The Value of the Doctorate in Health Administration and Leadership at the Medical University of South Carolina

The Value of the Doctorate in Health Administration and Leadership 253 Part II

Andrea W. White, PhD & James S. Zoller, PhD

Abstract This article describes the innovative Doctorate in Health Administration and Leadership Program at the Medical University of South Carolina. It is the first DHA program in the country and has now been in existence for eleven years. The article provides a description of the program’s structure and a discussion of the program challenges and benefits to faculty as they deliver the executive doctorate program. Benefits and suggestions from a qualitative study of program graduates are presented, as well as a discussion of future plans. Introduction The Department of Health Administration and Policy (DHAP) at the Medical University of South Carolina (MUSC) offers three academic degree programs: a Bachelor of Health Sciences (BHS) degree, a Master of Health Administration (MHA) degree in two formats (residential and executive), and a professional doctoral degree in Health Administration and Leader- ship (DHA). The DHA Program at MUSC started in 1996 and was the first DHA program in the country (Johnson 2001). It has currently graduated five cohorts of DHA students. Three other cohorts are progressing through the program as of this writing.

Please address correspondence to: Andrea W. White, PhD, Medical University of South Caro- lina, Department of Health Administration and Policy, 151 Rutledge Avenue, Building B, PO Box 250961, Charleston, SC 29425, 843-792-4493, [email protected] 254 The Journal of Health Administration Education Summer 2007

This article presents a brief description of MUSC’s DHA program to provide a context for the reader. Challenges and benefits that the DHAP faculty has discovered in delivering doctoral education in an executive format are conveyed. The article includes the perspective of DHA graduates regarding the value of the DHA degree to their professional growth and advancement and concludes with a discussion of future plans. Qualitative research methodologies were used to obtain the graduates’ perspectives. Purpose & Description of the DHA Program at MUSC James Johnson, who helped originate the DHA program at the Medical University of South Carolina, wrote an article in 2001 describing the program. Johnson explained that the program was initiated because there was recognition of the need for an advanced degree for health executives; there was increasing discussion about the need for more leadership training in healthcare; and there was an increase in the number of continuing education events for senior executives. Representatives from professional associations such as ACHE, MGMA, AUPHA, and ACPE had also reported that they had numerous requests for information regarding doctoral programs delivered in an executive format. In response to these forces, the DHA was launched at MUSC to enable executives to acquire additional healthcare management knowledge and skills in a focused, integrated manner within an academic environment that was both rigorous and accessible (Johnson 2001). Since inception, the program has maintained the same purpose–to meet the intellectual and career objectives of experienced health professionals interested in excelling as leaders who want to seek solutions to the complex challenges confronting health care systems and who recognize the importance of life-long learning and career development. The DHA Program’s mission is to advance health services leadership in South Carolina and the nation by: • providing innovative leadership techniques to experienced health administrators; • enabling students to engage in both individual and collective efforts to further develop their analytical skills and systems, and critical thinking abilities; and • serving as a catalyst for the student’s personal and professional growth and change. The DHA program objectives include: • further development of leadership and management skills, • training in systematic problem-solving methodologies, • acquisition of an enhanced ability to apply administrative and The Value of the Doctorate in Health Administration and Leadership 255

