White Coat and a Pinstripe Suit

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Richard HellerPhysicians, let’s face it: Conventional wisdom has it that we make lousy businesspeople. We’re great when it comes to the nuts and bolts of the body, but when it comes to the mechanics of finance, we’re said to be naive. Frankly, there may be some truth to this. The majority of us spent the bulk of our 20s and 30s in medical school, residency, and fellowship, focusing on learning the foundations of medicine and the practice of radiology.

We didn’t have time to study the differences between stocks and bonds, how options work, or when debt is better than equity. Not only did we lack the time, but many of us didn’t have the extra money to invest or the motivation to learn. Money was something that we knew would come later, when we had our real jobs. We didn’t enter medicine to get rich, but we could be reasonably sure that we wouldn’t be destitute, either.

I’m six years past a pediatric-radiology fellowship, and I’m a partner in a successful private-practice radiology group. This is what I worked so hard for, all those years—so why am I now halfway through an MBA program, spending every other weekend, for two years, in all-day classes on things like managerial finance, accounting, and corporate strategy?

As I looked around at the financial and political landscape, it was clear that significant changes were coming. Federal and state governments are facing critical budget deficits. Their expenses will have to be slashed, and this will certainly have an impact on the finances of health care. At the same time, radiology itself has become even more competitive. It was against this backdrop that I decided to embark on a business education.

As it turns out, those things that I was too busy to learn about earlier really are important to how we practice. The differences between a thriving practice or department and a failing one probably have a lot more to do with the things I’m studying now than with what they taught me in residency.

Now that I’m here, what do I think of physicians in business school? Out of a class of about 65 people, there are four physicians (I’m the only radiologist). We physicians are more than holding our own against our more traditional business classmates. What I have learned is that the skills that we developed over years of training and practice translate very well to a business setting; you just need to understand how.

Business has a language, just as all specialties in medicine have. If you want to communicate effectively in business, you need to know this language. Once you understand this language, it is much easier to translate the concepts that we use in everyday radiology practice to a business setting. Business school teaches this language and the mechanics of business practice. It doesn’t provide a defined pathway to success or riches (though we wish it did); rather, it provides the tools necessary for you to make your own pathway.

Imagine you are running a business, you are trying to increase brand awareness, and you are offered the chance to sponsor hat day at the local baseball park. For $20,000, your company logo would appear on the backs of all the hats given out to fans. Should you do it? This seems fully alien to radiology, doesn’t it? Not at all: Just reword the question in terms to which we can more easily relate.

For example, a clinician believes that the patient has a tumor and wants to know whether to order an MRI exam. We ask, ”Where do you suspect the tumor is?” In business terms, we would ask who should be the target of this advertising campaign. Another basic radiology question is, “Given where you think the tumor is, are there better ways to image the patient?” The business version of this question could be, “Are there more effective and/or cheaper ways to reach your target market?”

If the clinician thinks that the patient has lung cancer, we would say, “Skip the MRI exam, and get a CT exam.” If the businessperson’s target market consists of purchasers of industrial mining equipment, we would say, “Skip the baseball promotion, and maybe focus more on trade shows.” In radiology, we’ve learned that to get the right answer, you need to make sure you are asking the right question. This couldn’t be any more true in business.

A critique that I hear about physicians in business is that we are inflexible, but succeeding in business requires an appreciation that the world is constantly changing and shifting. I couldn’t disagree more with the notion that we are inflexible.