Research in Progress, Germany Veloso
Research in Progress, Rubin Pillay and Ken White
Advances in drugs, devices, and managerial, surgical, and medical knowledge have created health systems that can deliver the best care—but at sky-high cost and with unequal access and erratic quality. This trajectory is both unsatisfactory and unsustainable.
In interviews about the future of health care, 59 of the CEOs of the world’s largest and most innovative health-sector organizations most frequently used the word “innovation.” Their consensus was that innovation in processes and systems was more important than the invention of new medical and health-related products. But a content analysis of the current health care–related offerings at 26 top U.S. schools found the term “public policy” most frequent in curriculum descriptions, followed by “organization.”
Only seven business schools and one school of public health used the term “entrepreneur,” and only 25 of 91 course descriptions from business schools contained both “innovation” and “entrepreneur.”
CLEARLY, FOR HEALTH CARE TO CHANGE, THE EDUCATION OF ITS LEADERS MUST CHANGE.
21st-Century Health Care Management Education: Confronting Challenges for Innovation with a Modern Curriculum, was held in 2012 at Boston’s Harvard Business School, as a first step in reshaping the education of executives to meet the challenges of innovating 21st-century health care. HBS Professor Regina Herzlinger, the conference organizer, and her steering committee colleagues sought to leverage the expertise of the 157 conferees to meet these challenges.
They represented diverse academic institutions, professional organizations, and health care consultancies. Attendees from the European Union, North and South America, India, Russia, Africa, and Asia assured a global perspective.
A CALL TO ACTION
The CEO interviews reflected significant dissatisfaction with the skills of academically prepared candidates from diverse types of health care management programs. In a separate survey, academics largely agreed with them. A few highlights:
- Innovative processes are more important than innovative products.
- The current academic focus on isolated training in finance, ethics, medicine, etc., is less helpful than a holistic curriculum that mirrors real-life situations.
- Skills in change management, communication, and team building are essential for innovation.
- Breaking down the silos separating the schools that offer expertise in differing aspects of health care management is crucial for collaboration.
- A broad-based knowledge of how health care works—including financing, organizational structures, technology, and public policy—and how to apply that knowledge are prerequisites for evaluating and implementing innovations.
- Management education helps with business problems; health care policy, medical, and scientific education does not focus on managerial issues. Uniting these two camps with shared purpose and common language is a critical step for creating significant change in future health care systems.
- Fieldwork and structured mentorships offer lessons the classroom cannot.
Asked to name obstacles to the innovations necessary in health care management training, the academics most frequently cited the difficulty of finding appropriately trained faculty; the challenges to hiring and retaining teachers with real-world business expertise; and the limitations of curriculum materials themselves, including insufficient real-world data and too few case studies—especially studies of failure. HBS Professor Srikant Datar, coauthor of Rethinking the MBA, offered an inspiring example of how and why recent curriculum changes happened at HBS and many other schools of business.
In the white paper that follows, you will hear diverse and sometimes discordant voices from all corners of health care management: CEOs, independent consultants, leaders of professional organizations, and faculty members in degree programs. But despite the range of opinions and the many perspectives offered, all are motivated by real concern for the global state of health care and the imperative for change.
The conference attendees offered detailed recommendations for curricular content, pedagogical tools, professional values, and faculty career paths as curriculum changes are implemented. Of course, a broad review and revision of course offerings are in order. More nontraditional faculty should be brought on board, including professionally trained and experienced health care managers to help forge the vital link with real-world concerns. Field placements not only provide a rich learning environment, but also offer real-world perspectives on what is taught in the classroom. Networking should be supported not only between academia and the health care industry, but among different schools and academic departments to create cross-disciplinary courses and programs.
Improving the education of health care managers will not be easy. It will likely require reworking budgets and teaching loads as well as evangelizing among deans and teaching colleagues. However, if any group of scholars should believe in its ability to effect sweeping change, it is those of us in health care. Our area of expertise has more than once vanquished the seemingly impossible, whether by substantially increasing life spans, by revoking the death sentence of AIDS in the developed world, or by broadening global access to health care through cost-effective managerial innovations.
The 2012 meeting marked the beginning of an ongoing process of change that will be revisited in 2013 at Duke University. This white paper serves both as a record of the conversation so far and as a mile-marker for the next conference: “Here is what we collectively agreed we would do in 2012: How have we changed since then, and what more can we do to respond?”
We hope you will read on, to follow in the steps of the 2012 conference attendees who listened to the health care sector and each other as they began the challenging but rewarding journey towards innovating health care through innovations in health care management education.