IT WAS 1967. Just the year before, more than 23 million elderly and impoverished Americans had enrolled in the newly enacted Medicare and Medicaid programs, and the W.K. Kellogg Foundation continued towards its goal of professionalizing the management of hospitals. In that year, Tulane was one of only three universities awarded a Kellogg grant to establish a program in health administration. Dr. Thomas Hamrick, chair of the Department of Health Services Administration, hired Dr. Walter Burnett to serve as the first director to design and launch an MPH program in Health Services & Hospital Administration.
After piloting courses during the 1968-69 school year, the inaugural class entered in the fall of 1969. “Walter Burnett wanted the hospital administration program to be different, to include business subjects,” said Dr. Hugh Long, professor of health policy and management and the only remaining member of the original faculty. At the time, that focus was a radical idea among programs that primarily taught hospital organization and management.
Burnett partnered with Tulane’s School of Business to bring business faculty to the School of Public Health to teach courses in finance, accounting, and marketing. Long, a self-described “finance guy” fresh out of a Stanford doctoral program, was completing a year in Singapore on a grant but had already been hired to the business school faculty. In his very first semester at Tulane, Long taught, not uptown at the business school, but downtown in public health. He and a colleague team-taught a course in finance during the pilot year before the new program officially started. “We had no text book,” he recalls, but they did have three years of hospital financial statements courtesy of a student who was a physician. They were the perfect teaching tool for Long.
Dr. Joni Steinberg, who retired this past July, was also there from nearly the beginning. In 1971, she was hired by the Department of Epidemiology and Biostatistics to teach a computer programming course. She learned about the new program and the upcoming departure of the department’s operations research and management science professor. “I popped into Walter Burnett’s office and said, ‘I heard Juan [Prawda] is leaving. That’s my area.’” Steinberg was hired just as the experimental program formally became the Department of Health Systems Management (HSM) in 1973. She found that it was a good fit, and that the department offered a great environment.
“It was always a very collegial department,” she says. “We always had some diversity and even more so now.”
That diversity included two women in the first cohort of students, including Carole Philipson.
Prior to joining the program, Philipson was deciding between Tulane and the University of Florida law schools, either of which would have required her to take on additional student loans. Stuart Capper, a Tulane undergraduate classmate of Phillipson’s and a future HSM professor and vice chair, told her about this new program being launched by the School of Public Health that offered public health traineeships to cover tuition and a stipend. “That sounded like a good thing because it combined business, it combined healthcare, and I had been pre-med but decided not to apply to med school. I had multiple interests, and it seemed like a really interesting program.”
Although the program did include women from the beginning, that didn’t mean it was easy being a woman in hospital administration in those days. Steinberg recalls putting together a Women in Hospital Administration group for students in the mid-70s. “I needed to make sure they saw role models,” she says. They would get together at least once a year, and Steinberg would bring in program alumnae and other women in healthcare leadership.
The program, benefitting from the school’s pioneering work in international settings, includes a history of activities in international health systems. Over the years, the department has delivered teaching programs in Central America, China, and Taiwan.
Another point of differentiation was the department’s willingness to look beyond hospitals as the main employer of its graduates. “The program relatively early on stepped away from being purely about hospital administration,” says Long. Although hospitals remained the number one employer of program graduates, faculty and alumni helped students see a bigger pool of careers, with residency placements in multi-specialty group practices, consulting, and for-profit healthcare settings.
Physicians were also a critical focus of the department’s programs. While there has always been tension between physicians and managers, physicians are increasingly assuming leadership roles in health care, says Mark Diana, the department’s seventh chair. He notes that Tulane was the first to offer a Master of Medical Management (MMM) degree in 1995. More recently, the department has teamed up with the Ochsner Health System to offer an innovative Physician Leadership Certificate (as well as an Administrator Leadership Certificate), which is drawing a lot of attention.
What does the future hold for health policy and management education at Tulane? “This is a time of huge change in the healthcare field,” says Diana. “What I see on the horizon is this blending of public health and healthcare delivery. We can’t be just about treating people once they are sick. We have to think about managing the health of populations. Medical care doesn’t know how to do that; public health does.”
“I think as a department we’re poised to take advantage of that and be on the cutting edge of [this shift].” He gives a lot of credit to being located in “one of the best schools of public health in the country. Tulane is the place to do that,” says Diana.
Steinberg agrees. “There’s something about the department and being in a school related to public health and related to a broader perspective. There’s a commitment to community beyond institutions and the populations in those communities. There’s a broader world out there and I’m not sure other MHA programs convey that public health commitment.”
Diana is also thrilled that the school’s new dean is nationally known for his work in health policy and health equity issues. Thomas LaVeist, who became dean of the school in July, has joined the faculty in the Department of Health Policy and Management.
Although there is a lot more competition than when the program first admitted students in 1968, Diana, Steinberg, and Long all agree that Tulane, as it has for the past 50 years, continues to provide a top-tier healthcare management education.
“Healthcare is a huge opportunity. It’s one-fifth of the economy,” says Long. “We have good faculty, a good product, and a solid research program. Our faculty are current in the industry and they bring that into the classroom.”
“Our alumni go on to become successful leaders,” Diana points out. They compete successfully against peers at other schools in getting fellowships at top healthcare organizations like Henry Ford, the Mayo Clinic, Mass General, and others.
It’s been a good fifty years. “We’re only looking to get better and even stronger,” says Diana, which coincides with the department’s rebranding. Encapsulating all that has come before along with its bright future, the department will now be known as Health Policy and Management. SPHTM
Learn more at the anniversary website, hpm50.tulane.edu.