The HSM Journey: An international health care professional’s perspective of the first year MBA

Itai RikovitchAfter working with an Israeli medical devices Startup Company and negotiating several due diligence processes with top US corporations, I gained preliminary exposure to the US health care arena.  This experience triggered my decision to explore the US healthcare industry and better understand the various stakeholders’ roles and incentives. After thoroughly researching the various health care related top MBA programs, it was clear that Fuqua Health Sector Management (HSM) would be the best fit for me. The elements of the HSM program at Fuqua that made it a natural choice for me are: (1) the high level of industry interest within the class (25% of my MBA class participates), (2) a highly diverse class profile including 47% internationals, and (3) the proximity of Duke University Hospital.

My initial perspective as an international entrepreneur of the US health care industry was that it is an attractive, straight forward “6 steps to entry market”: “Develop your idea, get your device to work, know your competition, gain FDA approval, find a strategic partner and either scale up or divest.”  It took 48 hours into the HSM Bootcamp for me to realize how complex, but exciting, the US healthcare industry is and how different it is from the small scale, single payer, system I came from.

A lot has been written about innovation in Israel (e.g. the best seller Start-up Nation: The Story of Israel’s Economic Miracle by Dan Senor and Saul Singer) and the majority of bio technology and medical devices executives who regularly attend Fuqua events mention Israel as an innovation hub that fuels the US healthcare incumbent corporations. The level of attention the Israeli medical device and bio technology markets get is high and I always feel like I am able to communicate the differences in perception inside and outside of class.

My first year in the Fuqua HSM program has helped me to bridge previous industry understanding gaps and to gain the required foundations for my upcoming internship with a large medical devices company as a business development and strategic innovation intern. We have held multiple discussions about the possible reasons why the Israeli entrepreneurship market usually does not scale and commercialize its innovation and US corporations and start-ups do. Professor Ridley’s Health Care Markets Class, which covers the various trends and business models of the industry, was an essential part of the knowledge I gained. In addition, my view of the changing health care landscape was enriched through the various key opinion leaders that Professor Jeff Moe invites to speak as part of the required first year Health Care Seminar.  The HSM program leadership creates the ultimate environment to fully capture the breadth and depth of the US health care market as I complete the transition from the Israeli innovative market to the fast- paced and complex US healthcare industry.

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FCCP Project: Real World Client Experience Helping a Regional Medical Center

Sydnor GammonAs an applicant to business schools in the fall of 2012, I knew that I wanted to pursue a career in healthcare consulting.  I worked in clinic administration for an academic medical center where I found my passion for discovering and implementing best operational practices across healthcare systems.  Healthcare consulting represents an opportunity to do just that.  In learning about the Fuqua School of Business, I quickly realized I could gain the tools I needed to be a successful healthcare consultant at Fuqua through the HSM program and the wide variety of learning opportunities.

One of the many experiences where I could explore a career in healthcare consulting was through the Fuqua Client Consulting Practicum (FCCP).  My original goal for participating in the FCCP was to obtain real world client experience as practice for my summer internship. FCCP offers a wide variety of projects that span many disciplines and functions, including several in health management.  The FCCP faculty does their best to match students with their top project choices and I secured mine.

I am on a team with two other Fuqua MBA students and a Duke Master of Public Policy student.  Our project involves helping a regional medical center decide how to best aid an adjacent county whose local hospital has closed, leaving 9000 citizens without easy access to medical care.  While my initial motivation for taking an FCCP course was to better understand the world of healthcare consulting, this project has offered an additional experience. I have learned a great deal about the public health landscape in the U.S. and the challenges in addressing disparities in healthcare access and affordability.

To help our team develop a strategy for our client, the FCCP faculty lead weekly courses during Spring 1 that introduce important themes in consulting, such as client relationship management, data gathering tools, and strategic implementation tactics.  My team’s faculty member has expertise in the healthcare consulting field and we meet regularly with him to discuss our project’s challenges. As a team, we also meet weekly to work on project deliverables and for videoconference calls with the client to update him on our progress.