leadership concepts and techniques to real-world health care set- tings, • provision of the opportunity to develop long-term, mutually beneficial professional relationships among an array of health care professionals and academicians, and • cultivation of a greater appreciation of, and ability to, utilize diversity in administration and leadership. DHA Curriculum and Structure The DHA curriculum includes sequences in leadership, strategic management, policy, and applied research. Two years of formal doctoral coursework totaling 45 credit hours are provided during on-campus sessions and through distance educational technologies such as WebCT. The on-campus sessions are offered during an intensive summer session and four extended weekend sessions each year. While students are on-campus, they are housed together in local Charleston hotels and are provided and eat the majority of their meals together. A social activity is occasionally arranged. The in- tent of these outside classroom interactions is to facilitate the building of strong relationships among the cohort participants. Each class is taught by a departmental faculty member and a distinguished visiting scholar from industry or another academic institution. Papers and other required assign- ments are completed during periods of home study between sessions, often augmented by material and discussions on Web-CT, a web-based course delivery system. The third year of the program is devoted to 18 credits of individual, supervised Doctoral Project research, culminating in a Doctoral Project defense. Successful completion of all program requirements results in the awarding of a DHA degree. Applicants may be accepted into the program if they have a post-bac- calaureate professional degree (MD, JD, etc.), or Master’s degree in Health Administration, Business Administration, Public Health, or another relevant field of study. Applicants must also have a significant amount of management/leadership experience in a health or health-related organization or equivalent entity such as a professional association. Originally students were admitted into cohorts every two years, but they are now admitted into cohorts that begin in September of each year. Cohorts include a mixture of working healthcare professionals holding various positions such as Chief Executive Officer, Chief Operating Officer, Chief Nursing Officer, or Director in health systems, hospitals, managed care organizations, mental health facilities, social and public agencies, and consulting firms. The program also enrolls some military officers in 256 The Journal of Health Administration Education Summer 2007 the medical services corps and entrepreneurs in health-related businesses. Applicants often indicate that they hope to use the degree and knowledge for professional growth and advancement or to branch out into consulting or education at colleges and universities. Issues that have Presented Program Challenges The DHA program has now been in existence for eleven years. As with any newly launched initiative, areas for improvement and modification have been discovered. Four major issues became apparent during the offerings of the program and have been, and in some cases continue to be, the source of much faculty debate. The four areas include admission requirements and retention, class size, faculty expectations of workload for students, and faculty expectations of student research efforts. These issues are discussed below.

Admission Requirements and Retention What should be the criteria for admission into the DHA program? The faculty determined that having an MHA, MBA, MPH, or other similar master’s degree was important. Coursework in economics, statistics, organizational behavior, accounting, and financial management was specifically required. In addition, and equally important, was having significant administrative experience. Applicants must submit an organizational chart of their organization and indicate the position within the organization that they currently hold. The faculty is adamant that they want the DHA program to enroll students who can make valuable learning contributions to their peers in the class and who will be knowledgeable and experienced in a diversity of healthcare backgrounds. Several physicians and nurse administrators also express interest in the program. The admissions committee appreciates their clinical backgrounds and recognizes that they can be instrumental in helping to foster interesting and lively discussions and in providing relevant insights to topics. The program has encouraged these individuals to apply as well. The faculty is also adamant about offering the DHA students enriched networking opportunities. The faculty believes these goals can only be achieved if the student body comprises seasoned health professionals from a variety of areas in healthcare. A number of individuals who had only re- cently completed their master’s degrees have inquired about the program. These individuals are told to consider applying to the DHA program after having worked for a number of years and after having achieved a significant level of administrative experience. The Value of the Doctorate in Health Administration and Leadership 257

Although it is obvious that the DHA program faculty wants only to enroll students who have achieved success both academically and professionally, it must also be recognized that practical enrollment considerations do factor into admissions, specifically the faculty’s desire to have a full class and adequate tuition generation. Therefore, from time to time, questions about the adequacy of administrative experience have arisen. Anecdotally, it should be noted that past compromises made on this requirement for a small number of admissions in the first four cohorts frequently led to student difficulty in their ability to comprehend material or in their ability to participate sufficiently in the seminar style classroom sessions. The faculty believes it is wiser now and is willing to endure lower than ideal enrollment numbers in order to maintain a high quality student body. Most students who enter the program complete the program. Of the five cohorts who have now completed their three years or more inthe program: • 107 students entered the DHA program, • 13 (12%) withdrew from the program, • 76 (71%) graduated from the program, and • 18 (17%) are still in the research process. Those relatively few students who have withdrawn have done so because of professional or personal reasons such as a job change or the cost of the program. In a few cases students have been encouraged to withdraw by the faculty when it became apparent that they were having substantial difficulty in achieving satisfactory academic performance. This last situation quite honestly causes a great deal of concern and angst in both the effected students and the faculty and program director.

