Healthy Debate

For the last six months, faculty teams from Tuck and The Dartmouth Institute for Health Policy and Clinical Practice (TDI) have been taking part in an intensive series of seminars in preparation for Dartmouth’s new Master of Health Care Delivery Science program.

The 18-month program, which is scheduled to launch in July 2011, pairs Tuck’s world-class management and leadership know-how with TDI’s expertise in the science of measuring health care delivery and outcomes to teach executives how to dramatically change their organizations by reducing costs and improving care.“Teaching people to lead change in complex organizations is a core competency of Tuck,” says TDI faculty member Eric Wadsworth D’74. When you marry that to TDI’s expertise in delivery innovation, you get a graduate who will know what to do and how to get it done—a skill set desperately needed in the health care industry.” 

First, however, the two faculties must learn to speak the same language. Much like business and health care professionals throughout the country, Tuck and TDI professors initially struggled to integrate the two very different disciplines. The group finally hit “pay dirt,” says Wadsworth, when Tuck faculty members Chris Trimble T’96 and Paul Gardent T’76 presented a Harvard Business School case on the Spine Center at Dartmouth-Hitchcock Medical Center, which has worked to improve care by integrating doctors’ medical specialties and encouraging them to share resources.

“The Tuck faculty learned a lot about details surrounding health care processes—for example, the payment mechanisms, which are so key,” adds Tuck senior associate dean Bob Hansen, who, together with Wadsworth, is helping to lead the faculty-integration process. “And the TDI faculty learned that these kinds of integrated process units are something that the business world has experimented with and studied and knows a lot about.” Such synergy hasn’t always come easy. TDI, for example, has pioneered a statistical approach to health care that focuses on reducing unnecessary procedures in order to lower costs and free up resources for better care. That can be counterintuitive to a business-school faculty member. “A Tuck professor looks at that and says, ‘Why would anyone champion that redesign?’” says Wadsworth. “So far we’re not on the same page on that.” In another session, Tuck and TDI professors debated the word “marketing”—a descriptive term in business that can take on a negative connotation in a health care context. It took a healthy amount of back-and-forth for the faculties to realize they were talking about two different things.

But Hansen says it’s not important that the two groups agree on everything. “The attempt of any academic program is not to take a point of view but to explore issues. Differing viewpoints can be helpful for that.” As the educators began to share knowledge through the Spine Center case, however, Hansen couldn’t help but apply the lessons of Dartmouth-Hitchcock closer to home. “Health care organizations that change successfully are going to be those that really understand health care in an integrated system, not just within the delivery of health care but also in the management and economic parts of it. We are trying to integrate our faculties so they can teach students in an integrated way as well.”