Our work has required creative approaches from the team.  Much of the data that we need to make a sound recommendation is unavailable, requiring that we make substitutes.  We also have encountered challenges as circumstances at the client side have evolved, causing us to shift our understanding of the problem.  Because our project relates to public health issues, we have had to consider local politics and the perspectives of various regional stakeholders, adding an extra layer of complexity to navigating the organizational dynamics of our client.  While our project has proved challenging, our professor reminds us that it is not unlike a real world client consulting experience where consultants must navigate organizational dynamics, political environments, and evolving client demands.  In this way, I have been able to fulfill my original goal of joining FCCP to gain client experience.

With five weeks left on the project, I am eager to deliver a recommendation that will be valued and useful.  I have appreciated my FCCP experience as a “learning by doing” application of classroom teachings and as an opportunity to expand my understanding of the health sector.

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HSM Highlights of Fall 1 and 2

Heather LangermanFall Terms 1 and 2 were a busy and exciting time in the Health Sector Management (HSM) program, with weekly academic seminars, the November healthcare conference, and the December Town Hall meeting. These events kept us busy, engaged, and constantly learning.

Each Wednesday morning during Fall 1 and Fall 2 the entire HSM first-year class attended a seminar led by a different prominent player in the healthcare management field. For example, we heard from Richard Bartlett and Krishna Udayakumar from the Duke-based International Partnership for Innovative Healthcare Delivery. They both spoke about SalaUno, a center that provides affordable cataract surgeries in Mexico. In another seminar, Paula Garrett from Eli Lilly spoke about the power of consumer insights and segmentation by using Cialis as a case study. These seminars were a highlight of my week— I had the opportunity to catch up with my HSM classmates and participate in lively conversations about current issues facing the world healthcare market. The speakers and our discussions were very informative.

The November Duke Healthcare Conference was a day packed with speakers and networking. For me, the most interesting parts of the conference included the closing keynote by Jeff Henderson, the CFO of Cardinal Health, and a session on health insurance exchange implementation featuring panelists, some of whom were HSM alum, from Blue Cross Blue Shield, Deloitte, the State of North Carolina, and Aon Hewitt.

The day concluded with a networking session for first years where we were able to interact with panelists and ask follow-up questions, as well as learn more about internship opportunities at various healthcare firms. I was thrilled to be able to speak with alumni from some of my top-choice firms for my summer internship. I left the healthcare conference grateful for the strong Fuqua HSM alumni network. I valued the opportunity to learn from alumni working in various aspects of the healthcare sector who shared unique insights about their work by serving as conference panelists or while interacting during the networking event.

In December, a group of HSMers gathered on a Friday evening for a “Town Hall” event right before Fuqua Friday to hear from Dr. Brian Caveney, Vice President and Medical Director of Blue Cross Blue Shield of North Carolina. This session was an informal question-and-answer discussion in which Dr. Caveney discussed changes in the health insurance marketplace that resulted from the Affordable Care Act (ACA). It was fascinating to hear about these changes from the payer perspective. I had read frequently about payers’ reactions to the ACA in the news, but hearing about these issues firsthand gave me additional context to better understand the situation. I have been able to apply what I learned during this talk in subsequent HSM classwork and even in my internship interviews.

With so many healthcare topics in the news and rapid changes in the industry, it’s beneficial to have healthcare events on campus to keep me in the loop on what’s happening in the real world. I think that the analytical perspective we get from these events—and the HSM program as a whole—provides the tools we need to be future managers and decision-makers in the healthcare field.

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Health Sector Management: Finding your Niche at Duke

Manisha Bhattacharya

I am in year five of six of the dual degree program here at Duke. I am doing both the medical degree and the MBA from The Fuqua School of Business.

