Dr. Bocchino: That’s correct.
Dr. El Tarabishy: And Dr. Bocchino, thank you for coming here.
Dr. Bocchino: My pleasure.
Dr. El Tarabishy: I’ve read your resume, and I saw part of the resume is also that you have an MBA.
Dr. Bocchino: Correct.
Dr. El Tarabishy: Let’s talk about the MBA, because this course is about an introduction to health care foundations for MBA students, that either are MBA students that are interested in health care, or health care individuals that are interested in getting an MBA.
What do you define MBA to you, from a practical perspective, from a theoretical perspective, from an application perspective, and how it relates to the future for these young students. So a lot of questions here, but let’s get to the point.
Dr. Bocchino: Yeah, I think one way I could situate that, the answer to that question. I think back to when I did my MBA. At the time, I was working for a pharmaceutical company, and I often will remark to people that completing my MBA changed my entire orientation in how I looked at the enterprise, how I looked at the business component of what we were doing, how I looked at my own job.
My job didn’t change immediately after I graduated from my MBA, but my world view changed. And I guess I can’t impress enough how going through that type of curriculum can really impact someone. Whether you’re actively working in a health care sector or any business sector, or if you’re planning to break into it through the MBA.
When I link the MBA today to how I think about medicine, health care, science, we use some language in our field now, we talk about translational science, translational medicine. And the orientation in that space is that you’re looking at problems in a very integrated cross-disciplinary, cross-professional manner, and reflecting on the curriculum of the MBA, it’s interesting.
I could almost say well, you know, the MBA orientation that’s been around for decades in itself is translational, because the mechanism for teaching students in an MBA program is to acquaint them and orient them to different disciplines, whether they’re marketing or finance or organisational science, decision sciences. These are actually very specific decisions that many years ago, before I came into business, you would have professionals who are oriented very specific to that discipline.
And today, we find that we can do translational science and translational medicine much more efficiently if we have people who are much broader in their orientation. So, I can proudly say that I think that MBA, going back to where I started, that broadened my orientation in terms of how I looked at my job, how I looked at the company that I worked for, how I began to look at problems.
Dr. El Tarabishy: So, let’s dig a little bit deeper then. We had a lot of experts come talk to us here with their areas of expertise here, but I want to take it down and break it down into components, piece by piece. And I like your angle of translational in the MBA, but let’s take it from the beginning. Let’s take the concept of finance, right.
When I mention the word finance from the business world, it’s dollars and figures, it’s, you know, calculating return on investment, it’s calculating, you know, future value. How do you define finance from your world, which is the health sciences world, but also now you also have an MBA? What comes to your mind right away?
Dr. Bocchino: So, as you were articulating the components of finance, where my head started going was you know, in my undergrad I was focused on a degree that basically gave me the foundation for an accounting major. I’m not an accounting major, I ended up with a BS degree in management. But I have the foundation of working as an accountant.
The finance component today, when I contrast it to accounting, and my definition of finance is yes, we might think it’s very numbers oriented, but unfortunately in every component of our economy in this country, including health care — and maybe I don’t like that, but it’s the way it is — health care, like every other component, is driven by the financial foundation, by the financing that you can bring in.
And those decisions, those questions that we have to answer, they’re bigger than the numbers. And so when I think about finance, I think about how are we going to get there and there’s a component that is numbers driven. But again, I’m going to compare to the past. In the past, someone walked in with the numbers and their job was to deliver the numbers.
Today, their job is to understand the entire enterprise and to be able to problem solve, to be able to orient their thinking around the financial analysis, the financial forecast, whatever you’re doing with the numerical part of it, the black and white part of it, to really address the much bigger strategic goals. The mission. And so that’s how I would figure finance into my orientation.
Dr. El Tarabishy: What about marketing?
Dr. Bocchino: Wow.
Dr. El Tarabishy: I told you we’re going to break it down. [laughs]
Dr. Bocchino: Okay. So, can you imagine that today, almost all of the television advertising — and I don’t watch TV but I know this because I read the literature — most of the television advertising during the dinner hour is in the domain of health care, and almost all of it is in a subset of the pharmaceutical industry.
