Medicolegal Issues

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Ambitious hospitalists may be eager to add an MBA or a PhD to their credentials, in the belief those magic letters will open doors to leadership positions or higher compensation. But before you fork over tuition for an advanced degree program, consider whether that degree will pay off.


Hospitalists as Managers

As hospitalists move up the career ladder, many will find themselves managing their colleagues. Mastering new skills, including supervision and motivation, can go a long way toward success in these positions. Here are some tips for hospitalist supervisors from the article “New Role for Hospitalists: Managing other Physicians” by Paula S. Katz in October 2005 ACP Observer:

  • Effective feedback is key—and not just during an annual review. When providing regular feedback, focus on the individual’s behavior or actions;
  • Feedback can occur informally during work hours or formally, during a performance review. Conduct formal reviews in private, and let the hospitalist see a written review in advance; and
  • If you’re having trouble with a hospitalist under your supervision, document all applicable objective and measurable behavior. Schedule a one-on-one meeting to discuss the problem, and share all documentation with the hospitalist before the meeting. When you meet, be direct and succinct, and focus on the behavior by listing specific examples.

Ethics Are Part of the Job

Physicians working in the public sector aren’t able to completely transcend workplace politics, but ethical judgments must be based on sound ethical principles and reasoning despite the challenges of regulation, policy, and ethical issues in the hospital setting.

“Hospitalists need to recognize that ethical issues are distinct from medical ones and need to utilize different techniques in their resolution,” according to the authors of “Ethical Issues in Hospital Medicine” (Medical Clinics Of North America, July 2002, p. 869-886). —JJ

Choose Your Career Path

If you’re considering pursuing a Master of Business Administration (MBA), Master of Public Health (MPH), Master of Health Administration (MPH), or even a doctorate degree, the first thing you should consider is which career path within hospital medicine you’re interested in. What position would you ultimately like to hold? And which, if any, advanced degree can help you get there?

“Explore the idea [of earning an advanced degree], but the most important steps are to try to get some work experience and set some goals,” says Mary Jo Gorman, MD, MBA, the CEO of Advanced ICU Care, St. Louis, Mo. “Along the way, find out what you have an aptitude for.” Once you know your general or specific career goals, you can consider whether to earn an advanced degree.

“It’s a significant monetary and time commitment, so make sure it makes sense for where you want to go,” advises Dr. Gorman. “I’d also advise career counseling to help with this. Great people to talk to are recruiters. They’ll tell you what you need in order to apply for certain positions.”

It should be obvious that some positions will require certain degrees beyond an MD or a DO. Look at the next—or final—job you want. Is the job held by someone with an MBA, a PhD, or another degree? Is that person’s successor likely to need specific education?

“If you want to be the chief operating officer of a hospital, or the CEO of a large medical group, you’re not getting that without an MBA,” Dr. Gorman says. “In fact, if you’re planning to apply for a position that requires strong financial expertise, they’re not going to accept you without [an MBA] unless you’re of a certain age and have a great track record that shows you can do the job.”

On the other hand, many experienced hospitalist leaders don’t have an MBA and won’t need one. “A lot of community-based hospitalists are already doing these things and don’t need the degree,” Dr. Gorman points out. “They created the job, or they created the group.”

A New Way of Thinking

Perhaps the most valuable aspect of any higher degree is the training one receives, which can provide new ways to approach one’s work, problem solving and general thought processes.

“The degree alone won’t help if you haven’t learned while getting it,” explains Sanjay Saint, MD, MPH, hospitalist and professor of internal medicine, Ann Arbor Veterans Affairs (VA) Medical Center and University of Michigan Medical School. “That’s the real value: Learn the material and it will alter how you approach things.”

Fred A. McCurdy, MD, who holds a PhD and an MBA, was recently promoted from pediatric department chair at Texas Tech University Health Sciences Center at Amarillo to associate dean for faculty development. He earned his MBA with an eye on becoming department chair and says that the MBA program “gave me a background in thought process. From there, I could build on that foundation.”

As for his PhD, Dr. McCurdy says the degree “has its place. The program taught me methodology and scientific process. It taught me how to break down a problem into researchable questions, and I can apply that to areas like education. If your job calls for thinking logically and critically, a PhD gives experience in using scientific methods.”

Earning an MPH also bears fruit.

“Having an MPH is helpful,” says Dr. Saint. “In addition to helping you learn how to research, how to be a better user of literature, it helps prepare someone for taking a leadership role.”

[An advanced degree] may open the door, but you still have to walk through it.

—Sanjay Saint, MD, MPH, hospitalist and professor of internal medicine, Ann Arbor VA Medical Center and University of Michigan Medical School, Ann Arbor

Your Dream Job

While an additional degree can improve your knowledge and skills, it’s no guarantee you’ll move to the top of a list for a promotion or new job.

“It’s not a given that it will necessarily help your career,” warns Dr. Gorman. “You need to first do an analysis about what you want to achieve, then work toward that goal. A lot of doctors don’t really realize that they need to think in terms of their total career plan.”

Dr. Saint agrees, saying of an MPH, “It may open the door, but you still have to walk through it. You still have to do the work yourself. You cannot hide behind the MPH. You have to be productive and even be an overperformer. But it does give you the tools you need, and it can help you get that first job.”

Dr. McCurdy believes a degree such as an MBA can be helpful for today’s hospitalists: “For a hospitalist with a strong interest in rising up through the hospital administrative ranks, having an MBA early in their career could definitely be beneficial,” speculates Dr. McCurdy. “Holding an MBA [in academia] is becoming the norm rather than the exception. There’s an increasing awareness in academics that this is a business.”

Does an ad­vanced degree make a new hospitalist more hirable? “That dep­ends,” says Dr. McCurdy. “For hospitalists working in a large hospital system, it becomes a matter of choice. I don’t think you’d be hired based on an advanced degree [such as a PhD] unless the job has something to do with a scholarly pursuit such as research or teaching. If you’re competing for a job in an academic health science center, a PhD degree can help if it has to do with scholarship.”

The white paper online

“A Challenge for a New Specialty: A White Paper on Hospitalist Career Satisfaction,”

is available for download at under the “News” section. The white paper, prepared by SHM’s Career Satisfaction Task Force in December 2006, details the four pillars of job satisfaction. Find more information on guiding your career at SHM’s Career Center ( Browse opportunities and post or view resumes.

The Final Answer

Follow this sound advice: Chart your hospital medicine career path, and then work backward to see whether you’ll benefit from obtaining a specific degree.

“It has to do with what you intend to do in a five- or 10-year timeframe, with the course direction of your career,” says Dr. McCurdy. “If you plan to pursue academic scholarship, a PhD can be very helpful. If you aspire to become medical director at Maryland Shock Trauma, an MBA is the ticket you’re definitely going to need to punch.” TH

Jane Jerrard has been writing for The Hospitalist since 2005.

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