New Elective Lets Medical Residents Learn About the Business of Health Care

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As the practice of medicine has become increasingly complex, physicians have come to realize they can’t focus solely on caring for their patients. They must also navigate a bewildering array of business and financial issues, including insurance coding and billing; health care economics and policy; safety and quality improvement; risk management; transitioning patients through multiple providers, and more. Which begs the question: With all of the countless hours medical residents spend training to become doctors, are these future physicians being adequately prepared to succeed in the business of health care?

Sabrina Taldone
Sabrina Taldone, M.D., MBA, chief resident, 2018-2019, Internal Medicine, Miller School of Medicine

Enter Sabrina Taldone, M.D., MBA, a chief resident in the Division of Internal Medicine at the University of Miami Miller School of Medicine. Having earned her undergraduate and graduate degrees from the University of Miami, Dr. Taldone saw the need for a health care administration elective and decided to do something about it.

The intersection of business and medicine is a familiar one for Dr. Taldone, who was a member of the team that won the Grand Prize in the Graduate Student Category in the University of Miami’s 2014 Business Plan Competition. Their winning entry? Software that uses big data-type analytics to help hospitals lower readmission rates for patients with congestive heart failure.

“With this elective, residents can be better prepared to become effective administrative physician leaders and thereby enhance the overall quality of the health care delivery system,” Dr. Taldone said. “One of the most important ways we can improve the patient experience is by providing our physician-trainees with a better understanding of the intricacies of health care management.”

With encouragement and support from Tanira Ferreira, M.D., chief medical officer for UHealth Tower, and other UHealth executives, Dr. Taldone led the creation of the course curriculum, recruited lecturers, and organized interdisciplinary learning sessions with senior administrators at UHealth and the Miami VA Healthcare System — all while juggling her numerous clinical and administrative responsibilities as chief resident.

“The curriculum was long overdue,” Dr. Ferreira said. “Practicing modern medicine requires knowledge beyond pure clinical aspects and major collaboration between administration and physicians. We become better clinicians when we learn how to navigate patients through the complexities of health care.”

In addition to Dr. Ferreira, other senior UHealth leadership who supported and guided Dr. Taldone’s efforts included:

• Stefanie Brown, M.D., program director of the Internal Medicine Residency Program and section chief of the Medicine-Pediatrics (Med-Peds) Residency Program

• Yvonne Diaz, M.D., assistant dean for Graduate Medical Education (GME)

• Yanisa Del Toro, M.D., Population Health medical director for UM and associate program director of the Internal Medicine Residency Program

• Bhavarth Shukla, M.D., MPH, associate program director of the Internal Medicine Residency Program and assistant medical director of Infection Prevention and Antimicrobial Stewardship for Jackson Health System

• Brian Frank, M.D., third-year internal medicine resident

Health Care Administration class
A group of second- and third-year residents at the Miller School of Medicine learned about the business of health care in the new Health Care Administration elective developed by Dr. Taldone

The Health Care Administration pilot class, which launched in August, attracted 10 second- and third-year residents who were willing to spend two weeks immersed in a “health care business boot camp.”

Core competencies for medical residents, prescribed by the Accreditation Council for Graduate Medical Education, include systems-based practice “such that the future physician labor force will be able to serve their patients in the real world environment.” In developing the curriculum for the elective, Dr. Taldone hoped that students would gain the skills and knowledge necessary to become leaders in health care. Her four key goals were enabling participants to:

• Demonstrate effective leadership and collaboration skills in keeping with high standards of professional competencies as managers of a health care system.

• Develop an understanding of financial management and planning of health care systems, and incorporate quality improvement and patient safety in cost-effective care.

• Utilize health information technology to optimize care delivery.

• Facilitate creation of systems that provide high-value population health care.

Response from residents who participated in the class was enthusiastic.

Health Care Admin student
A participant in the Health Care Administration elective at the Miller School of Medicine

“The Health Care Administration elective provided a well-rounded introduction into how health care systems operate on a daily basis, great classroom learning from a variety of departments and topics, and valuable hands-on experiences,” said third-year resident Jonathan Bodager, M.D. “I’m grateful I had the opportunity to learn about the diverse teams and processes that help UHealth function at such a high level.”

Dr. Bodager’s sentiments were echoed by Danielle Neuman, M.D., MBA, also a third-year resident.

“As physicians in training, seldom do we get the opportunity to learn the business of medicine, despite its increasing relevance to the daily practice of medicine,” Dr. Neuman said. “I’m confident that the knowledge and tools I acquired will not only help me in the daily practice of medicine, but will also help me grow as a leader in the industry.”

The class is being expanded to accommodate 13 residents, according to Dr. Taldone, and the curriculum will aim to include learning sessions at diverse practice settings in addition to UHealth Tower and the Miami VA.

“Because different patient populations are being served by different institutions, I feel it’s important to broaden our scope and give participants an even more comprehensive experience,” Dr. Taldone said.

The Health Care Administration elective will now be offered twice a year, with the next class scheduled for April 22-May 3, 2019. For more information, contact Dr. Taldone at