And How This Impacts The Healthcare System
In my last post, I wrote about how their med school leaves doctors unprepared for the business of medicine. Today, let’s flip it. What’s missing in the lived experience of non-clinician business leaders who run healthcare organizations?
Why Doctors See the World Differently
Most students who go to medical school don’t choose it for money. They choose it because they want to help people. If money were the only goal, they could just head to Wall Street and make a killing moving numbers around. Trust me, they are smart enough and hard-working enough to do it.
Instead, after college, they spend at least seven to 12 years (depending on their chosen specialty) of their prime working years in medical school and residency. Long nights on call, holidays missed, birthdays skipped. Every note, every exam, every midnight study session is built around one lesson: the patient comes first. It isn’t just taught in lectures; it’s baked into the culture.
Older generations of doctors used to joke that medicine was “the mistress who cannot be denied,” because it demanded more time, more attention, and more loyalty than anything else. Like many a joke, it had truth buried in it.
By the time young doctors finish training, “patient first” isn’t a slogan. It’s in their bones. Part of who they are.
So when doctors speak up in meetings and ask, “What about the patient?” they’re not being difficult. They’re being true to the very core of their training. Those who have never experienced it never understand it in the same way. To them, the doctor who always asks that question sounds like an annoying pest.
But medicine is not like selling TVs. TV makers create demand with ads. They want people to want the newest model. But nobody wants to “buy” a doctor visit. Most people would rather not see the doctor if possible. Isn’t that the essence of the saying, “An apple a day keeps the doctor away?”
Even when patients ask for the newest drug, it’s because they’ve been struggling for years with a health issue. They want to live longer, healthier lives for themselves and their families. That’s a whole different thing from wanting gadgets for their cool features.
Nobody ‘wants’ to ‘upgrade’ their hospital stay from a regular bed to one in the ICU.
How The Gap Has Hurt Healthcare
Over the last 25 years, healthcare leadership has increasingly moved out of clinical hands. As a result, the deep understanding of the soul of clinical care among leaders has fallen. The resulting deficit hurts everyone in healthcare — both those who work in it and those who receive care.
Media articles show how private equity firms and large systems cut staff and push profits even when it hurts patient care. The drive to efficiently and accurately ‘capture’ value has led to doctors now spending more time clicking boxes in the electronic record than looking patients in the eye. Burnout is at record highs. There are also reports of doctors afraid to speak up for patient safety.
Business leaders often don’t get the patient-first mindset. Doctors don’t get business training. And because neither side gets enough training in the art of persuasion, the two sides talk past each other.
So what do we do?
Healthcare leaders must create systems for inviting practicing doctors’ voices into the boardroom, not as window dressing, but as integral to the decision-making process.. Healthcare systems must ensure that onboarding for doctors (and other clinicians) includes an overview of their organization’s business.
Medical schools and residency programs must teach future doctors the basics of business and leadership. Doctors must be eager learners of business basics, even when no formal training is offered. They must sharpen their public speaking and presentation skills so that when invited into the boardroom, they can be an effective voice for the soul of medicine.
In the last post, I said doctors need business skills. In this one, I’m saying business leaders need a little of the soul of medicine.
Healthcare isn’t about selling more products. It’s about helping people live better, longer lives. When the business of medicine is strengthened in ways that also nurture the soul of medicine, we create a system that works for everyone.
Let’s start building that bridge now.
This is right on, and an approach we’re taking with our undergraduate students pursuing healthcare careers at the Concordia College School of Health Professions. We do this by building curriculum which acknowledges the integrated nature of healthcare and the importance of understanding clinical and business applications.
Eric – Thanks for your comment. The more healthcare becames corporatized, the bigger this problem becomes. Thank you for the work you do in education to help bridg the gap between the business and clinical perspectives.
[…] shared goals. As we discussed here and here, clinicians and non-clinical leaders may not understand each other completely. And they may not […]