A recent survey found that more than half of both medical students and nurses in training prefer not to work in patient care. In the United States 63% of medical students and 60% of nursing students report hoping to work in non-clinical areas of medicine, such as public health management, research or business consultancy. On the surface that may sound rather odd, but perhaps not. It reminds me of all the teachers whose career advancement goals are to get out of the classroom and work in administration.
Fortune and Kaiser Health News reported that more medical students are also getting business degrees to prepare them for the business side of jobs related to medicine, but not practicing medicine. One business professor had this to say:
Still, it’s one of the few sectors of the economy where the people who know the most about what’s going on in their companies aren’t the ones running them, said J.B. Silvers, a management professor at Case Western Reserve University who has been teaching business fundamentals to medical students and physicians for decades.
Over the years I’ve met people with science PhD degrees who work in research. They chose PhDs rather than MD degrees because they did not want to interact with patients. I know a retired physician who claimed the days when he was involved in patient care stressed him out. I’ve also heard physicians claim that the problem of fighting with insurance companies wore on them and took too much time out of their days. They wanted to work in patient care, just not the hassle of getting paid for their work. Surveys have found that a significant portion of physicians’ time is spent on administrative tasks. This was called “charting” when I worked in a hospital. Charting is the process of writing down the tasks performed in patient records so tasks could be billed, but also as part of the patient medical record.
KHN and Fortune spoke with one physician who left medicine for a medical business:
Jasen Gundersen never considered a career in business when he entered medical school nearly three decades ago to become a rural primary care doctor.
But, today, he isn’t working in rural America and he doesn’t do primary care. In fact, he no longer practices medicine at all.
As CEO of CardioOne, which provides back-office support to cardiologists, Gundersen is part of a growing trend: physicians and medical school students earning advanced business degrees to work the business side of the booming health care industry.
Nearly two-thirds of medical schools now offer joint MD-MBA programs. Purportedly, the number of medical school graduates with a dual MD-MBA has tripled from a few years ago. Recent figures that track medical school graduates with business degrees do not take into account those who decide to further their education years after graduation, however.
The article naively asks whom these medical school graduates will serve: patients or shareholders? The same question could be asked about doctors working for hospitals. The answer would be the same in both cases: their employers, of course.
Gundersen, the CardioOne CEO, who attended the University of Tennessee program and now lives outside of Denver, found it useful to practice medicine for years after he got his business degree, juggling executive and clinical work. He stopped treating patients nearly four years ago.
Gundersen sells a platform for cardiologists to alleviate some of the nonclinical hassles that interfere with their time to care for patients. Yet, other doctors would rather work out of an office and get paid to direct others involved in patient care or involved in some aspect of medicine. Whichever the case, more physicians not practicing medicine is not necessarily a good sign.