Healthcare Management Education – Present. Future. Challenges.
Healthcare has become one of India's largest sectors - both in terms of revenue and employment. The Indian healthcare sector is growing at a brisk pace due to its strengthening coverage, services and increasing expenditure by public as well private players. The growing sector with its ever-increasing demand of quality services from current value conscious patients is strongly driving the need to optimise systems & processes. The complex healthcare environment therefore demands that its managers be suitably trained and equipped. This means that management education needs to be aimed at augmenting knowledge, skills and attitude (KSA) so that the upcoming healthcare professionals who receive such education attain the required KSA to become eligible for further contribution to the economy for its growth
By: Neelam Jhangiani
The scenario in healthcare management education has improved considerably in the last decade, but there still exists an obvious gap when the focus comes to skills taught in the classroom and requirements from the industry. It is pertinent, therefore, to design a programme such that it serves the needs of future employers at the same time equipping students with the requisite knowledge, skills and attitudes.
Institutions across India strive hard to keep up with the latest trends and update & revise their course material accordingly.
For instance, IHMR Delhi has formal redesigning and informal revision of the course at regular intervals. Formal redesigning is done once in 3 years and involves in-depth review of syllabus and modules carried out directly with employers from the industry. Based on the input received IHMR adds new courses, modifies existing ones or may drop a few courses. "Informal revision continues almost on a daily basis although the changes are incorporated annually, which is not a substantial revision," Dr. Sanjiv Kumar, Director, IIHMR Delhi says. The third component of revision is regular feedback of eminent people from the industry in various bodies, which is incorporated annually and substantial revision is done once in 3 years. The next part of review at IHMR includes inputs from research carried out in consultation with the client, which gives insights as to where the industry is heading. Similarly, programme design at Symbiosis International University is a meticulous affair, which includes approval by statutory
bodies at individual institute level and faculty level before it is formally approved through the academic processes of the university consisting of the Board of Studies (BOS), Board of University Development (BUD), Academic Council (AC) and finally the Board of Management (BOM).
"Besides academic excellence, thrust is on emerging trends, innovative teaching pedagogies and sessions, which contribute to all round personality development of the student," says Dr. Rajiv Yeravdekar, Dean, Faculty of Health & Biological Sciences, Symbiosis International University. Every year, a consortium of industry experts, academicians and alumni is conducted at Symbiosis to seek inputs to keep abreast with the latest developments to ensure the curriculum is contemporary. Sessions by eminent guest faculty (industry captains) further enriches the course content. Healthcare management education institutes strive hard to deliver high quality of knowledge & learning to students. Medvarsity Online Limited is one such institute where courses are designed by experts from medical field. Their UGC-approved MBA in Hospital & Healthcare Management course is designed in partnership with reputed institutes like Amity University & Apollo Hospitals. Medvarsity has partnered with world-class institutes namely Cornell, UNSW, Royal Liverpool Academy for different online medical courses. Amity University delivers some of the best programs in the country and Apollo Hospitals on the other hand is one of the biggest chain of hospitals in India well-known for their quality of treatment in the industry.
"By partnering with these two entities, we ensure our students learn from the best & get trained with the best," points out Gerald Jaideep, CEO, Medvarsity Online Limited, Hyderabad.
Medvarsity has trained over 10,000 graduates of Diploma in Healthcare Administration program. Sharing her ideas on course designs for healthcare management education, Max Healthcare Institute Managing Director, Dr. Shubnum Singh, says, "As the industry is so vast and rapidly evolving with not only hospital providers, ambulance service providers, specialty clinics, home care providers, diagnostic companies, medical technology companies, courses are designed with cross sectional inputs from them."
Max Healthcare Institute Pvt. Limited has partnered with Indian School of Business (ISB) to deliver such courses. Another college, the Welingkar Institute of Management Development & Research, offers AICTE approved two-year full time comprehensive course in healthcare management with specialisation in hospital administration and pharmaceutical management. "We benchmark our courses with other national and international institutes and look at their curriculum and what they are teaching and what would be useful to us in the Indian context," says Prof Dr. Uday Salunkhe, Group Director, WeSchool. The board at WeSchool comprise of eminent people from academia, hospitals, pharmaceutical industry, consulting companies, insurance and associations like pharmaceutical associations.
The programmes in healthcare management are nomenclatured differently viz. MD in Hospital Administration, Masters in Hospital Administration, MBA in Hospital Administration, MBA in Hospital and Healthcare Management etc. Popular topics include quality management, process improvement, general management, finance and varied soft skills courses on people management, leadership development, and so on. A recent addition to these is fueled by the demand for health informatics, which is projected to increase substantially because lot of information is being digitised in hospitals and in healthcare delivery, making health informatics cut across both hospitals and health management.
