Factors to Consider

Today I will present factors affecting your decision to become a Certified Physician Executive.

To set this up, I wish to mention an article on KevinMD by Patty Fahy, MD that talks about the Business School Mindset, or BSM.

Many business school graduates are taught this mindset.

Our Sponsor

We're proud to have the University of Tennessee Physician Executive MBA Program, offered by the Haslam College of Business, as the sponsor of this podcast.

The UT PEMBA is the longest-running, and most highly respected physician-only MBA in the country. It has over 700 graduates. And, the program only takes one year to complete. 

By joining the UT Physician Executive MBA, you will develop the business and management skills you need to find a career that you love. To find out more, contact Dr. Kate Atchley’s office at (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.

What Is the Business School Mindset?

Dr. Patty Fahy states that the BSM reflects these beliefs:

  • “…graduates are assured that an MBA degree has prepared them to manage in any industry: a tattoo parlor, a government entity, or a hospital system (emphasis mine – JJ).
  • “Managers are an elite caste, separate from those who are managed, monitored, and controlled.
  • “Efficiencies gained by controlling the behavior of professionals and other workers garner financial rewards…
  • “The principle that… an action is rational only if it maximizes self-interest…”

Not all hospitals are managed in this way, all of the time. But, when I was Chief Medical Officer, there were definitely times when I could feel the BSM “vibe” coming through… even though I worked at a non-profit hospital.

This leads me to believe that Business School Mindset leads to a different kind of BSM… Bulls**t Medicine. – Dr. John Jurica

To counter this, I implore my colleagues to pursue a career in hospital management. Such a career is intellectually stimulating, pays well, and is the only way we’re going to steer this industry in a new direction.

Getting Ready to Become a Certified Physician Executive

One way to accelerate your career progress as a leader is to become a Certified Physician Executive.

The Certifying Commission in Medical Management grants the Certified Physician Executive designation. It demonstrates to employers that the holder of the certification has the knowledge, skills, and core competencies to be an effective manager and leader.

Listeners have asked me to compare earning the CPE to obtaining an MBA. However, one should not compare the two, because the CPE can only be obtained after completing the MBA or equivalent business and management training.


There is evidence that employers use the CPE as a factor when considering job candidates. And there are several ways to meet the requirements for the CPE. But they all include getting the basic business and management education, plus real-world healthcare management experience. Physicians should consider several factors when deciding how to best acquire the CPE designation if they choose to pursue it.

NOTE: Look below for a transcript of today's episode.

Links for Today's Episode:

Download This Episode:

Right Click Here and “Save As” to download this podcast episode to your computer.

If you enjoyed today’s episode, share it on Twitter and Facebook, and leave a review on iTunes.

Podcast Editing & Production Services are provided by Oscar Hamilton

Transcription PNC Podcast Episode 219

Are You Ready to Become a Certified Physician Executive?

John: Today, I thought I would discuss another topic related to the pursuit of a job in hospital management. I mentioned this topic in a recent daily email and episode #33 of the podcast back in 2018.

Let me paraphrase what I wrote in the recent email related to this topic. It's really related to physicians working in the hospital environment, both as a clinician and then possibly as a leader. This is what I wrote about. I had read an article on Kevin MD by Patty Fahy MD. So, Dr. Patty Fahy. In it, she said that she was talking about BSM. It's an acronym for Business School Mindset. She thought I had a big impact on physicians and how they're working and the environment that they're in, which oftentimes is not very favorable.

The author, Dr. Fahy gives examples of the BSM mindset. Here are quotes from her article.

"Graduates are assured that an MBA degree has prepared them to manage any industry, a tattoo parlor, a government entity, or a hospital system. Managers are an elite cast, separate from those who are managed, monitored, and controlled. Efficiencies gained by controlling the behavior of professionals and other workers garner financial rewards. And the principle that an action is rational only if it maximizes self-interest".

Those are the characteristics that Dr. Fahy says represent BSM or the Business School Mindset. I don't know if all hospitals are managed in this way all of the time, but when I was chief medical officer, there were definitely times when I could feel the BSM vibe so to speak coming through, even though I worked at a nonprofit hospital.

This leads me to believe that the business school mindset leads to a different kind of BSM, what I call BS medicine. The approach that doesn't recognize a physician-patient relationship, or that puts quality safety and dignity behind the bottom lines. That's the BSM that I'm talking about. And I think we're caught in that. We're caught sometimes in that business school mentality and it leads to really miserable working conditions.

And so, the question is what are we to do? And I see three logical answers to that question.

The first is to keep working in the medical-industrial complex until we can't take it anymore and then retire. I think I've had a lot of colleagues that have done that. They've toughed it out and then just retired as soon as they could.

Number 2 is to leave for a nontraditional career, which of course, that's something that I talk about all the time.