Hate to admit it, but I worked for the company that was the first company to bring direct to consumer advertising to the dinner table. It was a product, I won’t name the product here, but it was a product for, as an antihistamine, to treat allergies. And no one could believe that the FDA approved going direct to consumer in the space of marketing.
When I think about marketing today, marketing and public relations, we used to keep those separate. They are so intertwined with social media, every single thing I say on this tape, everything that I put in print, on an email, becomes a marketing tool, a marketing component, a marketing detractor. So, it’s very hard for me to separate marketing from the identity of the enterprise. Everything we do in the enterprise today, unlike 30 years ago, is a marketing piece.
Dr. El Tarabishy: International business.
Dr. Bocchino: So, you use the word international business, and I will translate that to say globalisation. Okay? Having worked internationally for almost 6 years — and at that time our international business was separate from our U.S. business — today, again because of technology, because of legislation, because of how the small the world has gotten with regards to our product development, it’s hard for me to think of international business. It is a separate component.
And I think where my head goes there is raising the awareness of our students that made in America is not the only label that we should focus on, recognising that probably one of the greatest opportunities we have is to harness all the innovation that’s going on outside of the United States. So if you say international business and you mean international to the United States, having a grasp of that is terribly important.
The other piece I would say is that when I situate it in the context of health care, the world also has gotten very small and the United States is not the center driver for every health care procedure in the world any longer. We can find the same level of care in other places, and linking it back to finance, at times it can be even more efficient and more economical. And I think we’re going to see that trend continue.
Dr. El Tarabishy: Entrepreneurship.
Dr. Bocchino: One of the big words that we use all the time in health care is innovation, and entrepreneurship and innovation, yes, we can look in the dictionary and they mean different things, but when I think about entrepreneurship, it’s combining that business mind with the creative and really thinking hard about problems that we need to solve. Research questions we need to solve.
And often what that’s going to require is a different approach to our practice of doing things, to our business practice. And so, I can’t imagine entering the workforce today and not having a foundation in entrepreneurship. You know, we pride ourselves in America as being made up of a lot of small business people. What gets all the press are the big businesses.
But the engines that typically drive economies and drive a lot of innovation is the entrepreneurial nature of the people that we have with us. And obviously, I would, I would expect that we’re going to be turning out individuals who are armed with the skills that allow them to call themselves entrepreneurs.
Dr. El Tarabishy: So, I’ve put you in the hot seat here asking you all these business terms, and, but we’ve been working on this now for almost nine months or almost close to a year about trying to combine the School of Business and the School of Medicine in some joined activities, joined classes.
Tell us a little bit about the rationale that you thought of when we started working together and this, the programs that you are offering, the courses that you’re offering, and kind of seeing the beauty of both coming together.
Dr. Bocchino: Yeah, so, you know, one of the tenets of adult learning is that in order for a student to situate her learning most effectively is for her or him to have a context that’s meaningful. And for me, the natural integration of the activities of the School of Medicine and Health Sciences here at GW and our business school, the natural integration with the health care MBA allows students to situate most of their learning or a good part of their learning in the context of health care.
I can teach you finance, I can teach you finance in a manufacturing environment, I could teach you finance in, you know, the finances of running a PR firm, the finances of running a non-profit and what that might or might not look like, or the banking industry. The business of health care, you know, so much of our GDP now is oriented there, but the nuances, the details of that are quite unique.
And I think the beauty of integrating these, having people who are working in the health care sector who also have the expertise to be able to speak knowledgeably and put into context for students the principles, key business principles that we want covered in a curriculum as broad as the MBA.
A student going through that kind of experience is going to look very different than a student who basically does a typical MBA. You’ll get a great education, but this will put that student a notch above, I think.
Dr. El Tarabishy: Let’s say we came here 20 years from now and talked about the future of health care, where it is now, and looking at the business world, what’s your future outlook going to be? How is it going to be? What’s the new cadre of this MBA that has a health care background, or a health care individual that has an MBA?
Dr. Bocchino: So, the student coming out 20 years from now, I think is going to walk into an environment that’s going to be characterised very much by personalised medicine. And we talk about personalised medicine and each person who talks about it means something slightly different. It doesn’t mean that we’re going to get rid of health systems, but it does mean that we’re going to be able to target our solutions very specifically at the individual level.
