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Enhancing business skills

November 1, 2006
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A new online program aims to help behavioral health professionals master today's healthcare business environment

Few behavioral care practitioners are aware that in the 1980s, most of the clinical executive positions in healthcare companies were held by psychologists and social workers. Many came through the extensive in-house training program at American Biodyne, the only national health delivery system driven exclusively by behavioral providers. American Biodyne later morphed into Magellan Health, and the training tailored to create business savvy clinical directors has not existed for more than 15 years. Now most of these positions are held by psychiatrists and other physicians who have augmented their medical education with business training.

Realizing the need for business skills, partly to combat the business interests exercising increasing control over healthcare, physicians created the master of medical management (MMM) degree. This is essentially an MBA tailored to medical healthcare professionals. No such training existed for nonmedical psychotherapists until this year, when the Cummings Foundation for Behavioral Health (Reno, Nevada) and the Forest Institute of Professional Psychology (Springfield, Missouri) developed the master of behavioral health administration (MBHA) degree.

The MBHA is readily adaptable as part of a doctoral program in clinical psychology, or as an online postgraduate certificate for psychiatrists, psychologists, and social workers. As an academic degree, it requires some on-campus time commitment, and the cost is based on university tuition, two requirements not always feasible for practicing professionals. These difficulties are eliminated by the parallel online certification program designed specifically for practicing behavioral care providers, who can participate at their own pace with low-cost continuing education (CE) credits instead of more expensive college tuition. The CE credits are offered through a collaborative project between the Cummings Foundation and the Milton H. Erickson Foundation of Phoenix, which has sponsored the renowned Evolution of Psychotherapy conferences and has been providing CE credits in behavioral care for decades.

The Cummings Foundation surveyed top management at the nation's largest healthcare companies to determine whether the online certificate would have the same credibility as the academic MBHA. The universal response was that the certificate carries the prestige of its founders, among some of the most respected leaders and entrepreneurs in healthcare.

Each of the program's four semesters has four 30-hour CE courses, equivalent to four 3-academic unit courses per semester. The certificate corresponds to a 48-academic unit, two-year MBHA. Practicing professionals also can enroll in individual courses. The first four courses will be online and available on disks or CD-ROMs this fall:

  • Behavioral Health Entrepreneurship, taught by Dr. Nicholas A. Cummings

  • Healthcare Economics, Prof. Jeanne Wendell

  • Behavioral Health Management, Dr. Ron Fish

  • Medical Psychology, Dr. Janet L. Cummings

Future courses will reflect executive leadership, financial decision making for behavioral health executives, e-health, strategic planning, fundamentals of information technology in behavioral healthcare, principles of healthcare innovation, behavioral care practitioners as primary care providers, and quality improvement in behavioral health.

All courses are taught by acknowledged, if not renowned, professionals with a long history of success in innovating, marketing, and managing behavioral health delivery. Organized behavioral health delivery systems need personnel trained by well-respected, successful, and nationally recognized practitioner-executives, rather than by academicians who lack hands-on experience.

In our current market-driven healthcare system, this training has the potential to increase the ability of psychologists and social workers to participate in new, significant ways in the delivery of mental healthcare, and to attain practice horizons never before possible. It also has the potential to markedly improve healthcare delivery, and particularly that of behavioral care, by infusing our system with experienced, dedicated psychologists and social workers who will bring back clinical perspectives conjoined with sound business principles.

Many of us cannot help but to wince at the way executives who know nothing about effective behavioral care interventions are not only determining how we practice, but how much we should be paid and for what. Current third-party payers are mostly HMOs and managed care companies that utilize bean-counter techniques. They are run by business interests and psychiatrists, some of whom long ago remedicalized into a medicine-prescribing profession that has forgotten how to practice counseling or psychotherapy. Lacking the presence of appropriately business-trained behavioral care executives who can contribute a treatment perspective, many healthcare organizations have become managed cost, rather than managed care, companies.

For physicians, business training now begins in medical schools, and continuing such training after graduation is encouraged by the availability of medical business courses, postdoctoral degrees, and seminars. The same is true for dentists, podiatrists, pharmacists, nurse practitioners, and all other healthcare professionals other than psychologists and social workers. Because we have lagged behind, the U.S. Department of Labor's Bureau of Labor Statistics reports that psychology is now the lowest paid of all doctoral-level health professions, being surpassed in incomes in 2005 by podiatry, optometry, and other endeavors with fewer years of education than psychology. Sadly, social work lags considerably behind psychology.