Monday, March 27, 2006

Medical Schools Must Get Down To Business

An item at the UM Medical School news site caught my attention:
Medical Schools must get down to business (03/27/06)
Medical School leaders nationally must manage their institutions more like a business. The U-M Medical School is leading the way.
The reason it caught my attention is that I have a strong negative visceral reaction to the use of the phrase "run like a business."  The phrase was used often here in Michigan by the former governor, John Engler.  It that context, it meant to ignore humanistic values, maximize profits, and specifically to ignore the plight of the underprivileged.   Obviously, none of that would be appropriate for a medical school.

Besides, I learned in a high school Business Management class that something like 80% of new businesses go out of business within the first three years.  I don't recall the exact figures, but is was something like that.  The point is, that in empirical terms, to run something like a business means to adopt practices that are almost certain to fail within a short period of time.  The fact is, most businesses are not successful.

The article is about the new CFO of the University of Michigan Medical School, William Elger.  For what it is worth, it does not provide a direct quote of him saying that the Medical School should be run like a business.  Instead, it talks about some sophisticated mathematical models he has developed to help understand what is happening with the School's financial status.  I have no problem with that; obviously, it helps to have a clear idea of what is going on.  It helps to be able to model various "what-if" scenarios, to anticipate problems before they occur, etc.  
“Medical schools must have rapid-fire, up-to-date information on measurable, critical success factors, including market share, expenditures and revenue sources. We face eroding federal and state support for medical research and education, so it is essential that we understand existing resources and identify the ones we need to grow as an organization,” Elger says. “Without the metrics to assess key performance measures, we won’t be top medical schools down the road.”
I would have been happier to see a clear statement of the need to balance the harsh financial realities with the mission of the School, which has to be fundamentally humanistic in nature.  But I won't be too critical, since that is not what the article was about, anyway.  (The article was about an article that Elger wrote in the latest issue of Academic Medicine.)

Still, I hope that the School does not focus too much on "market share, expenditures and revenue sources."  They do need to strive for the appropriate balance between financial security and fulfilling their missions of patient care, teaching, and research.  

Or, as some would say, research, teaching, and patient care.