What docs don't get taught in med school: A new training program from Johns Hopkins and MGMA

This episode of the MGMA Podcast features guests Jonathan Leer, MHA, FHFMA, FACMPE and Shannon Bishop, MBA, of Johns Hopkins Medicine. Leer is the current division administrator for Geriatric Medicine and Gerontology as well as the division of Hematology, while Bishop serves as the academic administrator for the Department of Medicine.

MGMA Sr. Editor Daniel Williams, MBA, MSEM met with Leer and Bishop to discuss a new online physician business training program developed in partnership between John Hopkins Medicine and MGMA.

Editor’s note: The following Q&A has been edited for length and clarity. 

Jonathan, can you tell us about the origins of this program?

The origins of this came from real world experience and me being a new and burgeoning hospital administrator. After getting my first job, I talked with physicians and leaders within physician practice management organizations saying, “What about if we were to increase our work or view expectations, and what if we were to look at our contractual adjustments?” I would be using these words that came second nature to me and they would look at me like I had three heads. So, I think it was a very quick realization that physicians in their didactic medical education don't get any business training, which I think is criminal to be honest with you.

I think that if you're going to tell someone how to be in any environment of employment, whether you're working for Amazon in the warehouse picking items every day or you're at the very top levels of being in a law office or a medical practice, understanding how the business operates is important because you are part of that machinery. I think it creates this really tense exchange between physician leaders and administrators, because they view us as the obstructionist and we, conversely, view them as the obstructionist because each other is not talking the same language.

This really came out of me as a young professional trying to say that there's got to be a better way and we've got to be able to do something. For years, I tried to do this at my own organizations within orientation documents for new physicians, but that is one small dot compared to the larger landscape. So, when I spoke about this openly at the Leaders Conference in Boston two years ago, I was approached by MGMA leaders and said, “Let's really flesh this idea out and talk about how we could really expand on this.” Then, the rest is history, so that's how we started.

Shannon, when did you get started in this program and what is your role?

I was super excited to be involved because Jonathan and I got started talking about it in the context of faculty recruitment season. As a division administrator at that time, I had a number of fellows who actually came to me and were asking me for help with negotiating their contracts in external or internal environments. In some of the components, those same components that Jonathan was mentioning, they weren't familiar with that. What was an RVU (revenue value units) benchmark? What was the AAMC (Association of American Medical Colleagues) benchmark or MGMA benchmark for their salary? So there were components of those things that I realized they hadn't been educated on and I was willing to help them. When Jonathan approached me with the idea, I realized I wanted to make a more meaningful difference outside of just the divisions that I was working in at the time. So I joined him and MGMA on trying to craft a course that would functionally help the next generation of providers negotiate in the next steps of their career.

Shannon, what can you tell us about the nine modules and what physicians or administrators would learn from the course?

We thought it was first important to outline the healthcare landscape with an overview of practice models and business entities, and that really goes over everything from private practice to academic medical centers. That way, all of the new residents and fellows who are negotiating contracts understand the landscape in which they would really like to practice from a values perspective. Then we moved on to insurance, coding and documentation. Those are foundational things that folks need to know as they're starting a new career or restarting their career in a different place – what are those fundamental principles that they would need to know in each of those areas?

Another subsection of our program is understanding physician compensation – how do you negotiate and what are the benchmarks that are available to help you do so. This includes proprietary starting salary data. That way, the person who is purchasing this course has that information to be able to understand where they fall in the different schemas. We also go over credentialing practice performance and profitability. So understanding both, from a private practice perspective as well as how someone can be impactful to making an organization financially solvent, is important just from the perspective of people who are hired in different landscapes. Then we end that with personal finance for the physician. We realized that in the course of trying to help everyone, not only was there a business need, but there was also a personal financial need to understand how a new contractor, or a new job/role may impact their personal finance.

Jonathan, can you elaborate on what is a proprietary starting salary report?

There are multiple tools out there in terms of benchmarking anything from not only practice performance and profitability, but also in salary. The one that we really wanted to highlight, and I think is possibly the best value for your money, is that whatever subspecialty you're already in or you want to go in, you will be getting an a current MGMA compensation report that shows in a multitude of factorials where most individuals are in terms of compensation. It runs all the way from what type of organization you're a part of, whether that's a private practice or part of a health system (academic or independently owned). It even breaks it down to what area of the country you're that you're in because the East Coast pays very differently than the West Coast. I have been an administrator for a long time, and I have been on the other side of the table. So [we want to ensure] you don't get pressured into signing a contract where you haven't been getting the best bang for your buck.

The compensation report shows that you're going to be in a family medicine physician in the south half of the United States and your starting salary on average at the 50th percentile is $200,000 and you get an offer for $130,000. You may say, “I've been paid as a fellow and as a resident before that and I I've never seen a six-digit number. I've always seen a two-digit number (hourly) or a five-digit number.” I think knowing where your cohorts are, in terms of that level, is helpful in negotiation with those individuals that are seeking to hire you.

How can individuals or organizations access and purchase this course? Are there prerequisites or requirements for enrollment?

We tried to make accessing this course really easy – www.mgma.com/online_courses has the course available for purchase. There are no prerequisites or any foundational education that's required.

Walk us through the class structure. Is it self-paced? Does it follow a specific schedule? Are there assessments and evaluations?

We really did try to make it a self-paced course. It's basically a seven-hour course that's broken down into those nine modules that we described, but they can be taken at any time. It's not really on a time limit or schedule like some other MBA classes where you have to earn a certain number of credits within a certain amount of time. We also offer group licensure so that way, if groups of residencies or other programs would like to purchase this, there is special pricing for that. We also can accommodate that within a group form. So that way, everyone can take the course at the same pace. We've tried to think of multiple scenarios to make it easily accessible and fit within those different scenarios depending on the need.

Who is this course for?

(I think in the in the beginning, our sites were really focused on early careerists – people that were in their residency and fellowship programs. They were about to get their first job out into the industry. As we really started to develop it, we started to see that there is a lot of comprehension that can be given towards individuals that are maybe mid careerist and going into some type of a leadership role within the organization. A common thing that happens a lot in our academic medicine environment and also in private practice – you've got a great physician who is wonderful, very engaging and is a prolific member of committees and community organizations. That individual is then asked to become some type of a leader in that organization, whether it's a medical director or actual formalized leadership role. All of a sudden, they start getting bombarded with income statements and recruitment strategies. If they went directly from being in their residency and fellowship into being a practicing physician, they may not know what that means. I think it is important for early career individuals who are starting to take on that leadership role.

The precipice for this was – take this course and don't get the MBA. Doctors can go get MBAs. I'm not trying to say that it’s not for physicians. I just don't think it is necessary for every single one of them. I think that there is definitely the chatter out there that if I need to know anything about the business of medicine, I’ve got to go get an MBA. I'm here to tell you that it is not true. A traditional MBA program is going to teach you generalized things about business, but not specific healthcare business. So that's where we really tried to boil it down and give it in an easily digestible format. That's where I feel the audience is.

Resources:

This online course is for early-career physicians or physicians who need a comprehensive understanding of the business of medical practices. The course is 7 hours long and broken into 9 modules. It was developed by Medical Group Management Association (MGMA) and leaders from Johns Hopkins University School of Medicine. This course awards 7 hours of CME credit.

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