John Responds to a Listener's Question

This week, I spend a few minutes discussing which advanced degree to pursue. This issue was triggered by a listener’s question. And it truly made me think more deeply about the issue.

I start by listing the general principles to consider when deciding on which advanced degree to pursue if any. There is no randomized controlled study to apply to the decision. But my comments reflect my opinion based on my observations and conversations with other physicians.


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The Question.

The listener had decided to obtain an advanced degree to help advance his career. But he wanted a degree with practical short-term applications. And rather than the fairly popular executive MBA, such as the degree that my sponsor, the University of Tennessee Haslam College of Business provides, he had narrowed his search to the following:

  • Master of Applied Science in Quality Improvement and Patient Safety;
  • Master of Science in Quantitative Management and Healthcare Analytics; and,
  • Master of Science in Clinical Informatics Management.

Each was taught at a different graduate school. And all of them were well-known organizations with good reputations. And they varied from one year to two years in duration. We did not discuss the cost of each.

Deciding to Pursue an Advanced Degree

Here are the most important considerations I would keep in mind when thinking about this major decision:

  • Many current physician executives, including CMOs and CEOs, have NO business degree.
  • Many CMOs started with NO business degree and completed one AFTER getting their first CMO position.
  • There are 3 primary benefits to obtaining an advanced degree:
    1. You learn useful skills, techniques, concepts, tools, etc. Note, however, that most, if not all, can be learned through reading, online courses, and courses through organizations such as the American Association for Physician Leadership.
    2. You demonstrate your commitment and provide evidence of knowledge of business, management, finances, etc. that you might NOT be able to demonstrate otherwise.
    3. You develop a network of colleagues working in teams while completing your degree. Be sure to ask about this aspect – the vitality of the alumni group and connections developed – do they persist beyond the formal education?

Which Advanced Degree?

These decisions do not exist in a vacuum, and the most important issues to consider are:

    1. Does the program deliver all of the above benefits?
    2. What are the total costs of each program?
    3. How much time will you need to devote on a weekly or monthly basis (5 hours, 20 hours, full time)?
    4. The total time needed to complete the degree (as little as a year, even while working your regular job, or as long as 3 or 4 years completing one course per semester or less); and,
    5. Whether to attend a big name school to further enhance your prospects of landing the most competitive positions.

Summary

It is human nature to want to select the “perfect” option for your career when choosing the degree and the institution to attend. Remember, however, that the most important aspect may be the effect the decision will have on your finances, time demands, and family life. 

If you have a question about anything we talk about on the podcast, please contact me at nonclinicalphysicians.com/voicemessage and leave me a message. I always respond. And while I may discuss it on the podcast, I will NOT share your name without your permission.

NOTE: Look below for a transcript of today's episode that you can download or read.


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Transcription - PNC Episode 191

Which Advanced Degree Will Be Right for a Nonclinical Career? - John Responds to a Listener's Question

All right for this week, it is just me. And I'm going to be talking about an issue that I've mentioned before. And that is whether an advanced degree is necessary for transitioning to a new career. Now, usually this comes up with respect to moving into a leadership position in a hospital or health system, or maybe an insurance company or something like that. But I had a question the other day from one of my listeners.

And actually, this is a good point to remind you that I do take questions. So, you can contact me in any number of ways, but I love to get those questions. I respond usually within a day or two at the most. And if it's a topic that might be of interest to others, I will certainly consider putting it here on the podcast.

But there are many ways you can reach me. You can ask me a question on the Facebook group, of course, the Physician Nonclinical Career Hunters Facebook group, but that is assuming I'm going to catch it, which I don't always do. And the best way would either to do a verbal or an audio type of question or email me. You can email me at john.jurica.md@gmail.com. You can find that all over the website. I post it everywhere.

And if you're in one of my courses on Teachable, one of the free ones, I think I have that in there. And it goes to that email address, even if you just respond generically to something in The Nonclinical Career Academy, which is at nonclinicalcareeracademy.com. Anyway, the email is fine.

And then if you want to do audio, because sometimes that's fun, you can use my Speak Pipe. I've had this for a long time. I don't get too many questions in that way, but I'm going to start promoting that because I think it's fun to listen to the audio. And sometimes I'll actually respond in audio. And if you've never used Speak Pipe, I think the current version of that, that I have or the plan, would allow up to a five-minute audio file. So, most questions are going to take less than one or two minutes, honestly.

