VOL. 23, NO. 8	OCTOBER 31, 1997

By Jean Llewellyn

  Since its launch eight years ago, more than 200 students from a wide range of health careers have entered the Executive Master of Public Health (EMPH) program. Calling the program "an overwhelming success," founding Director Sheila Gorman notes that more than half of each class consists of "physicians interested in the managerial side of medicine and the rapidly changing and complex policy environment of today's health care professional."

  For these mature students, CSPH's EMPH in Health Services Management is exactly what the doctor—or nurse or administrator—ordered. Astute mid-career health care professionals are eager to understand and influence the transforming health care business.

  James Cowan, chief of the department of medicine at St. Luke's Hospital, in Bethlehem, Pa., found that the 16-course, 45-credit EMPH is "clearly aimed at health care executives." Having shifted from clinical practice to administrative medicine over the last ten years, Cowan observes that, by and large, business courses that he had taken were not applicable to health care.

  "Frankly," he says, "health care reimbursement is unlike anything in the business world." Students don't have long to wait to use what they've learned. When Cowan's chief operating officer reorganized his department, the planning process incorporated an analytic model and insights developed by EMPH Professors Tom Ference, and Samuel Davis.

  Davis, former chief of Mt. Sinai Hospital, in Manhattan, is one of many senior practitioners who have teamed up with Columbia health policy and management faculty to relate classroom theory to the realities of the workplace.

  For some students, however, lessons come late. Aloysius Cuyjet served as director of adult medicine at Newark, New Jersey's, United Health Care Systems from 1980 until it declared bankruptcy last February, a collapse largely attributed to management's failure to adapt to the rapidly changing health care environment. The closing left Cuyjet, and 1200 others, out of work.

  Currently employed at a medical school, Cuyjet is using methods of analysis learned in the EMPH program to determine what's happened to United's thousands of annual admissions, and hundreds of thousands of outpatient and emergency room visits since the closure.

  "What's key," says EMPH candidate Sandra Comerie-Smith, "is sensitivity to the needs around you. A health care provider needs to be a good manager, leader and a public health person. There is no way to take the program and not be changed in your sensitivity to people who have no access or no insurance."

  Many courses have been relevant to her Medicaid managed care work, Comerie-Smith notes, citing an outcomes research paper based on surveys of patients' satisfaction, and lectures that helped her understand how Medicaid policies are formulated. Now, she understands managed care better.