National assessment of business-of-medicine training and its implications for the development of a business-of-medicine curriculum.

OBJECTIVES/HYPOTHESIS: The objectives were, first, to determine the current state of business training in otolaryngology residency programs in the United States and, second, to lay the groundwork for development of a business-of-medicine (BOM) curriculum.

STUDY DESIGN: Cross-sectional survey.

METHODS: A survey concerning methodology and topics for management training of residents was mailed to the chairpersons or program directors of the 102 otolaryngology residency programs. A similar survey was sent to 576 otolaryngology graduates (classes of 2000, 2001, and 2002). An interactive BOM curriculum on CD-ROM was developed based on the results.

RESULTS: The response rate among program directors was 74.5% (76 of 102), and among the otolaryngology graduates, 38.2% (220 of 575). Seventy-five percent of graduates rated their BOM training as poor or fair. Only 8% rated their BOM training as excellent. Twenty percent of the graduates responded to having a BOM course during residency. Recent graduates reported that a BOM course can best be taught through lectures and apprenticeship/mentoring, whereas program directors reported that a BOM course can best be taught through lectures and outside consultants. Graduates reported that coding compliance was the topic most neglected in residency, whereas program directors reported that coding compliance was the main topic covered in the business training. Both groups agreed that department attending physicians have the most impact on a resident's business training. Program directors reported that correct coding, planning one's entry into medical practice, risk management, and reimbursement issues are the most important topics for residents to learn, whereas recent graduates stated that the most important topics should be correct coding, office management, risk management, and reimbursement.

CONCLUSION: The present study reflects a perceived necessity for improvement of BOM training in otolaryngology residency programs. Based on this finding, the outcome measures from the survey, and the authors' own experience from business courses given in the first author's department, a BOM curriculum was developed that is general enough to target all otolaryngology residents and intended to provide business skills which result in improved use of resources and, ultimately, higher quality of care.