And number 3, is to work your way into hospital management as either CMO, COO, or CEO and fix the system from within. And you probably already know that I'm partial to option number 3 because I believe we need a whole lot more physicians leading health care if we want to reduce both forms of BSM in our healthcare system.

Please consider a career in hospital management because it's intellectually stimulating, it pays very well and is the only way we're going to steer this industry in a new direction.

And by the way, as far as the income goes, I just went to salary.com today. And the median salary for a CMO is $418,000 with a range of $319,000 to $549,000. When I say it's lucrative, I'm really serious. It pays well over any primary care practice. And even for specialties, it's a much better lifestyle and you still make a good income.

One of the things that I'm convinced of is that if you want to consider a hospital management career, it's important for you to understand what the CPE is. That's what I want to talk about today. We all know what an MBA is. An MBA is a business degree. And then there is the MMM and MHA and other types of business degrees.

But the CPE comes up from time to time because it represents something that employers are sometimes looking for in the hospital setting. CPE stands for Certified Physician Executive.

As I was going through some CMO job descriptions before preparing for today's presentation, I looked specifically to see if the CPE was listed. And I found two hospitals in North Dakota and one hospital in Pennsylvania, just in a short review of the job ads that I saw. And they listed the CPE as a preferred designation. And the reason is that it represents something that puts the holder in a position perhaps a little bit better than simply having completed a business degree.

But the thing is, it takes more time and it takes some money to achieve. And so, I want to talk about this. And part of this came from a question that I received from a reader or listener back a few months ago, specifically asking whether I thought it was important to proceed with getting the CPE.

I want to try and answer that again. I addressed this, like I said, back in 2018, but let me bring things up to date today and really take a moment to walk through this for those of you that might be interested. This is how I look at the CPE as compared to an MBA. And it's not a fair comparison, I'll explain why in a minute. And these are my thoughts. These are my opinions as a holder of the certification and a former CMO and a member of the American Association for Physician Leadership, which is the AAPL, which originally created the certifying commission in medical management to create and to provide the designation of CPE.

Keep in mind, I am not speaking for the AAPL, although I've been a member of the AAPL for more than 25 years. And I have actually been involved in several of the committees that are involved with evaluating those that are sitting for the CPE, so to speak, by participating in the capstone.

Let's back up and talk about some definitions, and then we'll get into some more detail on this.

What is the CPE? The Certified Physician Executive designation. It's granted by the certifying commission and medical management. And it's designed to show that the holder of the certification has the knowledge, skills, and core competencies to be an effective manager and leader.

And to me the CPE is valuable because it demonstrates that not only does a holder have that MBA training. Now, remember MBA is a degree. It's kind of book learning, but the CPE has the MBA or the equivalent degree or the equivalent training and demonstrates experience in management and or administration.

And also, has sat through what they call a capstone, which is an opportunity for these applicants for the CPE to demonstrate that they can apply all of these principles in real-life situations, rather than simply take some curriculum and pass a few exams.

Let me get into a little more detail on it. An MBA is granted like any other degree. You complete a certain core curriculum plus some electives, and it ensures a certain level of knowledge. It's usually finances, marketing. In the programs that address physician executive MBA, they do focus on things like healthcare finances and the situation that we find ourselves in, the business principles in healthcare itself. Some programs do have a mandatory project that gets completed during the term of the schooling. So that gives them a little bit of real-life application of what they're learning.

But again, I'm going to mention why the CPE is distinguished from that. Because the CPE requires not only the knowledge base, which you can get from an MBA and MMM, and MHA or a similar degree, but it also requires that you have at least a year of clear management and leadership experience that does not include running a small private practice. And it has to be in a setting where you're really in a matrix with lots of other people. You're interacting. You're applying your communication skills, your marketing skills, your finance skills in a real-life situation. And so, it's more than just the book learning.

And in fact, you have to get a letter acknowledging and attesting that you have demonstrated these skills that are being sought for the CPE during those activities. If you've served as a medical director for a year or two or three, or you've been a CMO already, or you've done other things, let's say chair of a big committee at an academic institution and you've had exposure to management, to finances, to HR issues, to legal issues, then you can qualify for the CPE.

And on top of that, then you also need to spend four days doing what's called the capstone where you're getting a little bit more education about some of these topics, just to pull it all together. And you're actually being assessed for your ability to communicate and to lead teams and other skills of that nature.

To compare the CPE to the MBA is not really valid. The MBA or its equivalent is required to be even qualified to request certification for the CPE. That's why it's different. It does give you a little edge. If you have the CPE, it indicates that these skills are demonstrated, and it gives you a little edge. As I said, there were at least three hospitals just to my 10-minute review earlier today that said that the CPE would be recommended or preferred.

If you're competing with two or three or four people, and they all have the equivalent of an MBA or an MMM or something like that, and you have the CPE designation, which really attests pretty well to the fact that you've got the skills and experience to apply those skills, then you're going to have a bit of an edge over those others. That is I think primarily where it comes in handy.