Class Size The second issue that has prompted much faculty discussion is class size. Cohorts have varied in size from 11 – 26 with the average cohort size being 15. The issue of DHA student numbers is important because the faculty wants to ensure that the program is able to cover its financial costs and that the composition and size of the class will enable and encourage excellent interaction among students and faculty in class discussions. A large number of students (25 or so) would obviously provide more financial resources for the program but would also seriously impact faculty workload, specifically chairing and serving on doctoral committees. Faculty note that they want to be able to provide students prompt attention and interaction as they go through the research process, but are somewhat impeded from doing so if they have to assume the chairmanship of several doctoral committees, 258 The Journal of Health Administration Education Summer 2007 particularly since they also have research and teaching responsibilities in other DHAP academic programs. As mentioned earlier, initially the program accepted DHA students every two years, and accepted a fairly large class (about 22-25). The program realized that the biannual admission resulted in tremendous varia- tions in tuition revenue and faculty workloads. It was argued that yearly acceptances of fewer numbers of students would smooth out the tuition revenue flow and the impact on faculty workload. In recent years the DHA program has started accepting a new cohort each year, but with a smaller number of students (about 15). This number allows sufficient classroom interaction, a bonding of students in the cohort, and a more manageable number of doctoral projects for faculty to oversee, assuming the students finish in a year’s time. If they take longer or fail to start right away, it does create an overload on faculty time.

Faculty Expectations about Student Workload How much work should high level health managers and executives be expected to do in this professional doctorate program? The faculty recognizes that these students are full-time health administrators with considerable responsibilities both professionally and personally. They frequently question, as do students, how much work is too much, given their full schedules? The faculty has discussed this issue at length and recognizes that there must be the correct balance between what is reasonable, substantive, and doable. Discussions emphasized that the DHA program is a doctoral program, not a diploma program. The integrity of the DHA degree depends on students having substantive work and achieving real educational and learning outcomes that translate into continued and enhanced professional success and achievement. As faculty do with other levels of education, they have engaged in discussions among themselves about academic rigor, grading, and acceptance or non-acceptance of late submissions of work or other accommodations to life occurrences within the program. While inconsis- tency among faculty regarding expectations still exists, there continues to be discussion and a narrowing of the variation in student workload expectations.

Faculty Expectations about Students’ Research Efforts Faculty discussions regarding students’ workload also revolve around students’ research expectations. In conceiving the DHA program, DHAP faculty determined that each of the DHA students would be required to engage in a research project as his or her culminating learning activity. Therefore, after two years of didactic work, students enroll in their doctoral project The Value of the Doctorate in Health Administration and Leadership 259 course. The work is expected to take about a year or so to complete. Each student identifies a doctoral committee which is chaired by a member of the program faculty, and usually includes one other faculty member from the department and one committee member from outside the department. The DHA research project is not expected to be as exhaustive as a PhD doctoral dissertation, but it is expected that it will be original research and substantive. The projects have typically been applied research and may take the form of a case study, a qualitative study, survey research, or an evaluation of a project or program. Students often select participants for their studies from their own work environments, their health systems, their communities, or from a group of individuals with similar areas of interest. Table 1 presents titles of a sample of completed DHA Doctoral Projects. A question that is often asked is how a DHA doctoral project is different from a PhD dissertation. Viewing the output of some students’ DHA doctoral projects, one might conclude that there really are no differences in product between the DHA doctoral project and the PhD dissertation; however, the main difference is in what these students are expected to achieve at the end of the research process. For the most part, MUSC’s DHA students are not research-oriented and are not interested in doing research. When the faculty talks to potential DHA students, it lets them know that this DHA degree is not a research degree. They are told if they want a research degree or want to engage in substantial funded research activity, they should look into a PhD program. It is not expected that students completing their DHA will be capable of engaging in fundamental research in an academic institution, nor is it the belief that these students, once finished, will even be particularly excited or interested in doing research. The outcome that is expected is that students will have an understanding of what research is, have an appreciation for it and what it entails, and will be capable of addressing a practical issue or problem using some research methods as needed within their own institutions. Given this expectation, it often poses challenges for DHAP faculty who are interested in doing high quality research. They frequently have to adjust their expectations when working with DHA students, particularly when working with a student who has little understanding of research and does not appreciate how long the process can take. Within its curriculum, the DHA program offers two courses in research methods (HAP-866 Applied Research and HAP-870 Advanced Techniques in Applied Research). In addition, the program requires students to participate in five workshops throughout the first two years to help them begin thinking about their doctoral projects. The workshop topics are: 260 The Journal of Health Administration Education Summer 2007

