Design and Program Elements of a Clinical Leadership Program: The Saint Joseph's University Haub School of Business Experience

Introduction

To address the evolving educational needs of future leaders in the healthcare field, St. Joseph’s University (SJU) and Lancaster General Health (LG Health) collaborated to develop a comprehensive advanced degree program to train a physician and senior administrator cohort in topics ranging from the ethical, legal, and community implications of healthcare decision-making to the development, marketing, and structure of service provision for diverse patient populations. In addition to standard courses that would be present in any accredited MBA program, the program was also heavily focused on ethics so that the participants would be better able to recognize moral issues in healthcare and to distinguish these issues from questions of management, strategy, economics, psychology, law, and/or politics. Furthermore, physicians would have the tools to take the moral point of view toward these issues and to think of healthcare as not only affecting individuals, but also understanding the impact of healthcare delivery on entire communities and the institutions that support these communities.

For example, part of the program included an “immersion residency” trip abroad to study public hospitals in Latin America that are serving an increasing number of underinsured and chronically ill patients. The solutions employed by these hospitals made a deep impression on the students, who were inspired by the sense of mission among the hospital staff—to deliver equitable care to all patients—in spite of the sometimes inadequate resources available to accomplish that goal. The students were also able to readily see both the physical and quality-of-care differences between the public and private hospitals in healthcare systems that were functioning in an environment of political instability, social stratification, and economic hyperinflation, conditions that further exacerbate the disparities in healthcare delivery. In a final reflection paper, students could not help but comment on the endless marble construction inside one of the wealthiest hospitals in São Paulo, in contrast to the endless concrete inside São Paulo’s public Hospital das Clinicas. In observing the ways healthcare was delivered in Latin America, the students gained insights into issues of disparity within a tiered system and reflected on how they may take these insights back to the debate about healthcare access, quality, and cost in the US.

The objective of this chapter is to describe the development and implementation of the LGH-SJU MBA program for physicians who were already involved in leadership roles. The question of whether to train future physician leaders during medical school or to wait until they have already attained leadership roles within their organizations before initiating management training, while relevant, will not be explored here. This chapter will focus on the development process, selection of the educational institution and student cohort for the program, and the elements that are educationally appropriate for such a program. Two courses offered as part of the MBA program will be selected to describe in more detail. The authors will also discuss standard and novel mechanisms for evaluating the performance of the students and educators in the program and ways to coordinate the students’ educational experience with their real-life activities in the healthcare system. Program design, program content, composition of the graduate student group receiving the training, qualifications and range of expertise for the educators providing the coursework in the program, and the keys to successful completion of the program will be discussed.

Differing options for presenting required program information and conducting coursework will be defined and discussed. Training students in an environment where they may not be geographically proximate and where they are likely to be employed in full-time positions can be a challenge, and thus current modalities for facilitating instruction and allowing the widest range of student participation in the programs will also be discussed. Coordination with sponsoring commercial or healthcare organizations is a critical part of optimizing these types of graduate programs, as is crafting them to best fill the needs of the students and the organizations in which they will be working. Finally, philosophies of education that best suit this unique form of graduate education will be identified and discussed by the educators who have put them in place.