I chose Duke because it has a strong Health Sector Management program and also has the Global Health Institute.  Hear my story in this short video:  Finding Your Niche

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Week in DC: The Urgency of Translation – Advocacy and Scale

Jennifer FluderJeffrey Crowley, Distinguished Scholar and Program Director of the National HIV/AIDS Initiative at the O’Neill Institute for National and Global Health Law, spoke with our class about the need for advocacy and other impact-focused organizations to distill their initiatives as an organization into one base message and action point. Understanding the implications and best practices that can bridge the gap from a far-removed epidemic to a comprehensible and actionable initiative for a legislator is perhaps the most important element of all. Refining the message and ask, Crowley says, will allow for greater probability of uptake by potential partners, including legislators. Within the scope of the translation, being able to bring a situation that may be a world away into relatable terms is a great undertaking, and one that must be done in measured terms. Crowley also discussed the balance of reaching the most senior member of a team versus finding an advocate, who is well enough progressed within the firm to solicit change. An ally who believes in your organization is more important than the title they hold.

Our conversation with Mr. Crowley reminded me of a few studies I’ve read over the years that highlighted the difference in fundraising efficacy when an organization would either share a general statistic, say that 33 million people are living with HIV/AIDS, as opposed to sharing a story about an individual patient. The latter approach proved more successful than the former. If you give someone too much information, or if they feel their impact would be inconsequential given the scope of the problem – that there are 33 million people in need of your help – people are likely to remain inactive.  Here too, as Crowley points out, the need to distill the message of an epidemic into terms where a potential partner organization has a defined role with particular impact goals attached to it is important. The question remains, beyond sharing a personal story, what other tools do we have to translate the need when you can’t bring each potential partner or donor to the peri-urban slums of Nairobi?

Our next speaker, Wendy Taylor, Director at the Center for Accelerating Innovation and Impact (CAII) at USAID, provided us with a vantage point that begins to answer that question. Taylor spent time speaking broadly about CAII and its role as an organization that helps to identify, develop and introduce health innovations into the developing world. Taylor gave our class a deeper understanding of the innovation landscape that the CAII is currently developing including both its initiatives as well as its frameworks to standardize and organize the data they are gathering. This will eventually aid in the translation of the scale of problems as well as the impact of potential solutions.

Both Crowley and Taylor stressed the importance of understanding how a given innovation or initiative fits into the greater context of a community, country or the world. Learning how to make partnerships beneficial for all stakeholders and how to utilize past failures and successes to move forward more efficiently and effectively in the future is a key determinant of success.

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HSM Beyond the Classroom: Duke University Hospital Experiential Learning Project

Claudia BarnaThe Duke University Hospital (DUH) Practicum was one of the most invaluable experiences I have had at Fuqua. Firstly, getting to solve a real business problem in a real healthcare setting proved to be challenging but very exciting. The team I worked with at the hospital looked to me for business insights and advice – which was both awesome and humbling at the same time. Additionally, it felt great to be using my business knowledge in a space where there is a great need for these skills.

Secondly, as someone interested in healthcare but with no previous provider or clinical background, the DUH practicum offered me the hands-on learning you can only get from being in the hospital and working in that setting. Shadowing administrators and nurses/doctors alike was one of the most eye-opening experiences I have ever had, from both a professional and a personal perspective.

Last but not least, getting to present my project to the president of one of the top hospitals in the country is not something many twenty-something year old professionals can brag about. Overall, in just five months, this experience allowed me to grow and learn more than I ever thought I would. I very much enjoyed my DUH practicum and would highly recommend it to anyone interested in healthcare.

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Internship Recruiting: The Value of HSM

Theo AhadomeRecruiting is no joke! You can go from periods of anxiety, to depression, to desperation, to elation – sometimes all in the same week. Depending on whether you caught me on crest or trough of this emotional journey, you would have got some very different responses from me on the value of HSM in recruiting. Now that it is over for me for the summer, I can take a step back and give some honest reflections on that topic. Here goes:


HSM at Fuqua has fantastic alumni in the healthcare industry. As one of (if not the) biggest healthcare MBA program around, this is perhaps to be expected. However, it really dawns on you throughout the process: just about every healthcare company I looked at had a strong and/or growing Fuqua network. This certainly helped in getting to really know the firm and making a decision on if it was the right place for me. HSM seminars and healthcare club sessions also helped give great perspective on different sub-segments and functions to help me figure out what I was most interested in. In that regard, it was a fantastic experience.