Table 1.1 Sample of Titles of Completed Doctoral Projects

• The Migration of Surgical Procedures to Investor-Owned Ambulatory Surgical Centers and its Effects on Full Service Hospitals within the State of Florida • Exploring Physicians’ View of the Meaning of Good Nursing Care • Measuring the Culture Of Safety; An Exploratory Analysis and Case Study • Barriers to Physician Adoption of Telemedicine and Best Practices for Overcoming These Barriers • Perspectives of Senior Healthcare Executives to Health Information Exchange Collaborations with Physicians in Technically Developed Markets • What Is the Effect of Cultural Orientation on Conflict Management Style? • Cardiology Compensation Compared to Work Effort • Building Blocks for the Development of a Chronic Care Lung Cancer Model • Healthcare Administrators’ View on Quality and Quality Improvement • Health Plan Quality: Factors Influencing Hospital Participation in Health Plans • Return on Hospital Employee Education Investment • The Relationship between Medication Refills and Health System Encounters for Medicaid Clients with Diabetes Mellitus • The Role of Leadership in a Hospital Turnaround • The Effect of Leadership Behaviors on Employee Commitment, Satisfaction, and Strength of Culture • The Relationship of Patient Satisfaction and Financial Performance for a Sample of Acute Care Hospitals in the US • Racial and Socioeconomics Difference in Family Perceived Barriers to Satisfaction with End of Life Care • Development of a Conceptual Model for a New Hospital Design • The Impact of Freestanding Ambulatory Surgery Centers on the Cost of Health Care • Policy Analysis for Health Disparities in African American Medicaid Aids Patients in South Carolina • A Phenomenological Study of Transcendent Leaders in Healthcare • Antitrust Implications for Consumer Prices Resulting from Non-Profit Hospital Mergers • The Hospitalists’ Effect on Patient Satisfaction • The Impact of Education on Nursing Attitudes and Behaviors that Affect Cost Effective Care • Conflict Management in the High Stress Environment of the Operating Room • Role of Organizational Culture in Merging Hospital Clinical and Non Clinical Departments • The Relationship of Employee Turnover and Patient Loyalty • Organizational Readiness for Electronic Medical Record Success The Value of the Doctorate in Health Administration and Leadership 261

