The MBA mystique.

Is an MBA really the answer? Well, it could be - and then again, maybe not. This column is an attempt to dispel myths about physician executives and the MBA degree.

Five years ago, in our searches for Vice Presidents of Medical Affairs (VPMAs), health care clients rarely asked to see physician executive candidates who possessed both an MD and an MBA. The combination was not a common one, and clients did not place a priority on having an MBA for this position. They wanted physician candidates to possess strong clinical skills and to have demonstrated prowess in medical administration. We would ask if they were interested in candidates with an MBA; usually, they would not exclude someone with that degree from consideration and, importantly, did sometimes wind up giving the nod to a candidate with a management degree.

The situation has certainly changed. Today, health care clients seeking to identify the best physician executive for a senior management role are much more likely to see MBA-credentialed physician candidates. In fact, they may ask us specifically to screen for that degree. But that does not mean they hire based on that fact alone. The MBA is rarely the deciding factor when it comes to making a job offer. Few physician executive job descriptions actually specify the MBA or other graduate management degrees. In fact, it is evident that management know-how and proven experience always count for more than 'the initials' alone when clients offer a management job. Nonetheless, roughly half of the physician executives hired today are physicians with two degrees - not necessarily an MD/MBA. But more about that later.

What does an MBA really mean - to you and your career?

So, why is the MBA perceived to have such an attraction? Why does a mystique surround the MBA/MD? And why are so many physician executives of all ages making the decision to return to school and complete a master's of business administration?

It does set those who have it apart from the pack. The physician who completes an MBA is demonstrating a seriousness, a motivation to excel that is outside the norm, a true commitment to mastering business principles and theory.

And, it is a head-turner. The MBA represents a significant career investment for any individual. You have to look a little more closely at someone who has completed difficult coursework while holding a full-time job, because that effort earns your respect.

But the MBA is not enough, by itself Health care organizations are increasingly sophisticated about what can and cannot be expected from a person with a management degree. (Just a few years ago, the organization's darling was the marketing guru - with expectations that he or she was a messiah who could save faltering entities. And where are those marketing managers now?) The truth is, some individuals who have an MBA could not manage their way out of a paper bag. And health care organization CEOs know it, too.

Why go to the trouble?

It's like the old story of the man who is shopping for a yacht. He asks, "How much?" and the salesman replies, "If you have to ask, you can't afford it." if don't have a good enough reason to want an MBA, then don't get one. By itself, it can do nothing to jumpstart a career. Combined with the right experience and skills, however, the MBA can provide an extremely valuable grasp of business principles. It's like losing weight; don't do it for others - do it for yourself.

Some people just have a flair for business. I know a physician who has worked successfully for many years in a highly competitive health care business - genetic testing - who recently was paid a high compliment' by a longtime clinical colleague who was surprised to learn he is a physician! "I never knew he was anything but a business man," the colleague explained. This successful physician executive, incidentally, has no formal business degree.

I began a management degree program several years ago, and after more than a year in graduate courses squeezed in at night or on weekends, finally, I had to ask myself: Did the additional degree really fit into my career plans? Did I need it to accomplish my goals? It was a good program but I chose to leave. Not only have I no regrets, but I am glad about the choice I made, because I didn't need the degree to be an effective search consultant. A lot of my work is on the provider side, and I relate well to the issues and concerns of clients and candidates in the provider environment. Would the MBA make me stronger? Absolutely. My long-range plans could include completing that degree.

Why invest time and resources in an MBA?

As physician executives continue to mature professionally, there will be more and more line responsibility coming their way, and the formal business degree is an excellent background for this. More importantly, as the candidate pool becomes more competitive, the bar is being raised - and certainly the expectations for formal business and management training are on the increase. I used to advise that an aspiring physician executive under the age of 45 get the degree; now, I've raised the age to 50.

What degree

is the right one?

It's best when the information and concepts of an MBA program are integrated into one's life, when the learning is in context, not just to complete a course requirement. Clients are savvy about evaluating the MBA in context: They are interested not in what the person says, but what he or she is actually doing; looking at a candidate's performance helps clients judge whether the MBA is a mere adornment or if it is integral.

Other graduate degrees may offer physicians management training, but they are not seen as equivalent to the MBA.

* The MPH is seen as less rigorous and is thus less valued by clients when they evaluate candidates. * The MS is usually considered as continuing a clinical emphasis, not opening an executive up to business ideas. * The MHA, the classic health care degree, does not offer any significant differential from the education of a non-physician health care executive. * The JD appears to have some real application to the role of the physician executive. While physicians who earn it rarely practice law, their degree can offer important training in negotiations and communications. MD/JDs often seem to think and analyze better. Recently, two clients have hired MD/JDs and been pleased with their decisions.

What do clients want?

Clients are asking us to help them attract and hire physician executives who possess these sometimes intangible skills - with or without the MBA credential: * Ability to educate other physicians to the new health care realities * A sales orientation emphasizing effective communication that focuses on patients and payers as customers * Tact and sensitivity in negotiations * Comfort with ambiguity * Flexibility (things need not be done your way, every time)

Which school is the best one?

Here's a little secret to tuck away for future reference: IT DOESN'T MATTER WHERE YOU GET YOUR MBA DEGREE. Clients are more interested in results, and generally pay less attention to a top-name school, versus what you have been able to accomplish with your degree. The point is, as the number of MDs with MBAs increases, and it appears that it will continue to do so, expectations for action count for more than old-school prestige, no matter how hallowed their ivy-covered halls may be.

And now for something completely different...

I have had a lot of feedback from my recent column on resumes and CVs, including some pleas from colleagues who asked me to point out: Cvs of professionals are not judged by the pound. Length does not correlate with quality. A 35-page CV that includes every talk you've ever given, every committee on which you've ever served, and every award and honor since grammar school is not impressive. It is unwieldy. It suggests a mind that does not pick and choose, that is unwilling or unable to assign a priority and select only the best moments from a busy, productive professional life. Prune your CV to give it impact and relevance.

Key Concepts: What does an MBA Mean/What Clients Want from Physician Executives/Special Competencies

Is an MBA the solution for you? Do physician executives need to have a business degree to compete in today's competitive marketplace? What are clients looking for when they make hiring decisions? The answers may surprise you. This column is an attempt to dispel myths about physician executives and the MBA degree. Clients want to attract and hire physician executives who possess sometimes intangible skills - with or without the MBA credential. These intangible skills include the ability to educate other physicians to the new health care realities, a sales orientation emphasizing effective communication that focuses on patients and payers as customers, comfort with ambiguity, flexibility, and tact and sensibility in negotiations.

Mary Frances Lyons, MD, is an Executive Search Consultant with Witt/Kieffer, Ford, Hadelman & Lloyd in St. Louis, Missouri. She may be reached at 8000 Maryland Avenue, Suite 1090, St. Louis, Missouri, 63105, 314/862-1370. Please fax career development questions that you would like to have addressed in this column to Dr. Lyons at 314/727-5662.