Did I get frustrated at times because I had to be in class on Wednesdays and do some extra work that perhaps took away from recruiting time? Yes. Absolutely. However, if I do a cost/benefit now, the fact remains that the benefits above so far outweigh the time cost – and then there is the fact that it helps whip your multi-tasking and organizational skills into shape.

Interview Process

Interviews come down to you. HSM helped as stated above – and maybe even by merely being in the program I earned some healthcare credibility that factored in my getting the interview (but then again just about every other student invited to interview for healthcare companies is in HSM). But now it was all on my experiences and skills. I did have to do some healthcare cases, and here specific knowledge on the US healthcare system from HSM bootcamp was invaluable. The process started from early-January for me – as I also did some consulting recruiting – while the healthcare companies were on campus from mid-end of January.

What was perhaps more interesting than on-campus interviews were the off-campus second rounds, where I got to meet candidates from other business schools. For the healthcare companies that I interviewed with, it was great to see that Duke always had a good representation of candidates and that we were one of the preferred school for many of these firms. This means that the Fuqua network in the healthcare industry will continue to expand beyond rivalry, and I look forward to being part of that network in the future!

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HSM on Exchange: Field Report from South Africa

Tarika MansukhaniToday Ross Beerman, Managing Director and co-Founder of AllLife sat down with an intimate circle of students in the library at the University of Cape Town Graduate School of Business to talk about the company he started in 2004. While the name and even font in the logo suggests that AllLife is an old and traditional insurance company, it is really an innovative business model providing affordable life coverage for individuals living with HIV in South Africa. Over 10% of South Africans are HIV+, and most managed care companies immediately shy away from this group. Ross explains that the messaging around HIV in South Africa is generally “HIV = Aids = death = Use a condom.” While this certainly drives prevention, it does nothing to promote positive behavior in HIV+ patients who feel their life is over, a feeling affirmed when you can’t access insurance.

Ross’ team approached this problem by disregarding the age old insurance mantra that past behaviors drive those in future. They simply set out to change behavior, by changing the message HIV+ patients hear. While the average managed care company considers 75% adherence a success, AllLife now boasts 98% adherence rate for their lives under coverage. AllLife uses a system driven approach to create a high-touch, low cost model. They link to existing electrical medical record (EMR) systems in South Africa, and in doing so successfully track all their lives and use and strict monitor and reminder process to motivate their customers. When a patient is non-adherent they are immediately made aware of negative consequences to their policy, making it a very transparent and informative system that keeps patients involved. Ross explained that cost of healthcare is rarely an issue, as customers can access free healthcare in South Africa, and medical aid will cover the basic tests or treatments AllLife requires. They don’t use highly skilled staff, just data, IT and a system driven approach to create high-touch interaction with customers in an affordable manner. Ross says that people often think it’s about an emerging markets story of success because it’s South Africa, but he insists it’s a solution taking advantage of available first world technology.

I found this is particularly interesting, since I wasn’t aware that South Africa’s EMR system was that far advanced, especially given the host of trouble we’re having implementing it Stateside. Ross explained that they have similar issues here, and challenges with EMR platforms being compatible across hospital systems, but AllLife’s software serves as the technological link between all of them (there’s hope after all!). This makes it possible to track patient behavior everywhere, and also what makes them so uniquely able to provide their solutions at a low cost, something absolutely necessary in emerging markets. While the story of launch and success is more involved, Ross offers a great example of leveraging existing strengths in resource poor developing countries as a solution. He even mentioned they’ve recently begun coverage for patients with diabetes and will shortly begin pilot programs to test success of coverage. Certainly any success in improving patient adherence in this area could be a valuable lesson exportable not just to other developing countries, but back home as well.

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From Finance to Healthcare: Successful interviews require thorough preparation

Trevor JohnsonSix months of networking boiled down to two 45-minute interviews with the opportunity to secure a first year’s most coveted prize – an internship offer.  This was my experience this past January in interviewing for the offer I eventually accepted with Johnson & Johnson Ethicon.