• Writing a Literature Review • Using the Library and Databases • Defining a Research Topic • Research Methods Applied to the Doctoral Project • Details of the Doctoral Project Most DHA students have a good idea about what they would like to focus on for their doctoral project at the end of their two didactic years, but they have limited understanding of how to actually proceed. It does take a substantial amount of faculty time to individually mentor these students in the research process. There is considerable variability in students’ abilities and in their research backgrounds. Practical discussions and concerns regarding workload credit for faculty who are engaged in doctoral project mentoring are often raised. Because there is currently a cohort of about 15 doctoral students admitted each year, there is also a cohort of about 15 doctoral students who have completed the didactic component of the program and the comprehensive exams each year and now need DHA Doctoral Project chairs and committee members. Students typically ask faculty members who they relate well to, or who they perceive to have similar research interests, or who use research methodologies that the students want to use, to serve on their committees. Several DHAP faculty members have chaired multiple committees and also served as committee members on several committees in a given academic year. It does take considerable time and effort, and the issue is that it does not factor into the faculty members’ contracted workload for the year. The above description of issues presents some of the challenges which faculty struggle with currently or have struggled with during the course of the eleven years that the program has been offered. However, it must be noted that the department has also reaped many benefits from offering the DHA, as described below. Benefits of Offering the DHA Degree The department has realized many benefits from offering the Executive Doctorate in Health Administration. One benefit is that the DHA program has dramatically increased awareness of all the department’s academic programs, and it has enhanced the department’s reputation. Students in the DHA program come from all over the country. The faculty members were pleased to hear that several of the current DHA students had learned about the program from colleagues across the country who had heard and repeated good things about the DHA at MUSC. The department’s Execu- tive MHA program and the Bachelor of Health Sciences program have 262 The Journal of Health Administration Education Summer 2007 also enrolled students who have been referred by individuals directly or indirectly familiar with the DHA. Another benefit has been increased opportunities for faculty to collabo- rate with DHA graduates on grant proposals, research projects, scholarly papers, and presentations, including submitting articles for publication that have been modified and condensed from doctoral project work. In addition, several DHA graduates have expressed interest in and have taught in the Executive MHA program and the Bachelor of Health Sciences program. Both of these programs provide education to healthcare professionals working in South Carolina. As with the DHA coursework, the content of coursework in both the Executive MHA and the BHS is delivered primarily using Internet technologies. One extended on-campus session per semester is also required. The master’s healthcare accounting course and healthcare leadership course and the bachelor’s introductory health delivery systems course have all been ably taught by graduates of the DHA program. The DHA alumni have provided significant support to the department. They have been involved in fund-raising for the department, have provided monetary gifts, and have opened their facilities to several of the department’s Residential MHA students to do internships and administrative fellowships. They have guest-spoken in master’s degree classes and have added greatly to the department’s alumni support. The benefits of the DHA Program to the faculty and the department are clear, but a more important question is this–what is the perceived value to the DHA graduates after they complete the program? DHA program graduates were asked to respond to a question about the value of the DHA degree. Graduates Perceptions of the Value of the DHA An electronic survey was administered to 56 graduates with valid e-mail addresses from the first four DHA cohorts using Survey Monkey. The participants were assured that their responses were anonymous. Seventeen responses were received for a response rate of 30.4%. An analysis of the responses that graduates made to the question inquiring about the value of their DHA degree revealed a great deal of consensus around several com- mon themes. Sixteen of the seventeen (94%) responses indicated that the students had very positive impressions of the value of the degree. Benefits which were consistently mentioned by the graduates included enhanced credibility and respect from colleagues, significant gains in knowledge and skills, advancement in position, movement into new fields of interest, valued friendships and professional relationships, and increased appreciation for research and scholarship. The Value of the Doctorate in Health Administration and Leadership 263

A few recommendations and suggestions for improvement were also expressed. There were a few conflicting comments about the program’s alumni relations which may reflect the maturing of the program and two comments about the cost of the program. The discussion that follows presents the points of view of the participants, frequently in their own words.

Enhanced Credibility and Respect Several graduates indicated that the DHA degree has enhanced their credit- ability and the respect they receive from their colleagues. A few graduates mentioned that while their degree was beneficial, they felt it held less status than a PhD. One graduate wrote, “The degree has lent greater weight to my credentials. It has opened doors that might not have been accessible without it.” Another graduate commented, the DHA “is increasingly a recognized credential, and having the degree increasingly influences my professional interactions with others. It has a very interesting effect on relations, particularly with physicians. They seem more willing to accept my information regarding administrative and management matters knowing that I too have had extensive education in my field and have the terminal degree.” Another wrote, “The gaining of a doctorate advances your status in the professional community. This status can have great and meaningful impact.” The writer goes on to say however, that the status is “clearly not as much as a PhD since it is a different degree. Inside healthcare, it might not matter as much, but outside healthcare, there can be a stigma that it is less transferable.” Another graduate reflecting a similar sentiment noted that “Outside the academic community, no one seems to know what a DHA degree is. A ‘PhD’ is so much more widely recognized and validated.”

