MBA Reflections Part 1: Learning From Adjacent Domains

Mustafa Husaini, MD, FACC

The reason I wanted an MBA, at first, was to help fix the frontline inefficiencies in health care, and as the WorkLife with Adam Grant podcast preaches, "Make work not suck." Learning about strategy, operations, and managing people and teams enabled me to enhance my ability as a physician leader to improve both the physician and patient experience. My hope is that some of these reflections will convince others that learning nonclinical competencies is time well spent.

What's Next?

After the initial excitement of starting your first attending job – and the resulting attending paycheck (see the guide to personal finance articles part one, two, three and four) – subsides, your attention eventually turns to the reality of this long phase of your career: your independent practicing life.

Frustrations from training are in the rearview mirror, but a completely new set of challenges lie ahead. There are simultaneous waves to balance, many of which were neatly separated during training. Imposter syndrome often returns, and you need to quickly learn practice management, how to make decisions independently, your role and fit within your organization and more.

While only a minority of us will pursue formal business training, the lessons from pursuing an MBA are fully applicable to all of us as we consider what's next in our respective careers. MBA classes have a mix of hard skills, often taught with accompanying textbooks, and soft skills, which are often learned through group discussions, live reflections and social media. Soft skills include team management, communication, when to determine a meeting is actually needed, understanding informal organizational structures, negotiations and conflict management. These skills are rarely taught within medical educational despite, in my opinion, being germane to our work as physicians. These skills are imperative to personal connections and are arguably more relevant within medicine than in the business realm.

What is Business?

To learn from the business realm, we should first ask, what is business? Here are some common answers: To start a company. To make money. To be independent. To think differently. To control the world.

These are all incorrect. The point of business is to solve a problem and retain an ethical compass. Within medicine, we should apply this idea of solving a problem to our clinical thinking skills, ability to critically appraise, and maintenance of our North Star.

What's an Adjacent Domain?

One of my favorite and ever-expanding reflections is through the concept of adjacent domains. The concept uses analogies in creative thought to draw knowledge about solutions from one area to an adjacent one. It is asking the question, "who else is dealing with the same generic problem?" But the problem may look different on the surface and may be a problem for an entirely different reason. Frans Johansson famously described this phenomenon as "The Medici Effect," referring to the creative explosion in Florence, Italy which occurred as the Medici family brought together people from a wide range of disciplines. Creativity happens when ideas embedded in different knowledge sets are combined in new and useful ways. As Steve Jobs noted, "Creativity is connecting things." Utilizing these ideas from adjacent domains (i.e., business) enables solutions in our own domain (i.e., medicine).

How Does Nike's Supply Chain Relate to Health Care?

Many of us often fail to look and understand potential knowledge from adjacent domains. In medicine, there has been an increasing emphasis on work-life balance and increased physician wellness. This is often at odds with the requirements of our "day job" (i.e., generating wRVUs ). In the 1990s, Nike's supply chain decisions centered on cost, quality and time; this led to mounting criticism about working conditions and "sweat shop" labor. Despite the importance of improving labor conditions and sustainability, organizational responsibilities/resources often had sustainability practices superseded by the traditional practices. Learning how Nike was able to adjust its culture, organizational charts and supplier relationships is directly applicable how physicians can level the importance of physician wellness, work-life balance and clinical responsibilities.

The skill is identifying these domains and then gleaning the applicable ideas and lessons. Learning from adjacent domains argues for an increasing breadth of knowledge (i.e., learning from adjacent domains) rather than increasing our depth of knowledge (i.e., learning siloed to health care). Depth of expertise is important, but mostly in the first few years of your career. Breadth of expertise improves with time as you incorporate ideas from adjacent domains. What we can learn from the adjacent domains will only further our clinical, research and administrative abilities.


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Mustafa Husaini, MD, FACC

This article was authored by Mustafa Husaini, MBA, MD, FACC, an assistant professor at Washington University in St. Louis with editorial assistance by Mohamed Esmail, CFP. Husaini graduated from the executive MBA program at Olin Business school within Washington University in St. Louis and is a member of ACC's Sports and Exercise Cardiology and CV Management Section Leadership Councils.

This article is in memory of his daughter, Aliza, who was born at the start of his MBA and died a few months before graduation. Social Media: @husainim.

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