This post was written by Than Moore ’20. Connect with him on LinkedIn.
Before matriculating to business school, I worked full time as an emergency medicine physician assistant at the University of Vermont Medical Center. I, along with my colleagues, was solely focused on maximizing patient care. My responsibilities included diagnosing and treating patients of all ages and acuity levels. The clinical world became my home. Putting on scrubs every day to go into the hospital, I join the hundreds of other employees working towards a similar mission of delivering the highest level of patient care. The ability to practice and treat members in my community is a privilege. It is one of the greatest accomplishments with which I can relate. However, it can also monopolize your life, and is forever demanding. It becomes nearly impossible to pause and observe the system in which we operate. The pursuit of my MBA disrupted the traditional linear trajectory of my medical career and provided the time and space to refocus the lens in which I viewed the world.
Medicine is a vortex. To become a doctor, one must dedicate years of commitment to the craft. You must first complete prerequisite coursework before donating countless years toward schooling, residency, and fellowship. By demonstrating academic and clinical excellence and passing more tests than one could imagine, it then becomes time to start your clinical practice. The journey is arduous, but the reward to grant another breath to a gasping loved one is worth all the effort. Medicine becomes an addiction. We are slaves to the system to glean all the knowledge we can to optimize our performance. It monopolizes our lives with long days, demanding call schedules, and tragic cases that keep us up at night. However, I was granted the opportunity to take a sabbatical from my clinical responsibilities and observe the field from the outside.
I first learned of The Sustainable Innovation MBA (SI-MBA) program at UVM from a friend who knew of my love of academia and solving problems. Sustainable business became the perfect blend of my undergraduate analytical mathematical degree, my medical background, and my passion for the environment and society as a whole. Embedded in the curriculum are quantitative business skills such as finance, accounting, and economics, but there are also fundamental organizational skills taught through courses on corporate social responsibility, sustainable leadership, and teamwork. The focus of the coursework is to optimize a sustainable enterprise by maximizing the triple bottom line: people, profit and the planet.
The beauty of the SI-MBA program is that one can personalize their education to incorporate individual interests. For example, I am fortunate to tailor my business research and projects towards medicine. Subsequently, I wish to highlight ways in which the triple bottom line educational model has broadened my perspective to incorporate sustainability into fundamental daily operations in both the medical community and greater society.
To begin, people are at the core of all operating systems. Our world revolves around successful human interactions. The ability to collaborate with one another stems from leadership and teamwork skills. Group work is a fundamental component in the SI-MBA curriculum. During each of the module terms, every student is designated a team. The team is responsible to execute all projects, presentations, and assignments together. Rarely, do you see employees working alone, so why should academics reflect that?
Medicine, in particular, revolves around team collaboration. With the blending of specialties and skills to navigate different disease processes, we are constantly reliant on our colleagues for their expertise. If a trauma victim presents requiring extensive resources, multiple hands are needed to gain IV access, deliver medications, perform diagnostic studies, and make life altering decisions. One could not operate alone in such a high stress environment. By maximizing team collaboration, executing impeccable leadership qualities, and maximizing the potential of all skilled team members, a team can perform at its highest capability. Medical schools are paying more attention to these traits by focusing efforts on team based learning; however, the ability to acquire these skills outside of medicine through my coursework and integrate them back into the clinic will become a critical asset in my performance as a provider.
Human nature has tainted us with the dollar sign as being the goal for many operations. It is easy to entice individuals with a lucrative salary when pitching ideas; however, it becomes difficult to attract people to work without a profit. I am all for philanthropy and volunteer work, but at some point a profit needs to be made in order to become a sustainable operation. In class, we learn quantitative skills surrounding sustainable ventures, managing cash flow statements, creating sustainable value portfolios, and observing the balance between the willingness to pay and willingness to sell in multi factorial economies. We explore the methodology behind profit maximization by either increasing the net income or by decreasing expenses.
Relating this to medicine, it is with a heavy heart that I admit, healthcare is also a business looking to make a profit. While I wish we could focus all our efforts only on patient care, it is not quite that simple. I have a new found appreciation for the cost of procedures, equipment, and resources in medical facilities.
