Earning an MBA Helps Medical Professionals Better Understand the Business Side of Healthcare
For Dr. Myriam Garzon ’13MBA, who is chief of anesthesia at the Orlando VA Health System, an MBA helped satiate her intellectual curiosity and better understand the business side of healthcare.
By Laura J. Cole ’04 ’08MLS
When Dr. Myriam Garzon ’13MBA decided she wanted an MBA, she was less interested in a promotion. The year was 2000, and she was working at a full-time anesthesia practice at AdventHealth, which was then Florida Hospital. She had two young kids, had just given birth to her third, and was home on maternity leave thinking up ways to fill her “free” time.
“I wasn’t interested in an MBA to necessarily get me any further in my career, but I was intellectually curious,” she said. “At the end of the day, medicine is a business and patients are consumers. As physicians, our view of the patient experience is now framed by the idea of customer service.”
Unfortunately, at the time, she couldn’t find a program where she could accommodate her work schedule with attending classes. And she was less than enthused about carving out time to study for the GMAT when she wasn’t sure she’d actually pursue another degree.
Twelve years later though, the itch still lingered. Dr. Garzon had stepped back from her full-time practice and thought pursuing a mini-MBA through her anesthesia society might help scratch it.
“Rather than satiate my curiosity, I think it made it bigger,” Dr. Garzon said. “What I didn’t like about programs that focused on MBAs for MDs was I realized I wanted more diversity of thought than being in a program with other physicians.”
Dr. Garzon applied to Crummer at the same as a new position opened up as head of the department of anesthesia at the Orlando VA Health System.
“This is where my curiosity, my risk taking—everything went ‘Wow. This would be a huge opportunity,’” she said. “It was the chance to build a department from scratch and prepare it to move to a hospital then being built in Lake Nona—those kinds of positions don’t come around often for female physicians. Wouldn’t you know that I not only got the job as chief of anesthesia but was also accepted to Crummer? I started both at the same time.”
At Crummer, she found what she was looking for: classmates who provided her different perspectives from the ones she’d found working in the medical field and preparation for the profound ways healthcare would change over the following decade. And while she’s still a practicing anesthesiologist, she’s also now lead physician for process and performance improvement at the Orlando VA Health System.
“Crummer was a wonderful experience,” Dr. Garzon said. “I’m still very good friends with a lot of the people on my team and many of the ones in my class. I have to say if I had been younger in my career, my MBA would have catapulted me to even greater success than I’ve had. Maybe I’d be a CLO, chief of staff, or CMO. Now, I’m seeing more physicians obtaining MBA or MPH degrees alongside their MD to learn the business-side of medicine and be part of the administrative C-suite.”
We asked Dr. Garzon about the benefits of pairing an MBA with career in the healthcare industry, trends in the industry, and the skills she learned at Crummer that she incorporates into her work today.
What are some of the complications you’ve discovered working on the administration side of healthcare that your MBA prepared you for?
While it is an industry to help people, at the end of the day, you have to turn a profit. You have to pay salaries. And the insurance companies do a great job of really not always holding up their end of the agreement.
It takes a lot to run a hospital—a lot of the infrastructure, the logistics of everything. COVID has been a perfect example of what happens when a wrench gets thrown into things. Suddenly we have shortages, suddenly you have traveling nurses and doctors because there aren’t enough of us to go around. And I think that’s where a physician at the helm, looking at things—not just as a physician but as an administrator or an operations person—can foresee things that non-clinical, non-medical, and other administrators can’t.
Can you elaborate on that a little more? How are physicians turned administrators better prepared to understand scenarios than others with different backgrounds?
Let’s take a surgical procedure for example. Say you’re the COO of a hospital or healthcare system and a physician or a surgeon wants to do robotic surgery. The administrator may only look at the dollars and cents of things—the cost of the equipment rather than the nonmonetary return on investment. A robot can get a job done in a certain amount of time and cost a certain amount, and surgery will have a different amount and cost based on OR time, supplies, etc. The insurance company will only pay so much, so will we be at a loss or will we be at a profit? They’re going to look at the bottom line.
A doctor on the other hand will look at it and go, “Well, recovery time for the patient will be better. The patient will have less pain. The surgery will be much more precise because the robot allows you to go down to the nitty gritty.” We’re going to look at not just the dollars and cents but how will the patient benefit from this? Will it still make a profit or will the profit be in good customer service for example?
