Medicaid | JohnGSelf Associates, Inc

We are moving into an era of extraordinary change.

Healthcare will change because government can no longer afford some of its signature programs including Medicare and Medicaid, and because the quality of care and the level of patient safety too often do not match the price we pay.

As this era of change accelerates, we need to think about the role that graduate education will play in solving some of the challenges we face, specifically how we educate physicians, nurses and other clinicians as well as healthcare leaders.

A CMO candidate who practiced law for more than 15 years described medical school as a place where bad practices and inappropriate attitudes are handed down from generation to generation. “We will never have meaningful and sustainable improvement in the quality until we make changes in how we educate and train young physicians.” Tough talk, but there is increasing evidence that he may be on to something. I will leave that judgment to physicians and physician educators to tackle that thorny issue.

Graduate business programs, including those in healthcare, are also coming under increased scrutiny because they tend to focus on teaching people the hard skills of finance and management practices and less about people skills – leadership, the art and ability of negotiation, or the mindset for innovation. So says Jay Bhatti, a Wharton MBA, who was interviewed by John Hockenberry of NPR’s The Takeway. Mr. Bhatti focused on MBA programs and how they are turning out thousands of students, many loaded with mountains of debt only to struggle to find jobs. “We have a proliferation of graduate education programs and a job market that has shrunk,” he said. The theme of the show was the declining value of the MBA.

In the 1950s and 60s, said Mr. Bhatti, the Fords, McKinseys and Goldman Sachs of the world complained that college undergraduates were not adequately prepared in the field of business management, that it took too long to bring those students up to speed. So began the popularity of graduate management programs. “MBA programs have done a good job of this for 50 years,” Mr. Bhatti said, but the game is changing. He believes that MBA programs must reinvent themselves to prepare students tomorrow’s changing world.

This brings me back to the changing world of healthcare management. There has been a proliferation in healthcare graduate education programs as well, and based on my interactions with students from several schools across the U.S., we will face a critical skill shortfall over the next 10 years. They know the theory of managing hospitals based on a knowledge base that is rapidly becoming outdated. All of this is happening at a time when fewer and fewer health systems offer administrative residencies or fellowships.

In healthcare, like general business, there are more graduates than jobs and many of these indebted students are not prepared for healthcare’s changing world.

This imbalance between curriculum and change, together with a surplus of students from healthcare management programs, will pose some extraordinary career management challenges in the not too distant future.

As I prepare for my speech to the Healthcare Leadership Network of the Delaware Valley at Villanova on Thursday night, I find myself thinking out loud with my team, sharing ideas for brand management in a new healthcare environment.

One of the more radical perspectives being discussed is that the young healthcare management graduate students face an immutable truth: the career they thought they were going to have appears to be moving into the category of ancient history.

The healthcare industry is rapidly approaching the front door of sweeping change, one in which the healthcare delivery business model that we have known for the last 40 years will be dramatically different in terms of design and reimbursement.

Here are some of the factors that will force this overhaul:

Medicare is the biggest driver of the U.S. deficit.
Every four seconds, another Baby Boomer qualifies for coverage.
Healthcare costs continue to outstrip the rate of inflation.
We are currently borrowing 30 to 40 cents of every claim that is paid.
Unfunded liabilities for Medicare, Medicaid, veterans benefits, retirement programs, and disability, now top $60 trillion over the next 50 years.
The federal government will not be able to fulfill these commitments without significant reductions in spending that some argue must be $9 trillion over the next 10 years.
Corporate benefit programs are undercutting the ability of U.S. companies to compete in a global economy.
Corporations will aggressively push to shift the cost of healthcare to their employees (with allowances and tax benefits).

In the past, being a health system or hospital CEO meant you were responsible for bricks, mortar and all that goes inside – people and technology. The future, with market demands for lower costs through an emphasis on improving population health, means CEOs will be managing smaller facilities and teams of people strategically positioned throughout the market; an era of leadership of geography not just the traditional venues.

Join the conversation: Describe your vision of the CEO role over the next 20 years. What skills and values will be necessary to succeed?

Tag Archives: medicaid

Graduate Education In A Changing World

Thinking Out Loud: The Career You Thought You Were Going to Have