By Tom Ellis/FirstMEDPractice.com blog
Autonomy is a word that has taken on a life of its own in medical circles. Depending on who you talk to, it seems to be injected into the conversation surrounding many different aspects of medicine, clinical to operational to the business thereof. The generic definition always revolves around issues of “control” starting with the most basic: That a physician can implement their diagnoses and control the way he or she cares for their patients. This matter seems to come up more and more as medicine becomes more corporatized.
However, when the desire for control comes up in other areas—especially those related to HR, staff oversight, scheduling, facility usage, payers, marketing, etc.—it seems that physicians may have the cart ahead of the horse.
For over twenty years one of the resounding phrases I’ve heard is, “Doctors are terrible at business.” But I don’t agree.
Physicians aren’t bad at business. They are just UNDEREDUCATED about it.
Physicians are smart people. The rigors of med-school training are intellectually demanding. But there is little or no educational training that provides the basics of how medical practices work as required course work.
I believe autonomy, defined as “control,” needs to be based on education commencing as early as possible, best before the final year of training, when the end of residency or fellowship is in sight. Rounding in the final year is a tremendous opportunity to examine, up close, the variety of different business models employed by different specialties and have access to the administrative types that are responsible for the operations of each practice.
Almost as valuable, it gives the graduates a chance to discuss practice governance and how it’s deals with long range planning and implementation.
Building this knowledge base is necessary preparation for fielding and analyzing the flood of job offers that will soon come. It’s the antidote to the anxiety when literally dozens of employers start making contact (most graduates receive at least 50 offers).
Which brings us back to autonomy. True autonomy comes with knowledge. The path to autonomy starts before entering practice, by having the necessary knowledge to make a good first choice or employer and practicing environment, where business education can continue and be offered and continued. A choice that isn’t filled with anxiety due to undereducation on these topics
In their busy schedules, residents and fellows, preparing for their first practice, shouldn’t overlook the importance of business education. It’s the building block of autonomy and a successful career.---TOM ELLIS