Even before the coronavirus pandemic ravaged health systems worldwide, the healthcare sector was facing huge changes. An aging population, big data, technological breakthroughs, and videoconferencing have long been promising to revolutionize the way doctors and hospitals work, but the pandemic has exposed the fractures and fault lines in many systems, accelerated those evolutions and introducing others. Rather than watching the world change, in the UK some medics have grasped the nettle and decided that they want to drive and direct it.
The tool to do so? Business education. We are, perhaps, witnessing the rise of the medical MBA.
Traditionally, doctors have taken executive MBAs as a way to move into hospital management. But a new generation see a full-time MBA as a way to open their options and have an impact in whole new ways, says Ayo Adegbiji, a careers consultant at Imperial College Business School.
“A number of different things are happening,” Adegbiji tells Poets&Quants. “Medicine is not immune from the digital transformation we see in other industries. Also, doctors are high-achievers and come to the point when they want to self-actualize and explore different options in terms of how their careers play out.”
AN MBA WAS ‘THE BEST COURSE OF ACTION’
These days, there are plenty more options and a doctor with an MBA has plenty of impactful options. “Some want to pivot into entrepreneurship, others to being medical experts or mentors to start-ups and venture capitalists in the healthcare space,” says Adegbiji. Consultancy is an option, either in a traditional consultancy with a life sciences team or a specialist life sciences one. There is the option to move into pharma, too.” Others who stay in medicine might move on to become a chief medical officer or chair of a medical board.
One doctor who has decided to take the plunge is Ramon Julian Pesigan. Born in the Philippines, Pesigan followed his parents’ footsteps into medicine.
“They were both doctors and although they never really encouraged me to become a doctor, it was sort of the default for me,” he says. In 2007, he moved to New York and in 2014 went into sports medicine, working with such organizations as Mount Sinai Medical Center. Pesigan worked with several elite soccer and ice-hockey teams, as well as the New York Jets professional football team, and latterly was affiliated with the Actors Fund, treating actors on Broadway as well as in TV and movies.
During the first wave of the pandemic last spring, Pesigan found himself treating Covid patients. “That was scary,” he says. “It was a flip of the coin for every patient because of the lack of structure here in the U.S. It sort of accelerated things I’d been thinking already. As physicians we are not taught how to manage, it’s all about clinical work. That’s one of the reasons we’re in the hole we’re in, at least in the US system, it’s like having someone else dictate the way we do our work.”
What he experienced reinforced a feeling that had been growing and he decided that the best way to create change would be “doing something where I would be more of an administrator.” He goes on: “I started speaking about that with my wife and I think it started to like really like make sense to me that an MBA would be the best course of action to fulfil that part of me. I think more doctors should be doing management courses.”
CAREER OPTIONS BEYOND BEING A DOCTOR
Rather than stay in the U.S., Pesigan decided that Rotterdam School of Management in the Netherlands suited him best — first because the cost was lower than a U.S. MBA, but also because, he says, “I want to have more of a global perspective.” Also, he says, RSM sustainability focus chimed with his values. “A lot of what I want to learn as a businessperson really stems from a better way of doing things, and more sustainable way of doing things, and I think RSM really spoke to me in that regard,” he says.
Aged 39, he will probably be one of the older members of his MBA cohort. He decided on a full-time MBA rather than an Executive MBA so that he could throw himself fully into it, and give himself options to move his career beyond being a doctor. Pesigan, his wife and two children will relate to Rotterdam when his program starts, in January 2021.
The long-term plan? As yet, of course, that remains to be seen. “Staying in healthcare, consultancy or some sort of entrepreneurship are all options. I’m looking forward to having classmates with different paths and skills, and who are younger and broad-minded,” he says.
‘YOU NEED CLINICIANS IN THE C-SUITE’
Another doctor who was inspired to take an MBA by Covid is Londoner Vatshalan Santhirapala. He graduated in medicine from Imperial College London in 2013 and worked for the NHS for five years, before following his interest in public health and taking a two-year research fellowship at Harvard Medical School working on a project to deliver healthcare in a “frugal environment,” as he puts it, in rural India.
Back in London, he was working at Guy’s and St Thomas’s hospital during the first wave of Covid in the spring. Seeing daily critical decisions being made about issues such as how many ventilators were needed, and ensuring the hospital had enough supplies of drugs, Vatshalan had an epiphany. “Clinicians need to have these kind of decision-making skills because we can’t just be people who deliver frontline care. We need to be at how those macro level strategic decision-making skills,” he says.
“In my mind, covid has completely shaken the foundations of the health system, but has also given us the ability to rewrite how things are organised,” he says. “It’s phenomenally rewarding working with a patient one to one, but sometimes the system that you’re in is kind of teetering at the corners. It can quite frustrating sometimes to work with systems that is so imperfect.”
An MBA, he thought, would be a good way to give himself the required skills. Because of its strong STEM credentials, and his existing relationship with the university, Imperial College Business School was the obvious choice. He won a full scholarship and began his program in the fall.
“It feels like what I’m learning now is how the real world works,” he says. “In the public healthcare system you don’t really understand why people make these decisions or you don’t understand the trade-offs that someone makes from pursuing one therapeutic agent over the other and things like cost and return on investment, all those kind of things you’re not taught as a clinician.
“I think increasingly you’re going to need physicians who have this kind of corporate macro level experience of how to run complex systems. Because as much as you need doctors and nurses delivering day-to-day care, I would argue that you need clinicians at the top table, in the C-suite, making decisions, to make strategic changes and actually advise on how the health system is designed as opposed to just work with it.”
EXPANDING ONE’S SKILL SET
Another NHS doctor with big ambition is Mancunian Arslan Anwar, who gradated in medicine from Manchester University in 2016. As he continued his medical training. however, he began thinking about his long-term goals. “I spoke to friends a lot and decided that what I am really passionate about is having an impact on a larger scale,” he says. “I imagined myself as a consultant in a hospital and while I’d have an impact on patients throughout my career, I felt that I wanted to help more people.”
To do this, he decided that he would need to expand his skill set and was awarded a Young Potential Leaders scholarship to take full-time MBA at Alliance Manchester Business School which he began in 2016 at the age of just 25, making him one of the youngest in his class.
If the rigours of a full-time MBA were not enough, Arslan was also working part-time in a hospital A&E (accident and emergency) department while studying. “I wanted to stay in touch with my clinical skills,” he explains. When covid struck, he was on the front line, and even caught the virus. “It’s been emotional and stressful, and it takes a toll on your mental health. But I suppose you power through for the greater good of people,” he says.
Since finishing his MBA in May, he has been working on a project. Health services are usually reactive, but the future is all about being proactive, “to concentrate on population health and prevention,” as Arslan puts it, and he is working on a large-scale digital platform that could use data to provide personalised, preventative interventions. The project is called Caspa (which stands for Collaborative, Accessible, Sociable, Patient-centres and Affordable) and at the moment, Arslan is working on the idea alone, but is actively looking for partners. “Covid has kind of hampered my ability to network,” he says.
Healthcare systems were already ailing before they were further weakened by Covid, and the pandemic has highlighted just how they need to change. Who better to restore them to health than ambitious medics armed with MBAs?