Entrepreneurism should be part of medical school curriculum

Physician Executive, May-June, 2004 by Robert Aquino

After having the opportunity to be a guest lecturer for a group of New York University first- and second-year medical students, it is quite apparent that entrepreneurism should be a core course.

There were several telling concerns that arose from the medical students' questions. One of the most common was: How do you position yourself to either join a practice or start a practice once you finish training?

It was clear that the majority of the group wanted a private practice lifestyle, but did not know the basics of office management, billing, collections, managed care contracting and legal issues. The rest of the group seemed undecided and/or thought about working for a hospital, HMO or being part of academia.

This gave me a preliminary plan for an entrepreneurial core curriculum course--although at this level I believe the name should be Medical Business Administration 101, or MedBA 101.

The basics should include a course on medical business jargon; this should include the ABC's of managed care to definitions of co-pays, deductibles and the resource-based relative value scale.

Another course should include medical management of patients through the oversight of a managed care company. How a managed care company "sees" the management of patient care.

The third course should be an introduction to medical office management, this would include information on: employees, managers, and information systems, local laws for office space, safety and security.

Another course on finance and banking should include financing of office space, equipment and working capital. Part of the course should deal with existing debt, securing new financing and banking relationships.

The final course should deal with the legal issues of practice, contracting with payers, malpractice, employee contracts and professional contracts.

These five core courses should be the basis for medical students while in their first few years of medical school. This is important because their choice of a specialty can vary depending on how well informed they are about the parameters to start.

These courses should be the first set of business courses for medical students. At the latter part of their residency, these same courses should be updated and be placed on an online service that the senior residents could use at their leisure and as a reference.

Robert Aquino, MD, MS, PhD

Astoria, N.Y.