21 years in the business

I was reflecting the other day that earlier this week (26 August 2013) marked the 21st start to a Fall semester that I have spent as a professor of healthcare management. September 1992 was the start of this journey as a first year assistant professor in the Department of Public Health at Oregon State University. I had defended my PhD on July 25, 1991 and began my search for a full-time faculty position. In retrospect, I was so very fortunate to be offered the position at OSU where I could hone my teaching and advising skills, develop as a health management researcher, and learned to connect with healthcare providers across the state. I was given the opportunity to direct first a BS degree program, then an MPH degree and finally a PhD all with an emphasis on healthcare management. In 2008, my journey took me to Washington, DC and the George Washington University where I currently work as a Professor of Healthcare Management and Leadership and direct the Master of Health Services Administration degree program. This is a truly remarkable opportunity to play a role in a program that has been in existence for 53 years and has graduated almost 3,500 students.

Over this 21 year career, I have seen this field grow and evolve primarily in terms of how healthcare is paid and the effect of payment reform on the delivery of care. When I entered the field, retrospective (fee for service) medicine was the norm in many parts of the country. The Emergency Medical Treatment and Active Labor Act (EMTALA) had been enacted by Congress in 1986.  Hospitals and physicians were adapting to the demands associated with DRG's and RB-RVS. Mergers and acquisition activity was sweeping its way through the industry with the growth and (sometimes) demise of various forms of integrated delivery networks both vertical and horizontal. Stated simply, the only constant in healthcare from the time I began my career as a healthcare management educator was change.

What I would like to do over the next several months is to look back and look forward to what I consider to be the most important changes in healthcare over the past 21 years and the ways in which educators have responded as we prepare both undergraduate and graduate students to make a difference in whatever part of the health sector they choose to work.  I invite you to submit your thoughts and ideas about the intersection of healthcare management and healthcare management education. My plan is to have two new blog entries every month. I look forward to your thoughts, comments, and reaction whether you are an educator, healthcare practitioner or an interested consumer.