But anyway, to find the Speak Pipe, the easiest way is just to go to nonclinicalphysicians.com/voicemessage. And that should bring up my Speak Pipe. And then you can draft your question and record your question, and then you can listen to it. If you don't like the way it sounds, you can just erase it and start over. So, it does give you that opportunity. You don't have to send in your first draft if it's something that's funny, because when I send audio questions to others or respond to them, I usually have to do several drafts because I don't know. Even right now, I'm trying to do this episode extemporaneously. And I usually have to plan my question and answers out quite a bit.

Even some of the coaching. They'll respond to me. I'm talking about my marketing coach. They'll look at something I've sent in and then rather than send a written answer, they actually send a video answer, but then I have the opportunity to respond. And it usually takes me several takes. It doesn't have to be perfect obviously, but at least I feel like I'm just pausing too much and so on and so forth.

So anyway, those are two ways you can ask me a question and feel free to send me any question. I'm not saying it will always be featured on the podcast. If I'm going to put it on the podcast is sort of the neatest for an episode then I'll probably ask your permission to include your name in it, but you don't have to.

These are some of the best kinds of podcasts, I think. I have several colleagues that use this method. They're answering a question and it really gets to the nitty-gritty of an issue that can be quite interesting and useful.

Now I'm not going to read this question in its entirety, but I will say that the person asking the question has a plan to eventually have the ultimate goal of reaching CMOs status. Now, again, I believe this is a health care system or hospital. Although, like I say, there are a lot of jobs that this question may come up in. Really anything with leadership.

So, let's just get this out of the way. If you're going to get a job as a physician advisor in a hospital or a medical director in an insurance company, or a third party, the utilization management or benefits management company, for those entry-level jobs, you definitely do not need an advanced degree. And I'm using this term advanced degree instead of advanced business degree because the question that was sent to me is quite interesting because it references several types of degrees, which I don't consider to be business degrees, although in a way they are. And I'll explain because I'll explain what the program is that is being mentioned.

But I do want to make the point that having an advanced degree of some sort can definitely help with career transition, but again, it's not always needed. And in fact, I'm getting ahead of myself in a way, because I do answer that particular question. But I want to give examples where it would be helpful. Obviously, any leadership or executive position. So that would apply in the hospital and health system arena, CMO, CMIO, of course beyond that. Some of those CMOs become COOs or CEOs.

You wouldn't generally need an advanced degree to become a medical director. A lot of medical directorships are related to a very clinical department or service line. And even though you're doing management, you're still doing a lot of clinical in those jobs. And it definitely would not be a prerequisite for most medical director jobs in the healthcare arena involving a hospital or a multi-hospital system. But it would, as you went into the COO, the CMIO, the Chief Quality Officer. The CMIO, by the way, is the Chief Medical Information Officer. Other similar jobs like chief patient safety officer, if it exists or chief integration officer.

But there are other jobs where this would also apply, for example, in pharma. Something like an MSL or medical monitor, of course, you would not need any kind of an advanced degree. Although master’s in public health wouldn't hurt in some of those areas because of the extra epidemiology and statistics you would have learned. And there are other types of degrees that would be applicable to some of these other jobs that again, aren't exactly management degrees.

So, there is overlap between some of these and these are mostly master's degrees basically. And I'll get into that in a minute. But again, if you're in pharma, but now you're moving up to, I've heard some people say that in pharma, you can have assistant medical director, associate medical director, medical director, senior medical director, executive medical director. There are a lot more layers. And eventually, though that is moving up into the director role or the chief medical officer role. And definitely, as you start to get into those positions, the advanced degree will be very helpful.

Well, I think we'll cover some of these things as we get into answering this question. So, let me go ahead and read off some of the rest of the questions. So, this listener said that the three master’s programs that I'm looking at are master of applied science and quality improvement and patient safety at Johns Hopkins. Master of science and quantitative management and healthcare analytics. And that would be at NYU business school. And a master of science and clinical informatics management through Stanford.

Notice that the name of these degrees, I mean, definitely it's a master's degree. One is strictly the quality and patient safety. So, there's no mention of management or of analytics. The second has quantitative management in healthcare analytics. Again, I'd have to look at the curriculum to know exactly what that would be. And then the third has clinical informatics management. And so, it has the word management in it as well. So, I'm assuming if they're using the term management in the description of the degree that it does have some of the content that let's say an MHA (masters of health administration) or an MBA would have.

So, this is something I haven't considered in the past because when I've talked about this, I've talked mainly about an MBA and MHA and MMM - Masters of Medical Management, which is strictly provided through an organization, the school that's working with the American Association for physician leadership, the AAPL.