The other thing to keep in mind, though, when we talk about this is that you can meet the requirements without having one of those degrees. In a way, if you were going to get the MBA or the MMM, or MHA, anyway, my case was actually an MPH. I got some credit for that. Well, then that's fine. And you can use that as the basis for proceeding onto the CPE if you're in some kind of leadership or management position.

But sometimes you can meet the same requirement by taking the equivalent courses through the AAPL. The AAPL is known for providing education and training and management and leadership for physicians since it was called the American College of Physician Executives.

They have a lot of ultra-high-quality courses that many physicians have taken. You can use this alternative pathway. Many hospitals and health systems provide leadership training through the AAPL, or physicians themselves will seek the training on an as-needed basis through the AAPL. And so, they do these courses and over time, there is a core curriculum through the AAPL, that if you accomplish that, then you've basically shown that you have the equivalent book learning that would be obtained through the MBA or other similar degree.

You can think of different scenarios here. If you've already taken, let's say one half to two-thirds of the CPE coursework through the AAPL, it may definitely be quicker and less costly to simply complete the curriculum through the AAPL than to enter an MBA program and spend $50,000 - $70,000.

I'm not saying that the AAPL courses are cheap, but even if he had to do another 5 or 6, 7, 8 courses, it's going to be much quicker and less expensive than matriculating in a business degree program.

The other thing to keep in mind is that sometimes the AAPL, or actually the certifying commission on medical management, which grants the CPE will accept courses done for a business degree that maybe you didn't complete. That's the other way that that can be effective.

You want to be efficient. You want to use and get the information you need. But there is no reason if you've already taken a course in healthcare finance to take another course in healthcare finance as part of your MBA or vice versa. You should be able to get credit for that in whichever direction you go.

It can be complicated. If you find yourself in a situation where you have some of the AAPL courses and you're contemplating going to a degree program, then you would check with the degree program, see if any of those courses would apply to the degree, and then you might get a reduction in your tuition, and it would speed things up.

And vice versa, if you've done let's say six months on a business degree, and now you've already got some other AAPL courses and you want to apply for the CPE, you can find out if those courses from the other business degree would apply to that.

There are certain business degrees that are aligned with the AAPL. For example, the master of medical management is a specific program geared for physicians only. And there was a lot of overlap in the content of the MMM and the courses through the AAPL.

So, you would want to really ask both sides of that if it would apply. In other words, you would check with the AAPL. They have a career or education department that will tell you if you've done some of the work for the MMM that would apply for the CPE if let's say you decided to finish it up with the AAPL courses.

Now, if I was just getting started, I would investigate my options. I would look at the cost, the location, the time commitment, and I would just figure out which one is the most efficient way to go. If you haven't been exposed to any of those, then you can make a valid decision.

On the website at the AAPL, which I'll put a link to in the show notes, for those that are listening to this on the podcast, you can go there and it will give you pretty clear which direction to go in. And it explains which of the business degree programs have courses that would cross over, or which ones would accept the AAPL courses.

Again, to find out for sure, it'd be best to check with staff at the AAPL. I think if I were starting out, this is like the master plan you might have in your mind if you were going to do this. I would look around, find a good low-cost convenient option to get your business degree. I would probably go to something like the University of Illinois, or even a smaller public university.

There's one nearby that's called Governor State University. And I know many people that have gotten their MBA through that. It's a four-year college. It's not a big-name college, but you get the MBA. And then if you want to go ahead and move on to the other requirements for the CPE. And then while you're doing that, you should acquire some clear management experience either by finding a paid medical director position, being on one or two really important, big committees where you're involved in big projects, let's say in a hospital.

And that way, when the degree is done, or the coursework is done, then you'll have the management experience. And then you can apply for the capstone and things will move forward very smoothly. If you get the MBA, but you really don't get any management experience in the meantime, you can't apply for the CPE.

Before I go, I do want to mention, I found this just recently. I didn't know this existed, but there's something called the Canadian Certified Physician Executive - CCPE. I don't know that it's exactly equivalent to the CPE that we're talking about today, but I know it does exist and you can look that up online. I will put a link in the show notes, again, for those who are listening to the podcast.


Many of the links that I refer you to are affiliate links. That means that I receive a payment from the seller if you purchase the affiliate item using my link. Doing so has no effect on the price you are charged. And I only promote products and services that I believe are of high quality and will be useful to you.

The opinions expressed here are mine and my guest’s. While the information provided on the podcast is true and accurate to the best of my knowledge, there is no express or implied guarantee that using the methods discussed here will lead to success in your career, life, or business.

The information presented on this blog and related podcast is for entertainment and/or informational purposes only. I do not provide medical, legal, tax, or emotional advice. If you take action on the information provided on the blog or podcast, it is at your own risk. Always consult an attorney, accountant, career counselor, or other professional before making any major decisions about your career.