Oct 10, 2015
  1. Resident [Any Field]

I would like to hear your opinions on my current situation.

I finished my residency in anaesthesia last year. During my residency I was able to study a part time MBA. I'm currently working in the ICU and would like to make use of the MBA and gain more experience. I considered conducting cost-benefit analyses. Would you recommend doing something else?


D P356

ASA Member
May 2, 2011
  1. Attending Physician
I’m an anesthesia attending; I’ve got an MBA as well.
Who wants the cost benefit analysis? And are they willing to pay for it? If the hospital is asking you to do it, find ways to cut costs, and will pay you for your work, that’s a win.

If you’re wanting to do it on your own and just present it to the hospital leadership, they may or may not value it.

I’m sure as you learned
Profit = Revenue - (overhead + raw materials + direct labor)

To get more revenue from billing, there is strength in numbers. If you join other groups with many clinicians, you can negotiate better reimbursement from insurance. The same can be said for the hospital and their charges to insurance. Depreciation of equipment can also be seen as potential savings and write off of overhead expenses.

“Raw materials” could be considered medications, Blood products, crystalloid and colloids.

Overhead is fixed with utilities, maintenance, in-house medications, non patient labor (HR, accounting dept, administration pay, lab services, custodian, IT, pharmacy, food service, managers), mortgage, medical equipment (hospital has already paid for or leased CVCs, bronchoscopes, X-ray, monitors, vent, eeg, and all other ICU pt care equipment.)

Direct labor cost is best utilization of pt care staffing (physicians if employed by hospital, nursing staff, nutrition, RT, social work, etc)
Is their pay guaranteed or are they able to cut back on staffing day to day?

ICU care can be expensive to the hospital, especially if they don’t get reimbursed well form insurances. The suits are balancing between getting the pt out of the icu, but not having an empty icu as that will not generate money. They will still have to pay the staff and overhead regardless of if a pt is in icu or not.

Financial Summary: get leverage over insurance and vendors. cut overhead and labor costs as much as possible. Too much cutting will lead to inefficiency, disgruntled staff and turnover.

Your job is to take care of the patient and escalate/de-escalate level of care as needed, which is how you were trained.
I think it’s good to have an idea of the business of medicine like you do. I remember as a med student we rounded in the ICU with the CMO/executive(OB/gyn) joining team rounds. They were telling the ICU attending what they should be doing concerning patient care to make more money. What a joke.

PS. If they had you read “good to great,” “built to last,” or any of those Collins books and mentioned how great they are....No. too much fluff.

PPS. “The Goal” is actually a really good read.
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