And also, a lot of the people that apply for management jobs, sometimes have the MPH that I mentioned earlier, which has a little bit in there about management, a little bit about leadership, but it has definitely a lot of attention to quality and the measurement in epidemiology and statistics.

Okay. So, with that as a backdrop, let me try and go through the way that I would think about this. There are many physician executives, including CMOs, CEOs, and CEOs who do not have any business degree. Definitely in the hospital setting. And I'm assuming other settings as well.

But a lot of those individuals have been in leadership for a long time. So I would definitely say that in recent years, as applications for these positions become more competitive that seeing that advanced degree of some sort has become much more common. One of the things I've mentioned in the past is that you might go into the management track without the advanced degree, but you might acquire it while you're in the process of working part-time and working your way up to the upper echelon so to speak of whatever company you're working for.

So, one of the strategies is don't just get the advanced degree early on because you don't know where you're going to end up, and it may not use all of the content that you're learning if you go off on some tangent. So, for example, in today's question, one of the degrees is focused on informatics and informatics management. Well, if you have no intention of being an informaticist or potentially the CMIO, then that might not be the optimal degree to obtain and spend those years obtaining that degree when it would have been better spent obtaining a degree that's a little broader, whether it's an MBA or an MMM or something like that.

I just wanted to get that out of the way though, that you should consider moving forward as quickly as you can towards your ultimate goal by applying for these positions, even if you don't have the advanced degree. I would not put that off by several years while you're trying to get that degree. There might be some benefit to enrolling for one of these degrees, either the ones I mentioned, others like them, or the more generic degrees, and then apply for these jobs. Because even if you're early in the process, in your first or second course for this degree, you're demonstrating your commitment. You clearly aren't going to do that if you're an employed physician in a hospital and you're not seeking a management or leadership position.

So, in that case, it's more of a hobby that you're not doing for your career. But if you definitely are focused on moving up in an organization, whether it's in your current or in some future organization, then having started the process definitely has a positive, which I'll probably mention again in a minute, as I talk about why we should pursue one of these degrees.

Just to wrap up this first point, you don't need a degree to advance to some of these positions. And certainly, though, it is getting more and more competitive out there. And so, you should strongly consider getting one of these business or non-business degrees and try to decide which one will provide the most bang for the buck in terms of useful learning and skills that you can apply now and in the future.

Now, when I talk about advanced business degrees or advanced degrees in general, I always think about the three primary reasons why it is useful to obtain one of these degrees. And there are maybe other reasons, I'm not going to dwell on. Of course, the most obvious is that you're going to learn new skills and techniques that you don't already know. Even if you've taken some courses and read a lot of books, you're probably going to get a more in-depth knowledge of some of these concepts during a degree program than you will by going to a weekend lecture series or something like that.

But that's only a part of the issue. The second big reason is that again, I mentioned this earlier, is you've demonstrated your commitment and that's pretty important. Even if you already know everything that you're going to learn or 90% of it, and you are already fully capable of understanding health, finances, and healthcare law, leadership and management principles, things that you didn't learn in med school and residency.

Having the degree at least demonstrates that you definitely have those skills, which wouldn't necessarily be accepted if I was reviewing your resume for a position with my hospital when I was there and I saw a bunch of courses that you had taken. Some of which seemed to address those topics, as opposed to, if you had just completed an MHA or MBA, then I would just assume you know finance, you know what a P&L is. You probably know healthcare finance depending on the program.

And the third thing that I like to include, and I don't think this can be minimized, and I'll tell you why in a minute, but as part of your program, you're most likely going to develop a new network of colleagues who you will keep in touch with even after the program is done and who will be a resource for you in the future. In some programs, the alumni all keep in touch through whether a formal or informal process and they help each other move up the chain as they're looking for new jobs because they're a resource and you can think of these resources across the country.

You might all of a sudden decide you are in the city of Chicago, working at a job that is really not fully utilizing your skills and you reach out to your network and you find that there's a job in Arizona that will pay you 50% more and put you in a position to fully utilize your business and management skills. You might not have found that job without having that connection.

So, it's clearly something to look at when you are comparing and contrasting different degrees at different locations. So really that's something you should ask about from former students and current students, but really former students, if you can to say,” Okay, is there a network, did you have a team, a cohort you were working with for your projects? Do you stay in touch with those people? How about the rest of the alumni?”

My sponsor, the University of Tennessee Physician Executive MBA program now has over 700 graduates, as I mentioned every week. And you can imagine what kind of network that might be. Maybe not all 700 are easily accessible, but certainly, the class that you might graduate with and the team that you work with while you're in that class, doing the work for that, will certainly be a resource that should go on for quite a while.

