Why Doctors shouldn’t do an MBA

Most doctors shouldn’t do an MBA – especially if they are looking to quicky build and scale a successful business in the modern digital world. Aspiring, business-minded medics looking to do an MBA would do well to bear in mind Shoshin (初心), a Japanese concept from Zen Buddhism that means “beginner’s mind.” In short, the message of this concept is that even ‘experts’ or educated members of a field benefit greatly from looking at things with eyes free from assumptions and prior knowledge.

It can be incredibly useful in challenging entrenched and automatic beliefs about a process or system either in business or life. To quote a renowned buddhist monk and author of Zen Mind, Beginner’s Mind:

“In the beginner’s mind there are many possibilities… But in the expert’s there are few”

Shunryū Suzuki

So how does this apply to doctors wanting to start a business?

The MBA Cost/Benefit Analysis

Depending on where you have studied medicine, your personal background and how many years you have spent earning a salary, your personal debt can range anywhere from 0 to $200,000+.¹

Despite this, many doctors looking to go into business, either full time or on the side, see paying astronomical MBA fees and pushing themselves further into debt as the first step in their journey to becoming a successful business person.

Regardless of how you perceive your intelligence, and how being a doctor ‘puts you in the top 1%’, starting a business is not easy and many highly intelligent and motivated individuals end up in financial ruin. Paying for an MBA is simply not a guarantee of work in the same way an MBBS or MD is.²

The risk of making poor business decisions can of course be mitigated by education but MBAs do not eliminate this risk as much as is commonly thought. As an investment, MBAs offer a poor rate of return³ in contrast to other ways of learning and entering business.

“You wasted $150,000 on an education you coulda got for a buck fifty in late charges at the public library.”

Matt Damon / Will Hunting, Good Will Hunting

But before we look at why an MBA is not a good idea for most people looking to start or grow a business (and the evidence behind that statement), let’s look at the typical trajectory of doctor-entrepreneurs both inside and outside of medicine.

The Road To Hell Is Paved With Good Intentions

Unfortunately a lot of physician-entrepreneurs follow roughly the below path:

1. Feeling the push and pull. Most experience a mix of both of these drives: a negative push away from medicine, through stress, feeling undervalued, burnout, deteriorating personal relationships or loss of control over their own life. Or a positive pull towards wanting to contribute more to your own life, your community or society at large.
   
   
2. Feeling ‘pre-qualified’. You made it through med school, so can likely achieve a similar level of proficiency in another field. Not entirely untrue, but not the full truth either.
   
   
3. Investigating how to build your own enterprise or business. After reading around and talking to people, becoming secure in the knowledge that an MBA, especially from a highly reputable university (like London Business School or Harvard), is not only the right way but the way that will give you the best chance of success.
   
   
4. Feelings of stress or burnout. For those feeling a push away from medicine as part of their internal motivation, this drives tunnel vision to choose the above option despite these programs costing $50,000+ per year. As we will discuss below, there is no evidence to support correlation between doing well in an MBA program (or taking one at all) and success in business life. In fact, research from within the business community demonstrates the opposite.
   
   
5. Feeling pre-qualified (again). If I have the brains and drive to succeed at a Harvard MBA or similar, continuing in that fashion will drive my business to success. A seemingly logically consistent thought many have. However many also ignore personal stress levels, personal debt and current behaviours. “Once I get to place X, I will have the space, time and energy to make things work”.
   
   This is a cognitive bias that lets us believe the person we will be tomorrow will have more resources in terms of time, energy and happiness to achieve our goals. Basic personal reflection or daily journaling will highlight the fallacy of this thinking.
   
   
6. Leaving your MBA deeper in debt. Most surprisingly to many, they graduate with more debt but with little practical knowledge on how to actually start and run a business. The exception here is those looking to move into international finance, management consultancy or a Fortune 500 company – within these disciplines a Harvard MBA or similar is essential in even being noticed in the first place.
   