Preparation was the most critical component to my successful interview process.  I found that doing my work on the front end of the process was key.  That was the time to develop my STAR stories (Situation, Task, Action, Result) and to articulate my thoughts on general questions such as strengths and weaknesses and career ambitions.  By doing my work upfront, I had a lighter workload when interviews actually arrived, as my preparation then simply involved tweaking responses for particular companies and industries.

Networking was also critical in helping to ease the process.  Networking allowed me to demonstrate my talent and personality over a longer period of time than just the hour or so I was in an interview, and helped me hone the reasons I was interested in a company and industry.

On top of this preparation, I also utilized a number of resources at Fuqua.  Beyond the resources of the staff in the Career Management Center, every first year is assigned a second year Career Fellow to guide them in their preparation.  My Career Fellow interned at a company I was very interested in, so she was instrumental in helping me to network with the company and tailor my resume, cover letter, and interview material to that company.

I also conducted mock interviews with my Career Fellow through the MBAA (Fuqua student government) and through the Health Care Club.  The MBAA arranges for companies to conduct mock interviews with students in December, and fortunately I signed up in time to get a mock interview with Ethicon.

The variety of programs held by HSM and the Health Care Club to discuss current topics in healthcare also prepared me for any technical healthcare questions.  This was especially important for me as a career switcher, coming out of finance.

All of this preparation, facilitated by Fuqua, allowed me to find success in my real Ethicon interviews and to feel confident during an otherwise awkward and intimidating process.

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HSM Bootcamp: Launch pad for the HSM experience

Steven MaDuke MBA students who are also part of the Health Sector Management (HSM) program arrive on campus a week early for an intensive, 5-day, healthcare bootcamp. It serves as a primer of the US healthcare system and is the launch pad for our entire HSM experience. Half of the HSM folks do not come from the healthcare industry. Even for those of us who do, most only have experienced one or two different areas of a very diverse industry. While I was familiar with pharma and biotech, I had much to learn on the provider, payer, and regulatory aspects of the US healthcare system.

I get asked this sometimes from prospective students – the HSM bootcamp and the HSM courses focus on the US healthcare system in general. Sometimes comparisons are made to UK, Canada, Japan, or China, but I’d say more than 90% of the time our topics focus on the US. However, we have classmates from all over the world who share rich healthcare experiences overseas. Also, the bootcamp amounts to 3 academic credits, so the hard work does end up paying off!

The bootcamp was a nice preview of the MBA experience, and I’m thankful for that – having been out of school for a few years. We began with a lecture at 8am after breakfast. After lunch, we had more seminars and a handful of external speakers that talked about diverse issues such as health policy, ethics, tech transfer, venture capital, and global health. In the evenings, we had a company-sponsored event and heard about post-MBA opportunities in these healthcare companies.

The fall terms were definitely fast-paced and many would consider it the most stressful period in the Duke MBA. During bootcamp, on 3 of the 5 days we left campus around midnight and had to get back for class at 8am. This was not something I was used to doing since graduating from college. Having the HSM bootcamp (and also the Global Institute) before the fall terms started was helpful in getting back to the academic mindset.

Another benefit to the bootcamp was that the 90 or so HSM students could meet and engage with one another before the entire 400+ class was on campus. Everyone was passionate about healthcare and I definitely learned a lot from classroom discussions, especially on the provider and regulatory aspects. After the entire first year class arrived, we were divided into 1 of 6 sections, so the HSM bootcamp gave us the opportunity to connect with folks across the different sections early on.

The HSM bootcamp provided a great overview and brought everyone up-to-speed on general knowledge of the US healthcare system. It is a rapidly evolving industry with many stakeholders and governed by powerful forces. Coming from an R&D background the bootcamp was a great primer to get a first look at some of the issues impacting the business of healthcare.

This post is also featured on my blog From Bench to Board where I share my experiences at Duke.  I am particularly passionate about those related to the MBA’s Health Sector Management program. Visit my blog to learn more!

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