To the Editor: Practicing medicine in the current environment is more demanding than ever. In addition to providing high-quality clinical care, physicians must adopt electronic medical records, navigate health care reform, and maintain their practices under the constant threat of reimbursement cuts. Are “the golden days” of medicine gone? We think the answer is “No.” But to overcome these challenges, we must train a new breed of physicians.
What new skills will these doctors need? We propose three categories: population medicine proficiency, organizational expertise, and business competence.
Regarding the first category, the traditional dogma of focusing on the individual patient is necessary but no longer sufficient. Today’s physicians are expected to provide appropriate clinical care to each patient while also being good stewards of public resources. To do so, they must understand the findings of clinical effectiveness research and be exposed to all health care stakeholders (e.g., pharmaceutical companies, insurers). Such preparation will help them effectively navigate the health care system to provide cost-effective, high-quality care for their patients.
Second, physicians must have organizational expertise. They need opportunities to refine “soft” skills like managing, public speaking, and negotiating. These competencies can enable them to be effective players in the nation’s discourse on health care. Changes in each physician’s practice environment are inevitable, and they must be equipped with the tools to take an active role in navigating these changes.
Finally, doctors would benefit from training in business fundamentals. A basic understanding of finance, accounting, marketing, and strategy is required in order to develop a nuanced view of health care reform and to execute effective strategies for operating hospitals and clinics in an ever-changing environment. Mastery of these areas will ensure that research is properly financed, that clinical leaders are effectively rewarded, and that the necessary resources are available to safeguard the social mission and autonomy of medical professionals.
For too long, physicians have allowed professional managers and government regulators to control care delivery. But this does not have to be the case. Physicians are highly intelligent and hardworking. But to succeed in medicine today, they need more. Armed with the skills described above, this new breed of doctors will be a powerful force—ensuring that health care remains accessible to patients and friendly toward physicians for generations to come.
MD/MBA candidate, Perelman School of Medicine and Wharton School, University of Pennsylvania, Philadelphia, Pennsylvania; firstname.lastname@example.org.
Peter Derman, MD, MBA
Orthopaedic surgery resident, Hospital for Special Surgery, Department of Orthopaedic Surgery, New York, New York.