Central Ohio's doctors are choosing a business focus for continuing education.

Last year, Fairfield Medical Center's Chief Medical Quality Officer Martha Buckley, MD, added the Physician Leadership Institute of Ohio (PLIO) to her already extensive educational credentials.

"Being part of the Leadership Institute really reinforced the need for physicians to be business savvy," Buckley says. "To be a good doctor today you need more than clinical skills. That's the changing paradigm. It's learning how to work together as a team across the medical center, because team-based care is how we deliver quality healthcare."

Buckley represents a growing trend: doctors seeking business training to enhance their clinical skills. "The workplace is changing rapidly. It's trending that independent, private physicians are shifting to employment in a hospital setting. Many are moving up the hospital administration ranks to essentially become physician-executives," says Reggie Fields, Ohio State Medical Association (OSMA) communications and external affairs director. Across Ohio, 46 percent of physicians are employed, Fields said.

That new role requires new skills. "When doctors work privately, they're their own boss and may take care of the operational aspects of the practice. As they move into hospital employment, they encounter different organizational dynamics. PLIO helps them develop additional skills that they can utilize in these new situations," Fields says.

PLIO, a partnership between OSMA and the Ohio Hospital Association (OHA), develops this new pool of talent. The graduating doctors have the knowledge, skills and experience to become transformative leaders at their hospital system.

The Ohio State University's Fisher College of Business also offers several programs that focus not only on leadership, but also system and operational quality.

"Business principles can have a wonderful impact in healthcare. Not that you run healthcare like a business, but the disciplines, insight and tools that have been honed for years in the business community now are being successfully applied in healthcare. It's fertile ground for the work we do," says Larry Murphy, Carol L. Newcomb-Alutto Executive Director, Executive Education at Fisher College.

Healthcare reform and ever-changing regulations are adding to the need for business knowledge, too. "It's the push for quality and increased patient care management that's driving hospitals and doctors to work together more closely," says Cliff Lehman, OHA senior vice president of membership services and operations.

Health systems that are actively developing their culture to include skilled physician-executives have an array of options to choose from. With the proper training, physicians on the fast track in administration can help their hospital improve operational efficiencies, reduce costs and, ultimately, enhance patient outcomes.

Physicians Leadership Institute of Ohio

Physicians enrolled in PLIO are up-and-coming leaders at their health system, or they may have already begun to serve in leadership roles.

"They're finding themselves in positions where they're making decisions and implementing ideas that impact the bottom line and patient experience," Fields says.

The class meets four times for a day-and-a-half over 10 months. Eighteen physicians, including Buckley, graduated from the first class in November 2013. Berger Health System in Circleville and Mount Carmel Health System enrolled doctors in the current class of 13 that will graduate in July 2014.

OHA and OSMA looked to the University of South Florida's Physician Leadership Institute for the program's design, structure, curriculum and faculty.

"Medical school and residency focus on clinical patient care, but healthcare delivery is much more complicated. Clinical and non-clinical people work side-by-side in team-based care to deliver quality patient care. Being an effective physician- leader goes well beyond diagnosis and treatment," says Buckley, who also works part time as a hospitalist physician.

PLIO takes an experiential approach. Doctors learn to see themselves as leaders, inspire their teams, build consensus for change and deliver transformative outcomes. "The program puts their clinical expertise into a different focus. For example, doctors certainly are used to having difficult conversations with patients, but now those conversations may be with other employees as they work to bring about organizational change," Lehman says.

"Those skills are not taught in medical school," Buckley says. "They're not intuitive to everyone, but they're certainly teachable."

Each doctor undergoes a skill assessment at the beginning and end of the session. They also are paired with a personal coach. "The coaches help them clarify and put the skills they're learning into practice. They offer suggestions as the doctors go about their day-to-day work," Lehman says.

OSU's Fisher College of Business

The Academy for Excellence in Health Care is a non-degree program offered through Fisher College. It helps healthcare organizations identify and solve operating challenges. The Academy is a partnership with Cardinal Health, which has experience with LEAN management principles, that combines academic and industry experience.

Employee teams with expertise in functional support areas, direct patient care leadership and supply chain or materials management are good candidates for the academy. The project-based approach blends in-person classes with a hands-on project, interactive simulations and personal coaching.

"We launched our inaugural cohort in February 2014 with five teams, or about 20 total participants, from hospitals across the country," Murphy says. Fisher College expects to conduct two to three cohorts annually.

"After a week on campus, they take on a project at their home hospital using the tools they've learned. They come back in a few months to report the progress and results. During that time, they work with their coach," Murphy says.

For some doctors a more rigorous business curriculum is a better fit.

"Fisher College's Executive MBA program is seeing increased participation among physicians. Eight doctors are enrolled in the current class that has 41 students," Murphy says. "They come for a variety of reasons. Some are rising through the managerial and administrative ranks at their hospital. Others are pursuing entrepreneurial ideas alongside their medical practice."

Fisher College's Master of Business in Operational Excellence (MBOE) for Healthcare targets employees seeking greater acumen in operations. It teaches value stream management, employee engagement, waste reduction, capability building and innovation. The purpose: improve end-to-end physical and information flow so patient safety and satisfaction is improved.

"It was clear that what I was learning was immediately applicable," says Susan Moffatt-Bruce, MD, PhD. The thoracic surgeon became OSU's Wexner Medical Center's chief quality and patient safety officer in 2010. That year she also enrolled in MBOE for Healthcare.

"It's steeped in continuous improvement, but leadership and change management is embedded throughout the program. You must embrace it to meet the challenges of accountable healthcare and the reforms we're experiencing at every level and in every department," Moffatt-Bruce says.

Currently about 45 professionals from across the country are enrolled in MBOE for Healthcare. "Some are physicians and other clinical employees, but we also have a number of non-clinical employees who impact their healthcare system's operations in some way," Murphy says.

"MBOE's curriculum gives us tools to meet the challenges that are ahead of us. It doesn't matter if you're a physician or not, it's totally translatable across all healthcare disciplines," Moffatt-Bruce says.

The thread that runs through all of the leadership and business development offerings is recognition that the students are already well-educated and deeply committed to their profession. "They learn for a living," Murphy says. "They're experiencing significant changes and are looking for tools to help them manage that change. They see the need to be a leader and a strategic thinker, and that's what our programs develop in them."

Lisa Hooker is a freelance writer.