This was just the beginning of my extended, rocky path of learning how to put the management and leadership methods and tools that I learned during my Master’s of Business Administration (MBA) courses into practice and, along the way, shed the management practices of my clinical life. It turns out, the learning was easy, but the doing it was tough.

Making the transition

As medicine began its tortuous transition from traditional doctor-dominated decision-making to managed care, more and more administrators and executives were required as healthcare’s attention began focusing on productivity and profits.

The problem is physician executives were landing in their posts for the same reason that physicians became department chairs in academic medicine – not because they were good at management, but because they were well-respected clinicians. Physicians are trained in a different kind of problem-solving from business managers. We are trained to acquire clinical information for a careful history and physical examination that allows us to formulate a preliminary list of diagnoses. Using additional information from laboratory and imaging tests, we methodically remove from the list those diagnoses that are obviously wrong, to come up with a preliminary working diagnosis. Our next challenge is coming up with potential treatments, analyzing each of them using yet more information from the literature and from expert colleagues to formulate a treatment plan.