The industry faces some challenges in hiring upcoming healthcare professionals, as the students don't want to get in the function for which the industry hires them and the management does not have enough vacancies for them
The Indian healthcare sector remains as one of the largest player of employment and revenue generation in the economy of India. Today, the sector is witnessing state-of-the-art infrastructure and technological advancements that are favoring the sector to emerge at a high growth rate. As a result, the industry is witnessing high demand for trained healthcare management professionals. The ones who pick this challenging yet interesting profession face problems as there is a huge gap in the education provided and the practical application of it. Although the students face hurdles in the industry, experts in the field are fairly satisfied with employees from India's healthcare management institutes. Although the industry sees a clear advantage with these students as they have a deep understanding of concepts core to the healthcare industry, at certain levels they do fall short as well.
"The biggest advantage of hiring a person who has done this course is they are aware of a hospital environment and basics of a hospital. Most of them are either BDS or have done doctorate course and you don't have to teach them so much as far as the hospital environment is concerned," says Pratima Jain, Group Head, Paras Corporate Human Resources, Paras Healthcare. Others agree that the quality of students from different healthcare management institutes is definitely improving year on year. "Some of our senior leaders have graduated from top ranked healthcare management institutes and bring a good mix of knowledge, depth of industry and experience gained from interaction with fellow students," says Dr. Ritu Garg, Chief Patient Experience Officer, Fortis Healthcare.
Voicing her views on the satisfaction index of the staff from India's healthcare management institute, Manisha Sanghavi, Executive Director, Sancheti Healthcare Academy (a part of Sancheti Hospitals), says, "The staff appointed from healthcare management institutes usually have practical exposure through each learning phase of a management course and hence the quality is mostly satisfactory."
The industry however does face some challenges in hiring upcoming healthcare professionals from management educations as the students don't want to get in the function for which the industry hires them and the management does not have enough vacancies for them. "The challenges that we face largely includes the stark differences between theory and the ground realities. Technology that exists today becomes obsolete after a couple of years and healthcare is heavily dependent on the same. But are we changing our content and practices at the same pace?" questions Dr. K Hari Prasad, President - Hospitals Division, Apollo Hospitals Enterprises Limited.
Although satisfied with the quality at some level, Ms. Jain further says, "They are only theoretically strong, technically not that much and the kind of roles they want to go into needs a lot of software awareness, which they are not being exposed to during their studies."
For senior level professionals, doing such courses adds value in their growth path; however, a major chunk of people going into the course are freshers. Another challenge faced by healthcare facilities is their limited exposure to general management and leadership principles which cuts across industries. Employees who join the industry require reinventing their talent, strategies & building strong connections inside and outside the organisation. Employees that successfully complete this initial phase emerge to be strong leaders. Differences in convictions, cultural values and operating norms inevitably add complexity to collaborative efforts. These factors can also make them intellectually richer, more innovative and more valuable. Getting that value is the heart of collaborative leadership.
Medvarsity's Jaideep says, "While this rapidly growing industry requires a large number of doctors, nurses and healthcare technicians to fuel the growth, any average sized organisation also needs administrators, managers, marketers and other associated management professionals."
Additionally, with the medical tourism market growing at 27%, the skills required to serve this market do not currently exist. This is the challenge a healthcare management student needs to prepare for. In any rapidly expanding industry, the paucity of domain experts, established schools of practice and diverse operational practices means that the student has to pick the right partner for his/her education. The students also need to ensure that they are getting sufficient exposure to the hospital ecosystem as part of their course curriculum.
This practical exposure, prior to graduation, can have a phenomenal impact on their career. Some of the challenges are listed out by Dr. Kumar here: first is things keep on changing very fast in healthcare delivery in India and across the world; secondly, field visits are needed to understand practical aspects of everything that is taught in the class; third problem is that health is still dominated by medical doctors in India and so is health management, and many a times in the public sector, we do not have formal positions for health managers and hospital managers.
"In the primary sector, most hospitals are run by corporate houses so they realise the importance of management and there is not much of problem. In the public sector, we are advocating for a similar change."
Recent tragedy in Gorakhpur and other similar tragedies across the country further highlight the need of healthcare management professionals. The main reason behind the tragedy is because there are not enough people who manage the health facilities, the doctors by default land up managing them so they cannot give as much time to clinical care for which they are trained. But things are changing and colleges like the IHMR ensures that their students understand medical terminology as much as management, because they would work with doctors and need to understand the system of working of a hospital, health facility and health system in the country. One of the major hurdles faced by upcoming healthcare professionals, as pointed out by Prof. Salunkhe is, "Students, at least what we see at Welingkar, are looking for higher packages in IT, banking and other sector resulting in more of these professionals joining other industries as compared to the healthcare sector. If we were to resolve this issue, these students need to be motivated to join the healthcare sector."
Hands-on knowledge is crucial to any field of education including healthcare management. Practical working at the shop floor plays a huge role in shaping careers of students as healthcare management executives and attain greater heights. Medvarsity has some of the most reputed hospitals as its training partners like Apollo Group of Hospitals, Columbia Asia Hospital, Maxcure Hospital & more. The institute ensures their students get trained with the best professionals in the finest facilities where they get opportunities to implement what they learn & get hands-on training on resolving management issues.
