MD/MBA Program Provides New Health Care Perspectives

By Dirk Hoffman

The collaborative program is a partnership between the UB School of Management and the Jacobs School of Medicine and Biomedical Sciences.

The benefits of the program are enormous, according to Philip L. Glick, MD, MBA, professor of surgery in the Jacobs School and liaison for health sciences schools and the School of Management for MBA programs.

“The arc of my career is about 40 years long and throughout medical school and all of my residency training, everything was focused on patient care and there was very little during my training to teach me about the business of medicine,” he says.

Glick notes in the late 1990s the health care policy of the United States changed, and medicine began being treated like a business.

“In 2023, we are judged on our outcomes. We are in an environment with scarce resources and reimbursement is no longer fee for service,” he says. “Reimbursement is based on the outcomes, so you can do a lot of cases and if you do not have good outcomes you are not going to be successful.”

Glick says the business of medicine is more than just spreadsheets and bottom lines — it is human resources, operations and negotiations.

“Successful academics in the past — if you were good at patient care and you were good at teaching and you were good at research — you were considered successful,” he adds. “But there is now a fourth leg, which is how good are you at leading?”

Glick earned an MBA from the Kellogg School of Business at Northwestern University in 2005, 26 years after earning his medical degree.

“I thought I had set up a really perfect academic environment for myself, but there were things going on outside surgical academics, that I really didn’t understand,” he says. “So, I decided mid-career to go back and get an MBA. It changed my life. It exposed me to things that I had never really thought about before.”

“There is a lot to running a business besides making the balance sheet look good,” Glick adds. “You learn how to manage people, how to be a good leader, how to improve operations so that not only is it more economic, but you also have better outcomes. Doctors were previously just not prepared on how to do that.”

When Glick finished his MBA, he began having conversations with Michael E. Cain, MD, the former dean of the Jacobs School; and Paul Tesluk, the former dean of the School of Management.

“We had a dual degree sitting on the books, approved by the New York State Department of Education, for MD/MBA degrees and no one was using it,” he says

One of the next steps taken was to conduct a survey of 100 employers across Western New York — not just hospitals — but insurance companies and multispecialty groups, who were asked “if you were going to hire a doctor that had one additional degree to be a leader in your institution, what would it be?”

More than 80 percent of the respondents said, “we want doctors with MBAs,” Glick says.

With that knowledge, the School of Management created a concentration in health care management.

“It was the same degree that was on the books, but we now offered medical students a standard MBA with a health care concentration,” Glick says. “The MB/MBA Dual Degree Program is five years, with seven semesters at the medical school and three semesters at the School of Management.”

The program reduces by one full year the usual four-year MD program and two-year MBA program. Medical students apply to the MBA program during their third year of medical school and the following fall enroll and take MBA core and elective courses. In the fifth and final year of the program, students concurrently take their fourth year of medical school and remaining MBA electives and capstone.

“During their semesters at the School of Management they take regular classes just like any other MBA student, but most of their electives are in health care policy and health care management,” Glick says. “Ask anyone in this building if the students who come back from getting an MBA are different than the other medical students and it is hands down, they just look at the world differently.”

“They may aspire to be a CEO of a hospital, but they may also aspire to be a primary care doctor,” he adds. “That MBA knowledge will help them take better care of their patients. It will help them run their practices better.”

Nina Valenzuela, MD, MBA, is one of three medical students in the Jacobs School Class of 2023 who earned the dual degrees. She is entering her residency in obstetrics and gynecology at Hackensack University Medical Center in Hackensack, New Jersey, this summer.

She says she always had an organizational mindset due to the fact both her parents are medical technologists who work in hospital laboratories — behind the scenes, they run the tests doctors order.

“I knew early on that health care goes beyond clinicians and nurses and patients. How systems are designed, how you get all of these different people organized to accomplish incredible things, how work culture can impact performance and learning — I found these questions fascinating,” Valenzuela says.

During her clinical rotations, Valenzuela made additional observations, noticing that when attendings struggled or expressed grievances, they were usually systems-based rather than medical.

“Many had to fight with insurance companies to help their patients get care covered, some had to limit the amount of time they could spend with their patients, and overall, it seemed that there were other forces at play that were restraining how providers were delivering care,” she says.

“I realized there was a need for doctors and aspiring doctors to learn more about these forces — health care system design, market dynamics, reimbursement structure — so that we could better advocate for each other as well as our patients.” 

Valenzuela says the MBA degree coursework has strengthened her understanding of how the business side of medicine works, as well as her understanding of the different building blocks that make up the health care system.

