a nearly identical curriculum to my undergraduate health economics class. Many of these professional students have not seen economics in years or ever. My brilliant advisor in graduate school showed me that economizing on existing slides helps save time during preparation. However, one unique element that I only do for medical professional students is for their final project. For this project I have them design—but not implement— a fully-ready research project using the health system’s data. The prompt I give is to come up with a research question, determine what data at the hospital can be used to answer the question, explain what needs to be done to get the data, and identify an empirical method appropriate for the project. At this point in the year, they’ve already been exposed to instrumental variables, regression discontinuity, and difference-in-differences. I end up seeing really fascinating projects from my students, with the side benefit that if I think one has a lot of potential, I can collaborate with the student to grow the project out to an academic publication.
Sometimes the questions from the students surprise me. For example, they can get overly focused on minute details of papers and miss the methods I’m trying to teach because they’re less familiar with economics papers. It also takes a bit of time for the notion of scarcity and constraints to settle in, particularly for medical doctors. The Hippocratic Oath is a driving principal in their medical education, and “do no harm” doesn’t square well with economic concepts of tradeoffs and resource constraints. Sometimes it takes added patience when teaching these concepts that I find familiar but that run counter to their training.
In sum, teaching medical professionals is a great way to form connections with major health systems. While it is a bit of work and daunting at first, it can be a rewarding and productive way to push the classroom beyond normal settings. The demand for health economics is strong!