   
7. A return to burnout. Grinding for a few short years to try and burn through your newly acquired debt, before being crushed by financial and personal stress, feeling inadequate and unsure.
   
   
8. Returning to medicine. Only now with your tail in between your legs, convinced that job security is the holy grail and business ‘isn’t for you’ or is a highly speculative endeavour. 
   
   
9. Being ‘self employed’ rather than being a business person. The alternative to the step above is doggedly running a business 60 hours+ per week, overwhelmed with responsibilities and firefighting. Congratulations, you just used all of your intelligence and energy creating a stressful new job for yourself that will collapse the moment you remove yourself from it.

In the words of the founding Executive Director of Wired:

“No matter what they tell you, an MBA is not essential.”

Kevin Kelly – Wired

Don’t Just Talk Evidence-based, Live It

For a group who live and breathe evidence-based practice in their work, in our personal decision-making this scientific leveller can be mysteriously absent. Just look at smoking rates of medics versus the general population.⁴

When it comes to making decisions we still, like the rest of the human population, have a tendency towards the cognitive bias “The Bandwagon Effect”. This effect is pretty strong when we listen to the elite MBA narrative: “Very intelligent people compete for relatively few places at the best MBA programs. Overwhelmingly these graduates go on to make the best and brightest of the business world, leading their companies on average to greater success than others.”

How can you argue with that? We all know that is how MBA programs and other ‘elite’ university programs work and operate, surely this belief holds, even if just in general?

It Just Simply Isn’t True For Most

Some of you reading this, perhaps about to enroll in an MBA, executive MBA or even recently graduated, may be rolling your eyes or seething with anger at the claim that for most people looking to start or grow a business an MBA is not a good idea.

Where is the evidence to back up this claim?

In 2002, research from Jeffrey Pfeffer of Stanford University and Christina Fong of the University of Washington⁵ reviewed 40 years worth of data, focusing on business schools and the success of their graduates.

It didn’t find that there was a weak correlation between MBA credentials, MBA success and success in business, it found that there was none. 
Zero.

The researchers went further, stating: “A large body of evidence suggests that the curriculum taught in business schools only has a small relationship to what is important for succeeding in business”.

Despite this ground-breaking research, the myth and ideal of an MBA providing all you need for success still persists with strength in 2021.

A Better Way

There are the beginnings of rumblings and disruption in the MBA world, precipitated by online access to learning materials, communities and rapidly decreasing barriers to entry when starting a business.

Fortunately we do not have to spend $150,000+ to gain a solid grounding in business. Studying the fundamentals can be done for free or nearly no cost, before you make the decision to invest further in your business education.

If you have the desire and drive to build your own business, in healthcare or without, there are now multiple programs that offer excellent business teaching that is designed for implementation (i.e. actually starting and running a business) rather than high-level theoretical understanding. 

A focus on the immediate and practical gives learners what the majority of MBAs do not – understanding implementation and methods of application. This makes it possible to gain real world feedback, reflect and adjust throughout your journey, without sacrificing your financial stability and future.

Perhaps this path is best summarised as follows:

“The only purpose of education is freedom; the only method is experience.”

Leo Tolstoy

References

1. Ercolani MG, Vohra RS, Carmichael F, Mangat K, Alderson D. The lifetime cost to English students of borrowing to invest in a medical degree: a gender comparison using data from the Office for National Statistics. BMJ Open. 2015;5(4):e007335.
2. Karpis P. MBA jobs are declining—everything you need to know. Forbes.
3. Francesca Di Meglio. College: Big Investment, Paltry Return. Bloomberg
4. Cattaruzza MS, West R. Why do doctors and medical students smoke when they must know how harmful it is? European Journal of Public Health. 2013;23(2):188-189.
5. Pfeffer J, Fong CT. The end of business schools? Less success than meets the eye. AMLE. 2002;1(1):78-95.