“What might also be surprising to many is that during business school, I’d have weekly discussions about social determinants of health in my health care management courses,” she says. “At the end of the day, people there were trying to answer the same question I often ask myself: ‘how do we build it better for our patients and providers, while reducing health care costs?‘”

Valenzuela says the MBA coursework taught her a lot about herself as well.

“I’d never realized just how many personality assessments exist in the world, but the MBA definitely put me through plenty,” she says. “While it’s still a work in progress, it’s also helped teach me to be a better communicator, presenter, intentional and strategic in my decision making, and more comfortable with reaching out for help through development of mentorship relationships.”

Delving into entrepreneurship was a pleasant surprise for Valenzuela during her MBA studies.

“Some of my course work in health care innovations and entrepreneurship resonated with my creative side — before my love of the sciences was my love of the arts. Part of entrepreneurship is observing problems in your surroundings, identifying a need, and thinking of solutions to fill that need. Health care is plagued with plenty of problems.”

“For me, I thought about those, some of which are close friends, who struggled with their vaping addiction,” Valenzuela said. “With creativity and entrepreneurship, my team and I are trying to develop a solution for the vaping epidemic that have affected millions of young people.”

She is one of the co-founders of Liminal, a device that provides users with an easy, effective way to quit vaping using cognitive behavioral therapy, gamification and other proven addiction cessation methods.

The company has partnered with an engineer who has already developed a prototype for a vaporizer attachment to quantify people’s vaping habits.

Jennifer L. Pugh, MD, MBA, assistant professor of emergency medicine, is an alumna of the Jacobs School dual degree program, having graduated in 2009.

She says the MBA program broadened her skill set to include operations, strategy, marketing and finance. 

“Courses such as health care policy and strategy played a much greater role in my practice of medicine than I expected,” Pugh says. “These skills have been invaluable in my current position as associate chief of emergency medicine at the Erie County Medical Center — especially during the April 2017 cyberattack on ECMC and the COVID-19 pandemic.”

Pugh is focused on providing clinical care at ECMC and is proud to advocate for her patients at the Level 1 Trauma Center and urban safety net hospital.

“I learned that improving the quality of health care for my patients required a more proactive and forward-thinking approach,” she says. “The MBA program taught me the importance of fostering collaboration among all members of the health care team, including nurses, allied health professionals, pharmacists, social workers and physical therapists through open communication.”

Pugh says her career advancement in Buffalo has been influenced by a combination of factors.

“My mentors in the medical and business schools helped me to carve a career path that I did not think was possible,” she says. “My clinical experience while at University at Pittsburgh Medical Center Emergency Medicine residency — where I served as chief resident and as an early-career attending at Buffalo General Medical Center and the Veterans Affairs Western New York Healthcare System — also played a major role.”

A major part of Pugh’s daily activities is advocating for patients and for physician well-being. She is president of ECMC’s Medical Executive Committee and is a member of the Professional Development and Wellness Committee.

“My goal is to contribute to positive changes within our health care system to help improve work-life balance and reduce burnout,” she says. “The Professional Development and Wellness Committee is very active at ECMC and provides physician-led support groups and coaching to promote career growth and satisfaction.”

“Over the past few years, the ECMC medical executive officers have worked to change our peer-review and quality improvement processes to be physician-led instead of administrator driven,” Pugh adds. “The Quality Executive Committee and Leadership Council members play a major role in implementing processes to improve patient outcomes.”

Pugh says she encourages medical students to reach out to her with any questions they may have about the dual degree program.

“I found returning to medical school rotations challenging after a year focused on MBA coursework,” she says. “Students interested in this program should be excelling in the classroom and clinical rotations.”

Glick notes that Allison Brashear, MD, MBA, UB’s vice president for health sciences and dean of the Jacobs School, is a perfect example of the benefits of getting an MBA degree as well as an MD degree.

“While getting my MBA was a large time investment, it was worth every minute. Already well into my career as a physician-scientist, it put me on a different trajectory and provided me with the strategic insight and executive mindset needed to advance in the world of health care leadership,” Brashear says.

Glick says he is fond of a quote from leadership and organizational guru Arthur G. Zago that says, “Good leaders are made, not born.”

“I truly believe that. If you give people the proper skill sets, give them the opportunity to practice and give them exposure to greater opportunities, they will learn to become leaders.”

Glick also says Cain’s tagline about the new Jacobs School building — “Making Tomorrow’s Leaders Today” — is especially apropos for the MD/MBA Dual Degree Program.

“That’s what the collaboration between the School of Management and Jacobs School does. It helps make our graduates in medicine tomorrow’s leaders today.”