I recently was involved in a project to decrease the cost of suture kits in the medical center. Typically a dozen instruments are wrapped in a sterile manner and distributed throughout multiple departments. In the emergency department, these kits are opened frequently for the routine use of only three or four of the packaged instruments. Once the sterile seal has been broken, the whole kit needs to be re-sterilized before the next use. This process can cost upwards of $10 per kit and utilizes excess water and energy. We proposed a new solution to form kits containing only the most frequently used four instruments, negating the excessive cleaning costs of unused instruments. The other components could be specially ordered of needed. With the plethora of suture kits opened in the emergency department alone, thousands of dollars will be saved. By recognizing and prioritizing cost reduction and efficient packaging, this could be just the beginning to solving further medical advancements to bring down the price of health care.
The SI-MBA program began with a course titled, World Challenges. Through class discussions and readings by Jared Diamond and Jeffrey Sachs among others, we were quickly enlightened to the problems faced by our current generation. Example issues included growing population dynamics, increased resource consumption and waste production, food scarcity, and climate change. Our world and resources are finite and demand the attention to maximize longevity for future generations. Although it would be nice, I am not advocating that we all need to immediately stop what we are doing to save the planet. However, if possible, we should begin to integrate these topics into our decisions and actions.
An example outlined in creating a sustainable value portfolio is product stewardship. In this theory, we attempt to minimize the negative effects throughout the entire lifespan of specific products. Take a plastic bottle for example. Think about how that bottle is manufactured and where it goes after we consume its contents. How much energy is used to produce the container and how long does it take to decompose in a landfill or at the bottom of the ocean? By changing the way we think of products, we can create circular economies and reuse products to decrease waste and harmful environmental impacts.
Observing my clinical duties from afar, it is easy to now see some of the difficulties of implementing change. These world challenges are scarcely discussed when bouncing from room to room trying to maximize the amount of patients I can treat in one shift. For example, after an injured patient is cared for in our trauma bay, it is not infrequent to dispose of five bags of trash created from the casualty. Littered across the room are gauze bandages, tubing, medication containers, linens, instruments, syringes, gloves, etc. The excess plastic, paper, and metal products are quickly disposed of in biohazard and landfill waste. Furthermore, how many utensils in the operating room are opened only to be found to be the incorrect size and then either disposed of or sent back for intensive sterilization? While some may notice these harmful effects, the majority of us quickly move on to the next patient and forget about the waste we are creating on a daily basis.
Specifically, I chose to observe rubber glove consumption in the hospital. Each time I enter the room to see a patient, I put on new gloves. If I see fifteen patients in a shift and enter the room two or three times, I could use upwards of six gloves just for one patient, totaling 90 gloves consumed per day. All these gloves end up in landfills or biohazard waste units, growing exponentially by the minute. So how do we combat such a wasteful process? And how many other similar situations are occurring without gaining our attention? Could we invent a sustainable glove that is compostable or recyclable to offset our carbon footprint? Who is observing these trends and trying to offset our consumption with environmentally friendly alternatives?
Similar problems persist throughout the healthcare industry and beyond. How can we incorporate sustainable energy into the medical system, abolish social inequalities among patient-provider relationships, or outsource our food demands to only local farms? There are so many questions that arise around bettering our system, but it wasn’t until my invested time at SI-MBA that I began noticing the need to create an impact. By bringing attention to these adversities faced by our demanding population, I understand the importance of refocusing our efforts to best support our future generations.
Post SI-MBA, I’m privileged with the opportunity to return to the medical world equipped with this newly found knowledge and appreciation for sustainability. I plan to be re-inserted back into the medicine vortex by completing my quest to become a physician. However, I will enter medical school as a spy, as I have developed the knowledge and skillset to detect deficiencies in the system. I am privileged to focus my efforts on both maximizing patient care while also optimizing sustainable endeavors by strengthening impactful stakeholder engagement to better our future.
When asking yourself if a SI-MBA education is right for you, the answer is yes. It provides a tool kit to not only better equip oneself with quantitative, collaborative, theoretical, and managerial leadership skills, but also to develop a mindset in which to approach problems and develop solutions to better society in whatever industry you choose to pursue.