What I Should (but Likely Won’t) Learn in Med School

When I left medical school for a brief period to complete my MBA, colleagues offered variations of the question “What do MD and MBA degrees have to do with one another?” I can only speculate about the origin of such puzzlement, but one point was clear: business and patient care are seemingly perceived as mutually exclusive, jointly exhaustive activities.

Subscription to that false dichotomy is understandable. After all, we med students and physicians have all prepared for the “why do you want to be a doctor?” question by focusing on people, not money.

We may have consequently lost focus on value exchange. I regret that my medical professors are unlikely to explicate doctors’ value proposition: that my worth (and remuneration) as a physician should be proportional only to my ability to improve patients’ quality of life and/or longevity.

Uninformed of my value proposition, I might never question dogma disguised as “guidelines,” I might never develop novel ways to measure my clinical effectiveness and I might never pursue wealth that could fund others’ pursuits to improve patient quality of life and/or longevity.

My second regret is that, in medical school, I am unlikely to learn marketing – to promote, and improve upon, my ability to deliver a strong value proposition. Medicine is surely a recession-proof occupation and in some ways, it spoils practitioners with high, virtually risk-free remuneration and freedom to practice according to one’s interests.

Doctors’ marketing strategies are simple, are they not? People get sick; they need help; doctors “help” them; therefore, patients see doctors and doctors collect fees. Marketing, though, is more complex than demand stimulation.

Marketing is about planning the strategic improvement of one’s service quality, price, accessibility, and patient-practice communications as they support one’s value proposition. Without practicing marketing, it will be simpler to push medical expertise upon my patients rather than adopting a truly patient-centered approach to clinical innovation and practice.

Having never learned about how my value proposition may improve with marketing, I will believe that my success will be singularly dependent upon the services I provide at the bedside, irrespective of ancillary infrastructure.

Misguided, I might resist the opportunity to adopt an electronic health record system or other novel technology; I might never truly analyze my clinic’s operational efficiency; I will continue to equate “practicing quality medical operations” with “operating a quality medical practice;” and I will continue to think that my influence on patients is accomplished solely at the individual bedside. Never having learned to optimize the delivery of my value proposition, my revenues will be limited and my practice may not thrive.

I consequently lament the improbability of learning about wealth’s importance to both my practice and the healing profession. This may deepen my belief in the false medicine-business dichotomy, and I will morally equate the pursuit of profit with the pursuit of houses, cars, and other luxuries.

Having never been taught the principles of finance, I will not understand that money’s greatest moral and practical utility is in the creation of value for humanity through investment. I might then use my cognitive and physical good fortune to serve without actively pursuing fair compensation, believing instead that money will not impact my ability to deliver value to patients.

Still financially illiterate, I might become driven by consumption and operate my practice for the luxuries that money buys – becoming the stereotypical “1%” doctor. Simply put, I regret that if I am not taught financial and investment literacy, I may squander an opportunity to amass wealth that could be reinvested toward improving patients’ quality of life and/or longevity.

My MBA taught me that business is simply a process of value exchange, and that money is not synonymous with value. The study period allowed me to clarify that my title, my 20 years of schooling, my $200,000 student debt, and my altruism will be worthless insofar as they serve to improve patients’ quality of life and/or longevity. Business education supplemented my medical training with tools to strengthen my value proposition.

I will now certainly exercise strategic marketing research and promotion to improve my service, its accessibility, its cost, and its visibility; I will strive to improve the process of delivering my services as much as I strive to improve the services themselves; I will focus on maximizing my practice’s profitability and I will reinvest those profits in people and ideas that might improve patients’ quality of life and/or longevity in ways that I regrettably cannot.

A medical student’s highest calling is to help the many ill and vulnerable. Practicing medicine, managing a practice, and wisely investing money are three approaches to accomplish that mission. I lament that, in medical school, my colleagues and I are unlikely to learn about implementing all three.

What do you wish you’d learned in med school?

Abraham Nunes is an MD/MBA student from Edmonton, Alberta, Canada. His interest is the improvement of healthcare accessibility through technological and systems engineering.

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