A typical day for Lisa Saul, MD, MBA’17, begins with meetings with co-workers and seeing patients one on one.

Today, she is in Washington, DC—heading first to the Federal Trade Commission, then to the Congressional Budget Office. Yesterday, she and 25 other Kelley Physician MBA students traveled to the U.S. Capitol, where they heard from the Honorable Cliff Stearns, a senior advisor at APCO Worldwide and former U.S. Representative for Florida’s 6th congressional district (1989-2013).

These mid-career physicians, who have gone back to school to receive MBAs, are learning their voices can—and should—be heard.

“As physicians, we are trained to deal with patients on a one-to-one level,” said Dr. Saul, who is an OB-GYN in Minneapolis. “Being here this week has given me invaluable insight into how I can impact several thousand patients at one time, in ways I never considered before. I’ve also gained perspective into how physicians can collaborate with each other to effect change, which I don’t think we really think about in terms of public policy and lawmaking.”

This healthcare policy course is a week-long immersion into health policy and regulations, unique to the Business of Medicine Physician MBA Program through the Indiana University Kelley School of Business. It gives physician MBAs a deeper understanding of the regulatory process, as physicians discuss healthcare policy with policy makers and regulators in Washington, DC. The program is put on with partner The Washington Campus, a non-partisan, higher education consortium based in DC.

“These physicians need to understand not only current laws, but how policy is made and how they can be involved in the conversation," said Julie Manning Magid, professor of business law and the course instructor. "Through these discussions this week, the doctors can add to the conversation around healthcare policy. They add their unique perspective from not only understanding the world of business, but also from their deep concern in terms of patient care and healthcare improvement around the country.”

This week, the Kelley Physician MBAs revisit the basics—then dive deeper. They learn about what makes a bill a law, revisit the branches of government, think about healthcare policy and speak with legislators and staffers—all who are or have been directly involved in the legislative process, on both sides of the aisle. They talk directly to the people who administer regulations around anti-trust, cybersecurity, telehealth, and healthcare generally, and they work to better understand the fiscal impact through the Office of Management and Budget as well as the Congressional Budget Office’s role for scoring bills.

The days are long, but insightful, as physicians hear, one after the other, from Washington DC insiders, providing them rare insight into the workings of the Washington DC policy and regulation world.

“There’s always something interesting going on in healthcare, and every year there is a new issue that comes up, so we are able to think about this through the lens of improving healthcare policy,” said Magid.

“To have access to people from across the political spectrum, representing a great deal of healthcare policy knowledge built over decades, is an incredibly enlightening and unique opportunity. This opportunity helps our physicians understand where policy can be improved and the steps they can take to assure the physician voice is included in the process. We’re really encouraging them to do that: To be involved in the conversation and to have their organizations represented at the table, because our physician leaders represent one of the best opportunities to inject the process with broad thinking around ideas of business and healthcare and policy.”

On this trip, the physicians hear from Howard Dean, a physician and former Vermont governor and Democratic National Committee chair, and Tom Scully, former head of the Centers of Medicare and Medicaid under former President George W. Bush. They hear from advocacy groups and former staffers now working for policy groups and lobbying firms; many of whom played a role in major healthcare legislation over the years, including the Affordable Care Act.

These meetings couldn’t be more timely. The Congressional Budget Office (CBO) just put out its score for the cost of the American Health Care Act (AHCA) passed by the House of Representatives, and a representative for the CBO discusses why they do what they do and the scoring they produce according to specific legal parameters. As the U.S. Senate gets ready to take up the House’s version of the AHCA, policy makers discuss their predictions for that and how it could affect (or not affect) the doctors in the room.

Thoughtful questions are asked after every speaker finishes his or her presentation, and discussions ensue during the quiet moments between speakers and the physicians. Later, physicians speak amongst themselves, discussing what they’ve learned and what that could mean for them moving forward. Daily writing assignments reinforce the learnings from the speakers and activities and conclude with a proposal for how the physicians’ and their organizations can impact policymaking.

The speakers are open and honest, sometimes laying out stark details, discussing money and social security (that could be classified as a bit depressing). Others discuss in detail how legislation is influenced, the difficulty in change and the current climate under the new administration in Washington; some describing it as “chaotic“ while others offer the doctors a clear mission.

“We have learned that physicians are woefully underrepresented in Washington. This really has been a call to action to get more involved on both the local and federal levels,” said Dr. Saul.

One speaker tells the physician MBAs: Although it seems quiet in DC, there are always conversations and intense work happening behind the scenes. That’s what’s going on right now with healthcare.

Pete Slone, senior vice president for public affairs at McKesson, Inc., was just one of many speakers who responded to questions from the Kelley Physician MBAs.

“In a highly regulated industry, where business decision-making could help drive the cost savings and improved clinical outcomes that everybody seeks, it’s ever more important to understand the intersection of how business works with clinical practice,” said Slone following his presentation.

“So much of it is driven by public policy, legislation or regulatory policy. To ignore those influencers is to operate at a myopic, somewhat isolated way. Given the size of the share of healthcare spending of the nation’s GDP and the zeal on the part of policy makers to bend the cost curve, it behooves every physician to better understand the policy arena and engage.”

“We hope this course encourages all of our physician leaders to insert their voices into this process,” said Magid. “They’re so knowledgeable about the healthcare side and the business side as it relates to healthcare organizations. Now, they understand through our discussions in DC where they have a seat at the table to address the issues. They have a real voice that needs to be heard, and they’re learning here how to do that properly.”

One physician asks, “What can doctors do to better lend their voices to this process?”

A speaker answers: Start at the state level. Do not underestimate your ability to make change in your own area.

He added: Get involved in politics at a local level; that’s where change starts. Real reform comes from the state. Sit on the school board; don’t give up.

“I thought advocating for our patients was something other people did, those who hold political titles,” added Dr. Saul. “What we’ve learned today is that we have a responsibility and an obligation to be involved. Our voice is important. If we use it, we can get things done the way we want to get things done.”

Looking back at her two-year journey through the Kelley Business of Medicine Physician MBA Program, Saul says, “This experience has been invaluable. From day one, I’ve been able to apply what I’m learning to my work at home, and now that I’m approaching the end of the program, it’s interesting to see what I’ve learned about the business of medicine, how I can contribute and how I can take that knowledge to truly make an impact on improving health.”