And I also like to mention that there are certainly other considerations that I think they're pretty obvious, and you may want to create a grid when comparing different programs. You should definitely look around, but you need at least two or three other items. One is the cost. You can get an MBA at a community college. Well, I wouldn't call it a community college, but you can get an MBA from a local private college or state college for a really reasonable price. It might be $20,000 to $30,000 for a decent degree, decent program. But it can range in excess of $65,000, which I think is like an average across the country for the bigger name schools to closer to $100,000 where you can go into a formal traditional MBA at Kellogg or something like that. So, obviously cost is a factor.

And the second thing is the time. And there are two factors related to time. One is the amount of time you have to commit to it on a day-to-day basis. And so, what are the programs offering in terms of the day-to-day responsibilities in your situation? In terms of responsibilities at home and family life.

But the other time factor is how long it takes to get through the program. And those are kind of inversely related. If you are doing a program that runs for two and a half years, it's an online program with maybe some in-person meetings or Zoom meetings and projects that you're working on, but you're only doing one course per semester or one course per quarter. Yes, it's definitely going to take two and a half or three years to complete.

If so, the day-to-day time commitment will be less. There may be some weeks where you don't work on it at all. And then other weeks where you're really spending 5, 10, 15 hours on it. But if you're doing a program like the UT PEMBA one-year program, you are making a commitment to spend 15 or 20 hours a week, I'm thinking. And again, I don't represent the organization.

So, I'm just saying that if you're doing a program that will be done in one to one and a half years, you're going to have to spend time on that program every week. And again, depending on your circumstances, whether you're working a full-time job and how full-time that full-time job is, and what responsibilities you have at home, that may not even be a possibility.

The other thing that I responded to this listener with was this issue of looking at the actual programs that he was thinking about because none of them were classical management. They were a combination of a practical degree that would help with quality improvement, patient safety, healthcare analytics, clinical informatics. And so, they definitely would be very beneficial if you were going into even to be a medical director for quality improvement and patient safety, which would then lead into a chief quality officer job. Or becoming a medical or clinical informaticist, and then becoming the manager of that department and then eventually becoming the CMIO.

But I think if you want to get into that CMO position, you definitely have to make sure that some of the coursework and the curriculum includes the management leadership, healthcare finances, and as many of those topics as you can get so that you don't get pigeonholed in forever into a quality improvement job, or a patient safety job, or informatics job, if you want eventually to get into that executive position.

I don't think I'm going to tell you exactly the recommendations I gave to this listener, except that I was taking it at face value what the content of the curriculum would be based on the name of the program. I thought that number one, and we didn't discuss this but it is another consideration I guess I should have added this in the beginning. And that is whether the program is a recognized high-profile program.

Now people may argue with me, but when I hear Johns Hopkins NYU business school or Stanford, to me, those are very high tier very quality programs. Now you might rank others higher or that you may say, “Well, no, this one doesn't compare”. But we were talking that compared to the university of XYZ or some small private school that has really no reputation, any of the three that I mentioned earlier for this person, was a high-quality organization that would stand out on a resume, let's say.

But again, not absolutely necessary by any means, particularly as you consider the expense for some of these schools. And for me, the question really boils down more to whether you're going to get the advanced business learning as well as the analytics or the quality improvement or informatics knowledge. Then the name of the school, I would say it would be a secondary consideration in this case.

So basically, that's it. I would look at those things. I would definitely consider an advanced degree if you're looking to eventually get out of clinical, maybe continue to do one day a week, one day every two weeks, that sort of thing. And as I've mentioned before, I've known CMOs or rather CEOs of large academic centers who continue to do some clinical and they clearly were very busy running a multi-billion dollar organization.

But if you're going to be doing primarily nonclinical, you should consider getting one of these degrees. You could consider a degree like I've mentioned that this listener mentioned, which is a little bit different from the usual business degrees. There is also the MPH, which usually will be almost as good. And then you also have an MPA, which is master of public administration, which I think at least one or two of my guests have had. My impression is that with that degree, you tend to go into more of a governmental job, like a state-level or federal government job with the public administration.

All right. Well, that's all I wanted to say today. I thought it was a very interesting question, a very interesting concept, and consideration when you're thinking about getting an advanced degree.

If you have any questions like this that you'd like me to answer on the air, or just by email or by audio, then definitely go to nonclinicalphysicians.com/voicemessage, or send me an email at john.jurica.md@gmail.com.

All right. Thanks a lot for listening and I'll see you next week.

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