I speak English. I also speak broken emergency department Spanish.
I can request of a Spanish-speaking patient, “Siéntese, por favor.”
This respectfully means, “Please sit.”
Or I can implore, “No empuje! Por favor!”
This loosely translates to, “Don’t push! Please have your baby upstairs in the obstetrics unit!”
It is not unusual to have a patient who speaks Hmong or Armenian or Portuguese visit our emergency department.
I request, “Siéntese, por favor.” But they look blankly at me.
So I say it louder. “Siéntese, por favor!” This doesn’t work.
It’s as if they speak a completely different language.
The Language of Business
I see similar language barriers occur when physicians talk to administrators.
The physician speaks Medicine louder, and the administrator who speaks Business doesn’t get it. The physician says, “No empuje!” and the administrator pushes harder.
One of the most effective things we can do to better communicate with administrators is learn their language.
Five Things That Business School Taught Me
Here are five things that I learned in business school that helped me master the language of the healthcare business:
1. Managerial Accounting.
We want to buy a robot, or hire more nurses, or build a new clinic? It helps if we can say something other than “We really, really need it.” We need to learn the budgeting process. Our department, our group, our practice is being measured.
Do we agree with the budget? Do we understand the costs? How we you going to promote our vision if we don’t speak that language?
Physicians are notoriously poor negotiators. We tend to approach each negotiation as the final battle in a war of used car salesmen.
We have a position. We have a price. They’d better give in.
Unfortunately, when we speak a used-car salesman’s language of positional bargaining, we leave a trail of animosity and a lot of interesting opportunities can be taken off the table. There is an art and a fairly good science to negotiation. You want to know it. Through negotiation and discovering mutually aligning interests, we gain the potential to create significant profit.
3. Operations Management.
Why is there always a line in our waiting room? What is keeping the hospital from starting surgeries on time? What is taking lab so long? The answer lies in process analysis and a clear understanding of queuing theory. There is a better way.
We can use the same science that Apple and Amazon use to get things done. We learn how to destroy the bottlenecks of waiting that prevent us from being efficient. If we don’t understand the science, it is very likely that our limited working vocabulary will convey cluelessness as we present our isolated view of how to fix the system. The administrator will nod politely, but chances are they think we’re the bottleneck.
We hear each other talking in the physician lounge. Taxes and investing and leveraging. We have strong opinions. Economics is the class to take to make informed choices about the small, daily matters of life and the global, long-term issues effecting healthcare and the world.
Our economic decisions directly affect our bottom line. We need to speak the language of sunk costs, and opportunity costs, and setting prices. We learn about rent controls, labor unions, and subsidies. This is the class that makes the market come alive. Without a good understanding of economics, we are in good company, with a number of politicians and, perhaps, we talk like one too.
5. Organizational Behavior.
I learned how to communicate more effectively, build effective teams and manage conflict. The language of organizational behavior gives the basic nomenclature of how to drive change and build commitment to ideas. There are Jedi-Mind tricks of behavior and influence and this is the domain of these secret teachings.
Do we incentivize with extra salary or is there a more effective approach? A great question for the study of organizational behavior. We may think an offer of more money will do the talking, but are we missing other evidence-based possibilities?
A Strong Physician Voice
It is clear that a strong physician voice is needed during this time of disruptive healthcare market change. This strong physician voice needs a foundation of deep business knowledge to promote a physician and patient centered healthcare model.
It is also clear that there are several strong non-physician voices available to fill the gap if physicians are hesitant to step up. I encourage you to speak for yourself, using the language of healthcare business, and not rely on the words of an interpreter.
Things you can do now:
A physician MBA is not your only option. It is quite easy to pick a specific business topic that you are interested in and learn about it. The American College of Physician Executives offers an excellent selection of conferences and online courses on healthcare business topics that you can immediately apply to your practice. Additionally, they offer a Certification for Physician Executives if you decide to continue with your studies.
There are several other options if you would like to pursue an MBA or other master’s degree. I received my Executive MBA in Healthcare Management from the University of Texas at Dallas. My class had 40 students, all physicians, who came from all over the United States. I flew to Dallas every two months for a four-day course on healthcare management related topics. It was a great experience to be able to discuss healthcare cases with the professors and classmates who were PhDs, MDs and C-Level Executives. This was supplemented by very good quality online learning.
There are several MBA or master’s degree options for physicians, both online and classroom-based; there are a variety of flexible curriculums to meet your specific scheduling needs. Just google “physician MBA.”
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Please note that I use a language interpreter when I see my patients. However, I wouldn’t trust a Business interpreter to handle my healthcare businesses.