A straight up administrator wouldn’t know that unless they incorporated input from a physician in the decision making. They wouldn’t necessarily look at the safety aspect. They wouldn’t look at the recovery time for the patient.
Take for example a prostatectomy, removing a prostate. The old school way was to do a straight up open prostatectomy. A huge incision. Patient will probably be in the hospital four or five days and have a massive recovery time. It would take them a while to get back up on their feet. That same procedure done robotically, the patient goes home the next day or maybe even in the evening. Rather than a huge scar, they have only few little incisions. The recovery time is much less. The risk of infection and potential complications are much less.
In the end it’s a profit in customer service. It’s a profit in the patient having a great experience and decreasing their risk of any complications because it’s a different type of procedure. Then you meld all that and you realize to bring in a robot, even though it costs hundreds of thousands dollars, it’s still much more cost effective in the long run.
What was your big a-ha moment while studying for your MBA?
That I was the only person in my class who didn’t know how to use Excel. All kidding aside, I would say it was learning how to think more strategically and how much I could learn from my teammates.
What skills did you gain from Crummer that you’ve implemented into your current career? Is there something you approach differently now as a result of your MBA?
I look at things now always as a SWOT, right? Strength, weaknesses, opportunities, threats. And in the field of medicine, you have to look at that every time. Right now, we spend a lot of time focusing on whether we have time slots to fit in all of our patients. But if you’re a patient, you’d be more concerned with what services we provide that the competition doesn’t or how we rank in customer service outcomes.
In medicine, we do our differential diagnoses. SWOT goes beyond that into risk analysis really. What do we bring to the table? Where are we deficient? How do we make that different? How do we appeal to patients? So many hospitals now focus on satisfaction scores. They always have been, but I think now the patient is driving their care. As they should be. As healthcare professionals, we have to look at it from the patient’s perspective to improve services just as any other business and keep the patient, the customer, happy and informed.
You graduated from Crummer almost a decade ago. What trends have you seen in healthcare since then?
Definitely more of a focus on the patient-driven experience. Where in the past, there might not have been full transparency on things. Now I find nurses and doctors go to the nth degree to explain things to patients. In the past, you’d say, “This is what we’re going to do,” and that’s it. Now it’s more, “Do you understand? How would you like to be involved? Any thoughts?” I think in that aspect medicine has become more empathic, which it probably should have always been.
Insurance providers are also changing how much time we can spend with patients and how much they’ll reimburse for patient visits. Hospitals and doctors’ offices aren’t getting reimbursed for office visits the way they used to, so they’ve got to see more patients to make up for that. That means less time to spend with the patient.
Another trend is how patient-driven care is increasing the safety of care. For example, a patient goes in with a hernia and develops a bunch of complications. Previously, the patient or the insurance company might be paying for every readmission. Now you get a flat or bundled fee. And if there are complications, it comes out of that fee, which results in more vigilance and better care.
Medicine has always been a business, but today it’s big business. Venture capitalists are buying up physician practices. The mom and pop doctor’s offices are going away. Everything is a big conglomerate. There are big mergers and acquisitions of medical groups or hospital systems or advisors that come in and slash budgets or replace staff with their own employees. I’m a little bit isolated from all that because I’m at the VA, but I know it’s happening on the outside at other facilities and other hospitals. We now have mega groups that own the country, such as Kaiser Permanente in California. They’ve got almost all of California and I believe Nevada. AdventHealth stretches across the nation. These are now major hospital systems that are centralized as opposed to independent satellites working on their own. It’s standardization of processing and operations.
To be frank, I believe standardization is a great thing because with it comes increased safety and predictability. If you do things the same way every time, there is less chance of error. And you also have more purchasing power. I think from a business perspective, it allows you to negotiate and call the shots a little bit more in the world of business. I mean, think of all the supplies that you need from a hospital setting. If you can standardize something as simple as every hospital having the same kind of syringes, from the same manufacturer, now when I negotiate my syringe contract, I’ve got tremendous leverage with that company because I am purchasing for the huge hospital system I represent. Better supply pricing allows for greater profit.
On the downside, the system becomes so standardized as to become impersonal, but that just means personalization happens at the level of the patient-staff interchange.
What advice do you have for Crummer students?
Don’t be intimidated by doctors if you have them in your class because we’re totally out of our element. But mainly that the healthcare industry offers a tremendous opportunity to expand into as physician leaders.