Increased Knowledge and Skills Most graduates feel the program added new dimensions to their knowledge base, their skill set, and their ability to engage more effectively in strategic planning. A couple of graduates indicated that the degree led to their promotion or to their obtaining a higher level position in another organization. One graduate stated, the DHA program, “helped me develop a more comprehensive approach in providing leadership in healthcare. Because of the experience, I am a better hospital CEO and a better champion for healthcare in our community.” Another graduate stated, “The learnings from the DHA program have positively impacted my ability to evaluate and develop a broader perspective of healthcare related issues. The program helped advance my administrative and leadership skills and performance.” Still another stated, “I am happy to say that the DHA program was not a 264 The Journal of Health Administration Education Summer 2007 repeat of my master’s program. I learned a significant amount about strategic planning, business development, how to make better decisions using advanced quantitative analysis techniques, how to perform a comprehensive community assessment, how the government works and interfaces with healthcare, the importance of meeting with legislators, as well as effective leadership principles and applications.” Another wrote, “The practical benefits I gained included the fact that I learned some new things that I use at work. Most of what I have taken away is the nice framework for strategic planning and analyzing competitive advantage. I have used this several times and I like the way it frames things when you combine it with mission, vision, and values work.”

Advancement As mentioned above, a couple of graduates indicated they had benefited from promotions. “I was a manager at Ernst and Young’s Managed Care Health Care practice when I first considered the DHA. I always approached problems at work from a financial and systems perspective which limited the value I was able to add. I needed to broaden my skill set, but I couldn’t leave my job to work on a doctorate full time. MUSC’s curriculum emphasized strategy and leadership applied to real-world situations. In the very first course everyone was engaged in discussing real healthcare business cases and recommending strategies. I began examining problems from many angles–marketing, healthcare operations, and organizational behavior, not just financial. I began making sound decisions, adding value to my company where I couldn’t before. Senior management noticed and I was promoted while still in school and received another promotion after graduation.” Another student noted, “I chose this program for two primary reasons, the first being that I wanted to personally achieve the highest level of academic preparation in my chosen field. I also wanted to position myself to be able to advance my career to the hospital CEO level. I was at the director level and wanted to advance to at least the VP level. The good news is that I have just accepted a great opportunity with another hospital as its CNO/COO.” Movement into New Areas Several graduates stated that they had entered the program with hopes of moving into new areas, particularly education and consulting. One graduate indicated how pleased he was to now be “qualified to teach doctoral students.” Another stated, “The DHA degree enabled me to get a job I The Value of the Doctorate in Health Administration and Leadership 265 always wanted: teaching in a university setting.” Another commented, “At the most tangible level, I am now qualified and sought after to teach at the graduate level at area colleges.” On a different front, a graduate revealed, “As a result of the DHA degree I changed careers and used my doctoral project to pursue my consulting ambitions. The DHA program was a life- changing event.”

Valued Friendships and Relationships Almost all DHA graduates commented about the networking aspect of the program and how much they valued and appreciated their new friendships and contacts. “The DHA program was an extraordinary opportunity to learn from smart professors and interact with great colleagues and students.” Another wrote, “My cohort colleagues were a source of new information and experience. The contacts I met in the program have been great.” Another indicated, “I count some of my DHA classmates among my truest friends.” A graduate wrote, “I have developed a network of DHA colleagues that have remained over the years and are helpful from a career perspective and also just good friends to talk issues over with; this has enabled me to remain connected to a program in a closer way than most of my other alumni affiliations.” One graduate observed, “The DHA program offers students the opportunity to expand their network and gain exposure to industry leaders,” and another stated, “The cohort structure allows for the fostering of professional relationships across the country and beyond.”

