The entrepreneur mindset: How an MBA opened doors for one spine surgeon's practice

Written by Laura Dyrda | February 24, 2016 | Print  |

Richard WohnsDo independent practice physicians need an MBA to survive? The private practice world is increasingly complex and medical schools aren't training future physicians in business principles. Instead, some physicians are considering MBAs while others are looking at shorter programs to fill the gaps.

"Business school is good for everyone," says Richard Wohns, MD, JD, MBA, founder of NeoSpine in the Puget Sound Region of Washington. "MBA programs provide incredibly interesting and valuable information, no matter what you do."


Dr. Wohns completed his MBA in the 1990s with the goal of opening new horizons not only in his busy private practice, but in other realms as well. The low-hanging fruit was the benefit an MBA program in helping navigate the world of private practice for the next 20 to 30 years as the healthcare field was changing. The old adage, "availability, affability and ability," was still true, but business acumen was necessary to thrive.


He expected to learn about running his practice — which he did — and also learned much more in the process. The MBA class included executives from across the business landscape including Boeing and other airlines companies, finance and banking, pharma, Microsoft, healthcare and others. Each individual brought a different personality and perspective to the table.


The instructor challenged his students to reach beyond their scope of expertise with this illustrative example: Apple had ousted Steve Jobs from his CEO post and Dr. Wohns was tasked with giving a presentation forecasting the next steps for Apple's new CEO. Before long, Dr. Wohns changed his mindset from a neurosurgeon mentality to an entrepreneur mentality.


"It was an eye-opening experience in how little I knew about the way the world worked," he says. "It was humbling and good for my brain to be trained in a different way."


In residency training, neurosurgeons are often trained as the "leader and captain of the ship." However, in business school, teamwork is taught as the cornerstone of any successful business, with the captain as part of the team.


"You learn to be dependent on other people and other people are dependent on you. Everyone is equal on the team," says Dr. Wohns. "There are all these people out there with incredible skills and if we can tap into those skills, we can build a great environment to grow a business."


In one of Dr. Wohns' first microeconomics classes, the professor went around the room and asked each member of the class: "What is your business?" While the instructor passed through most of the class without question, Dr. Wohns was different. It wasn't enough for Dr. Wohns to say he was a neurosurgeon in private practice who operated on patients at different hospitals.


"That's not your business," the instructor said. "What is your business?"


Dr. Wohns talked about the brain and spine aspects of his practice and the revolutionary opportunities for outpatient care going forward. While brain surgery was a passion, it was becoming less invasive and more interventional. Dr. Wohns recognized that his practice would be predominantly spine surgery in the future. The two went back and forth until Dr. Wohns described his practice as among the only facilities in the United States performing outpatient spine surgeries at that time.


"That sounds like a business to me," said the instructor. From that point on, Dr. Wohns focused on building an outpatient spine surgery company — Neospine. He wrote a business plan and courted investors as a result of his training and connections in the MBA course.


"I had the help of the other physicians in MBA program plus the microeconomics professor to write the business plan. I had the help of my study group to devise an outcomes study as our final project for our statistics class," says Dr. Wohns. "After I graduated from my MBA program, I worked with a classmate from Yale Medical School who was one of the first MD, MBAs in the country, and whom had been a professor of entrepreneurship and venture capital at Harvard Business School. I then worked with PricewaterhouseCoopers and upgraded the business plan to a high level. I was able to recruit business staff and raise $20 million in venture capital money to start Neospine."


Symbion eventually purchased Neospine and Dr. Wohns continued to successfully run his outpatient spine practice as well as a consulting business.


"After earning my MBA, I realized I'm not just a neurosurgeon; I'm a strategist, thinker and business person," says Dr. Wohns.


Some surgeons worry about leaving their practice for a business degree, but Dr. Wohns was able to run his practice while earning his MBA. The program included one long class on the weekends and one night per week devoted to a study group working on assignments, projects and presentations. There was considerable preparation outside of class as well, which cut into personal time. It was a major sacrifice, but critical to building a successful practice and business as an independent physician in the evolving healthcare space.


"Changes in medicine can really throw a monkey wrench into a lot of physicians' practices," says Dr. Wohns. "You have to go with the flow and understand the economics of what is happening; you have to know whose interests are at play and the different niches you can work in to decide what is best for your practice. You need to understand the concept of return-on-investment and realize success in the private world so you know where to direct your efforts and money."


There are new challenges for Dr. Wohns every day and his business degree helps him navigate those issues. He sits on the board of directors for several companies, including publicly-traded companies, and his business background is paramount in those settings. Dr. Wohns subsequently attended law school and earned a JD. His consulting clients benefit from his outpatient spine surgery experience, plus his business and medical-legal expertise he acquired during his MBA and JD programs.


But is it necessary for busy physicians to take a whole two years to attend an MBA program? Will shorter, weekend courses suffice? Or maybe programs geared toward healthcare providers to learn business principles?


"There are a lot of ways to gain knowledge once you are in your career," says Dr. Wohns. "The formal MBA program is the full package. Without that, you may not maximally benefit from networking with colleagues from across the spectrum. Part of learning is being under stress and having to do presentations on subjects that aren't your area of expertise. I had to write a full business plan and analysis for a laser vision correction practice — definitely an experience I would otherwise not have had as a neurosurgeon. This is something valuable and incredible that you don't get in short form training. If you are going to do it, do it. It's worth it. It was really a fun experience."


More articles on spine surgery:
5 thoughts on outcomes measurements for spinal trauma patients
10 spine, neurosurgeons on the move in January


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