That has the implication that we have to rethink how we’re going to deliver health care, how we’re going to manage it. Are we going to market to individuals, are we going to still market to groups? What are we going to do in the aggregate? What are we going to do under the roof of a hospital versus what are we going to do in people’s homes?
When I think about the technology implications in health care delivery, the legal implications, the ethical implications — and by the way, all of these things I’m talking about are covered under the umbrella of an MBA education — question — we’re dealing right now with whether or not the FBI can command the company to unlock an iPhone.
We will deal with whether or not the FBI can command a health organisation to unlock a medical record for some reason. The business implications in a changing world like this, are significant. And so, I mean, those are just a couple of examples. I think the other piece is, coming back to your question about international business and my response to globalisation, we can no longer afford for every country to run its unique health system.
And there’s no reason in this world, in this century, that we could not organise a global health delivery system. This begs something more fundamental, and that is, should every human being be entitled to some level of health care? Think about the business implications of that. And that question is what scares the detractors who disagree that everyone should be afforded some level of health care.
Dr. El Tarabishy: You’re in the territory of the United Nations now, and they’re talking about the new sustainable development goals and talking about health. And the human right for quality health care. It’s an interesting take on where the future is. We had another expert talk about artificial intelligence as being part of our discussion. When decisions are not just made by humans but also supported by the Watsons. What’s your reaction to this?
Dr. Bocchino: I could go in two directions. So, if I stay with artificial intelligence and decisions, we’re going to put information — we already put information into computers. And the computers give us its best guess. Here’s how I see that translating into our health care delivery system.
Putting that information in the system and the system saying you should not be spending money on this, and making the very difficult decisions that we can’t afford to deliver health care in certain domains, when they say certain health domains. Not because the return on investment isn’t there, that’s not what’s driving this. We have a finite amount of resource.
Someone will go wanting. And I think we’re going to turn often to computers to answer those questions because I would not want to have to answer that question, and decide who gets health care and who gets health care at this level or not.
Dr. El Tarabishy: Let’s go back to that answer. Humans write program codes.
Dr. Bocchino: That’s right.
Dr. El Tarabishy: So, the answer that’s coming from the computer is based on somebody writing a code saying this is the barrier of a yes or a no. Now we’re getting into the territory of ethics and the decision making on this and the program [unintelligible 00:19:55]. It gets complicated, but should it be more science or should it be more art, or should it be a balance between both and what’s the balance?
Dr. Bocchino: It has to be a balance because I don’t think you can say it should be one or the other. And what I often will remind colleagues and students that I work with, is that our definition and our standards for ethics are continuously evolving. And I’m not suggesting they’re eroding. Every time we learn something, we should be revisiting our practice and our world view and our orientation.
I think to your question, science can inform more clearly, but at the end of the day when I think about health care, health care decisions ultimately have to be made by human beings.
And we have to use the wherewithal and I’ll bring this back to the MBA, and the broader your orientation and the more armed you are with being able to think about some problems from a very qualitative standpoint, which often equates to humanistic, versus a very quantitative standpoint, which will typically be the way a scientific or a computer algorithm will think, you need to integrate those two.
Where I thought you were going to go, and I think this is an important piece of this, too — we sit in Washington D.C. You know, George Washington University and our MBA program is remarkable on many levels, but the fact that we’re situated in the capital of the United States and this is a center for a lot of things that happen around the world, we should be at the pulse of how these kinds of questions around science and humanism are intersecting, and we’re not always the leaders in that space.
There are different ways of looking at it depending on where you are in the rest of the world. The nice thing about being here at the intersection of that world is we can draw from both the great things happening on the domestic level, and the great things happening more on the global level.
Dr. El Tarabishy: I think you’re absolutely right. I think we’re at the intersection. I think we’re also at the intersection of knowledge and the application of knowledge, and we’re in a beautiful room here that curates knowledge, but now it’s up to us as educators to let the students realise the knowledge available, but how to apply it. And I think you’ve done a fantastic job talking about the MBA program, but also the intersection of the MBA program with health sciences and medicine. Thank you very much.
Dr. Bocchino: You’re quite welcome. It was a pleasure.