Appreciation for Scholarly Activities Several graduates mentioned that they had developed much greater appreciation for research and scholarly activities as a result of the program. Comments such as, “My final dissertation project really cemented all of the concepts of research and statistics,” and “The program helped me have a better understanding and appreciation for clinical research (I’m currently working on my third abstract),” clearly indicate that research knowledge was gained. Another wrote, “I have an enhanced understanding of the process of basic research, writing, and analysis of results. I appreciated being afforded the opportunity to conduct original research and become the content expert on a topic of interest.” Another stated, “The integrity of the doctoral program and the rigors of the research process resulted in a credible doctoral research project that I have used as a basis for discussion and debate in other academic venues.” 266 The Journal of Health Administration Education Summer 2007

Suggestions, Recommendations, and Other Comments A couple of graduates offered the program some suggestions and recommendations. Many advised the program to continue centering the course offerings around leadership and strategic planning. “The greatest strength of the program was the emphasis on leadership, and I certainly hope that this continues to be what distinguishes the program. My suggestion would be to apply every subject to leadership and organizational change (strategic leadership).” Another graduate advocated that “there be a specific DHA Alumni Association” so that DHA graduates would be able to more easily keep in touch with each other. One graduate commented that while he learned some specifics about leadership and finance and appreciated the contacts he met through the program, he believes, “The program overvalues itself and the cost of the program does not match the potential benefits.” While that comment is disappointing, the faculty does recognize that the cost of the DHA program is substantial and students are justified in weighing the cost and benefit to them. Another student however stated, “I feel the over $80,000 that I personally spent on the program was well worth it.” Program Changes and Outcomes To conclude, the Doctoral Program in Health Administration and Leadership at the Medical University of South Carolina was the first DHA program to be offered in the country. Its delivery format appears to work well for prac- ticing healthcare executive students and departmental and visiting faculty. The purpose of the program has remained fundamentally the same. In 2001 an evaluation of the curriculum was conducted resulting in the replacement of three courses. The new courses expanded on the major program themes of Leadership, Strategic Management, Health Policy and Research Methods. A series of four non-credit “Doctoral Project” workshops were also added to help prepare students for completing the doctoral project in their third year of the program. A few other non-curricular changes have been made such as yearly admission of cohorts and changes to the student on-campus lodging and classroom accommodations. The program now houses the students in the Charleston area (a major tourist city) and teaches the classes in MUSC class- rooms instead of housing students at a beach resort (Seabrook Island) about 25 miles away from the campus. Students report that they enjoy walking around and seeing the many attractions of the city, and they better identify with MUSC as a result of this change. The Value of the Doctorate in Health Administration and Leadership 267

While not universally so, most graduates feel quite satisfied with the value of their DHA education and have found that the DHA degree has been useful both professionally and personally. As a relatively new program it is difficult to judge the long-term impact on career progression for graduates. Of the graduates to date, five have made a job change from health services administration to an academic position at a college or university, usually in the field of health administration. Ten of the graduates have used their DHA degree to support their transition to consulting or enhance their exist- ing consulting practice. Future Directions The future of the MUSC DHA program depends on market demand. Changes in specific courses and delivery have been made over the years based on student/alumni feedback. A thorough review of the curriculum is scheduled for this year; however no major changes are anticipated based on the positive responses received. As the trend to clinical doctorates (e.g. DPT, PharmD, DNP) continues, it is anticipated that an increased interest in the DHA degree will occur among practitioners intending to continue their administrative career versus making a change to academics or consulting. Additionally, there seems to be interest among clinical specialists (e.g. Anesthesia for Nurses, Occupational Therapy, and Physician Assistants) in using the DHA as a means of achieving a clinical doctorate. The faculty is anticipating that the DHA program at MUSC will remain a strong program for many years to come.

References

Johnson, J.A. “The Doctor of Health Administration: An Educational Innovation for Healthcare Executives. The Journal of Health Administration Education, 19 (Summer 2001). Associa- tion of University Programs in Health Administration: 333 – 340.