As a hospitalist, Mahdi Ajjan, MD, MBA’17, is accustomed to solving problems.
His specialty itself sprang from the need to alleviate primary care physician burnout in the early 1990s when these physicians were shuttling back and forth between practice offices and hospitals to treat admitted patients. Hospitalists began treating inpatients exclusively, dramatically reducing hospital lengths of stay. When Dr. Ajjan entered the field in 2006, the industry was still in transition and he noticed hospitalists were often misunderstood and mismanaged by hospital administration.
“Times of transition in medicine can be very chaotic because it’s not as if someone has gone ahead to work out what happens. Hospitalists suffered as practitioners, and hospitals suffered because they didn’t know what to do with us,” explained Dr. Ajjan. “It occurred to me that I could do a better job of managing hospitalists. I suggested to the hospital’s CEO that we hospitalists become a private company to serve the hospital. He thought it was a great idea and helped us expand. It was an amazing journey.”
In 2011, Dr. Ajjan launched Optimed Hospitalists Group in Statesville, NC, serving the area around Charlotte. He said the practice model changed the mindset among hospitalists and the hospitals in which they worked. Instead of declining patients, hospitalists were taking on more. At a conference a few years later, Dr. Ajjan encountered the concept of applying his hospitalist model to nursing homes to help those patients transition from hospitals.
“I approached nursing homes in the area, because we discharge our patients and never know what happens to them; many are readmitted within two weeks,” he said. “What if we move into nursing homes and care for them from there?”
This concept prevented readmissions and treated patients within familiar settings using hospital-standard care such as IV fluids and more acute medications than nursing homes typically provide. The idea became so popular that there’s more demand locally than Dr. Ajjan can accept. Optimed’s business office is now located in Davidson, NC, growing to serve three assisted living facilities, seven nursing homes, one hospital and a wound and hyperbaric care center.
But as his practice grew, Dr. Ajjan realized he needed a better understanding of business. His wife, Haya, a business professor at Elon University, had helped him with previous business plans, and she suggested his questions and interests would be better served by earning an MBA.
“I wanted to earn an MBA to learn how to really put it all together as a business and focus more efficiently on quality than growth,” he said. “As physicians, we feel like we know all we need in order to design a practice and see patients. But when you enter an MBA class, you discover you are not actually equipped with the right skills in medical school.”
Dr Ajjan had heard about the Business of Medicine Physician MBA Program at the Indiana University Kelley School of Business and appreciated that it was designed for physicians only. Based on Kelley’s reputation and recommendations from alumni, he enrolled. Along with the basic business principles of finance, accounting, management and operations, Dr. Ajjan says the
application of these fields to the healthcare industry was among the most useful skills he has gained.
“I used to read balance statements all the time, but understanding how to use them as tools incorporated appropriately into a business plan was a new skill for me.”
Dr. Ajjan says some of the greatest lessons he’s gained during his Kelley Physician MBA have been in personal communication – how to be genuinely focused on one’s motives and also empathetic during negotiations.
He expanded his leadership capabilities by gaining a better understanding of relationship building and a reaffirmation of what he already believed about treating others with respect.
“When I started my business, people suggested that if I listened to an employee and gave them what they wanted, it was weakness,” he said. “But because of this MBA, I recognize it’s one of my strengths; it’s how I managed to grow the company from five employees to 35. This was very reassuring.”
During the program, Dr. Ajjan achieved three major projects in his practice: He worked with a hospital partner to create an observation unit based on learnings from his operations class, his practice launched a free transitional care clinic for patients who are discharged but do not yet have a primary care physician or insurance, and he launched a venture capital project for new sensor technology to prevent falls in nursing homes. He attributes all of these innovations to business acumen, insights and confidence gained during the program.
“There wasn’t a single course that was irrelevant to what I do,” he said. “Every single lesson fit exactly with what I’m doing on a daily basis to see patients or innovate business ideas.”
Dr. Ajjan took advantage of the program’s electives, including the healthcare policy course that traveled to Washington, D.C. and two global healthcare studies courses that took him to Germany, Czech Republic and Cuba, where he studied unique healthcare delivery models. He says he discovered that all markets have one thing in common: the pursuit of higher quality care for lower costs.
“Every country, every culture is struggling to figure out how to provide quality care efficiently,” he said. “In comparing cultures, it’s very important to remove judgment, to examine the details, numbers and approach, to be open minded about finding solutions from anywhere and to begin implementing them. The experience was very useful and very humbling.”
During his time in the Kelley Physician MBA Program, Dr. Ajjan was awarded the prestigious William M. Plater Civic Engagement Medallion, an award recognizing graduating students who’ve shown exemplary commitment to their communities. Dr. Ajjan was honored for his commitment to caring for elderly patients in nursing homes and those without insurance, his work supporting Syrian refugees and his efforts to counsel and support fellow physicians in avoiding burnout. Dr. Ajjan finds his work with elderly patients particularly gratifying.
“Seniors in our communities deserve the best. I see them first as a people who have very rich lives, and then, I focus on the psychological and medical support, limiting medications that could be harmful,” he said. “I try to avoid prescribing benzos and narcotics and, instead, focus on their psychological energy. It’s a very gratifying thing for me personally as a physician. Sometimes, elderly patients come to the hospital in distress or confused, and then, they’re taken to a nursing home. They need the support and care that they deserve, and I’m honored to provide that.”
Dr. Ajjan graduated with his MBA in 2017 and continues to implement his business lessons into his practice. He believes the Kelley School of Business helped him solve problems both known and unexpected.
“Kelley was the perfect program. I couldn’t have asked for more. It had everything I asked for and some things I hadn’t even considered.”