'School of life' teaches practice management skills

Unless they are simply employees, they may play a role in deciding how their practices are run. But do they have the background to make knowledgeable decisions contributing to their practice's efficiency and success? Is more training in business procedures needed among residents and practicing urologists?

Urology Times posed these questions to urologists across the country. Several physicians questioned whether residents are receiving any information about the business side of a medical practice, but their opinions about the benefit of such training varied.

"It's basically an endemic problem. People coming out of residency now have the same experience I had 7 years ago and that people had 35 years ago. It really has been zero change in the business aspect of training.

"It would be helpful [for medical schools] to offer electives on business," Dr. Zapzalka added. "I would have taken them. I would have enjoyed having some knowledge going in. The truth is, nobody's going to make the first-year guy the head of the department, making those decisions on their own, right off the bat. You end up going through a sort of apprenticeship, where you see how things are done, how practices are run, through watching other people and through people showing you."

"They aren't trained very well, but then I wasn't trained more than 24 years ago," Frederick J. Snoy, II, MD, agreed. "The medical profession has never done a very good job of that, frankly. I don't think residency program instructors actually know very much about the business. They don't have that much exposure to it themselves."

Learning by doing

After 24 years in group and solo practice, Dr. Snoy, an instructor at the University of New Mexico, Albuquerque, says he prefers his current situation: solo practice.

"Having that kind of training in residency would be nice," Dr. Snoy said. "There are valuable, important things to know. Then you run into the problem where that kind of instruction and information are competing with teaching them urology as well. Having time to include business is a challenge."

Dr. Snoy cautions that although he gained entrepreneurial skills on the job, doing so has inherent risks: "I went to seminars and programs and learned over the years, but not without making mistakes. You try this, try that, and when that doesn't work, you try something else."

Like Dr. Zapzalka, Paul W. Shank, MD, questions whether residents would actually learn much about business during their formal medical training.

"I don't know that the academics who teach these residents have the insight that we who have been in private practice have. That's not restricted to medicine; in a lot of fields, academicians don't have that same real-world experience," he said. "In medicine, we do have grand rounds, where private doctors take part, but they are usually secondary players."