Similarly, in addition to onsite projects, Welingkar has its students work on live company projects in the campus alongside their regular course. Students learn the intricacies of sales and marketing. Special sessions are held for grooming the students in soft skills and etiquettes, which prepares them for a career in the healthcare industry. "IHMR has two guest speakers on an average in a month. In fact, one speaker recently spoke about the concept of virtual hospitals that will have no patients in the hospital, patients may be at home or at work wearing wearable devices like an arm band monitoring their vitals and key parameters. They can be timely informed in case there is a need for hospitalisation," Dr. Kumar says.
Likewise, Symbiosis Institute exposes its students to the unique nuances of the public sector. "This is done through two-week practical training stints in municipal hospitals of Pune, Pimpri-Chinchwad, Navi Mumbai and Thane Municipal Corporation hospitals, primary health centres and district hospitals," says Dr. Yeravdekar. Post that, an on-job-training in the 4th semester is an arrangement with the industry to actually test the candidate prior to the final appointment.
"Healthcare management courses at Max Healthcare Institute are embedded with industry relevant projects which the students undertake from a 'problem solving perspective' along with structured industry internships," Dr. Singh said.
Gaps in education & practical application
Similar to other industries, there exists a gap in the education provided in this space and the practical applications of it. In healthcare settings, this gap is a little more critical. A lot of times, the students do not get enough exposure of the healthcare industry. When we talk of the healthcare industry, it includes hospitals, ambulatory centres, pharmacies, healthcare IT, healthcare consultancy, healthcare BPO as well as healthcare insurance. There are times when these young managers are not even able to decide as to which sub section of the healthcare industry actually excites them. "A broad overview of what each vertical entails and what does it mean to be a part of a particular set up needs to be explained to the future students," Dr. Hari Prasad says.
Additionally, compassion and empathy are required to work in the healthcare industry. Students need to have exposure and hence role plays with specific situations that could potentially occur in a healthcare setup, is a good idea to include in their training. Sharing her views on the gaps in healthcare management education, Ms. Jain of Paras Healthcare says, "Every management school should have a finishing school to hone the soft skills and computer skills so that the students can have an edge above the rest."
Dr. Garg of Fortis thinks that such skills can be learnt later too. "As long as there is sound understanding of concepts with an attitude to learn, this gap can be easily addressed. On the job learning and practical application of aspects can also happen while working on ground."
People can learn through case studies but on ground situation with human involvement and handling of sensitivities make situations more complex. Hence, students must be quick to adapt the skills needed in the healthcare industry once they are in the profession. In addition to carefully observing the ways of the healthcare industry, the students need to apply their learning to improve systems. An open mind and an attitude to learn are critical to fill this gap between theory and practical application of concepts.
"Gaps can be filled by having on field experience and learning and identifying the problems and challenges so that it can be discussed while one is in the learning phase," agrees Ms. Sanghavi.
Specific industry driven courses with curriculum drawn from general business management studies and leadership schools is the most effective way to give a holistic insight to the working of the industry. It allows understanding of basic concepts and principles and learning about the nuances of an industry followed by practical application of concepts on industry specific situations. Also, such courses benefit budding professionals to develop communication skills, learn people management and build up inter-personal relations.
Healthy partnerships in the making
Some of the healthcare facilities have partnered with educational institutes to ensure that the programs are best suited to the needs of the healthcare industry. Dr. Garg of Fortis Group says they have been involved in some healthcare management courses and is looking at collaboration with universities in future as well. Sancheti Healthcare Academy which is an integral part of the Sancheti Group has healthcare management courses designed and delivered as per the specific needs of the industry and offers a platform for students to gain firsthand experience while they are still in the learning phase. "Our hospital works in collaboration with different faculties, which can be placed where the learning process is defined," points out Ms. Sanghavi. Other big names in the healthcare industry like Apollo Hospitals also runs two courses in healthcare management at Hyderabad and has been continuously working with the teams for further improvement of their program. "These courses need to be very adaptive to the environment and ideally be reviewed periodically with inputs from senior healthcare professionals. Also, the institutes should look at the healthcare trends and plan their subjects accordingly so that students are ready to face the world," says Dr. Hari Prasad.
With the concept of healthcare going beyond hospitals, the healthcare industry in India has witnessed remarkable growth in the past few years. International Customer Management Institute recommends a management to staff ratio of 1:20. On the basis of that data, India will require additional one lakh managers to serve the growing clinical workforce in the next 3 years. These managers need to bring in equal skills in general management, technology orientation, quality management and financial competency. HR and people related skills are another large growth area for management professionals in this industry and the need to nurture and scale this immense workforce is a critical need for every organisation. Currently, there is a great demand and tremendous shortage of professionally trained man power. Overcoming a few challenges and bridging a few gaps in the method of education in management courses will yield exceptional results. So yes, the future is bright and it's time for the healthcare management institutes to roll up their sleeves and deliver professionals with sound technical knowledge and requisite skills to match the demand!