Doctor of Healthcare Administration (DHA) Degree Programs
There are doctors that can be found in the executive ranks of major healthcare organizations and big insurers and medical device firms, and of course, you’ll also find them in the government agencies that drive regulation and health policy. But we’re not referring to MDs here. We’re talking about career administrators, backed by the experience that comes with decades in the field and the kind of global perspective on the healthcare industry you can only get with a Doctor of Healthcare Administration (DHA).
They are at the helm of an industry that is passing through troubled waters, and that kind of experience and perspective is the exact thing we need right now to keep from crashing into the rocks.
In the past fifty years, healthcare has undergone a massive expansion in the United States, with health spending per capita jumping from $355 per person in 1970 to more than $11,000 in 2018 according to the Kaiser Family Foundation. That has pushed healthcare expenditures from around 7 percent of GDP to almost 18 percent, turning the industry into the largest single employer in the United States in that same year. And according to a CDC report in 2018, more than 80 percent of American adults had contact with a healthcare professional at some point that year, making it an industry that is inextricably woven into the lives of just about every American.
What is a Doctor of Healthcare Administration, and How Does it Fit in to the Big Picture?
Facing those kinds of challenges and protecting both healthcare providers and patients takes more drive, more knowledge, and more skill than ever before. And it’s going to have to come from professionals who have pushed themselves to earn the highest degree in the field, the DHA.
A DHA is the most advanced degree you can earn in the field of healthcare administration. Graduates become well-versed in all the elements of running healthcare organizations in a complex medical environment:
Maybe even more importantly, they also absorb all the ethical considerations and strategic vision to become confident, well-respected leaders who will take those organizations into the future.
If you are in a position to be considering one of those doctoral programs, then you have probably already seen this expansion happening up close and in person. Most doctoral candidates in the field are decades deep into careers in the healthcare industry and have worked their way up within it. They already hold positions of great responsibility, and now they are looking at getting a seat at the big table where they can take on some of the biggest challenges and contribute to the most important advancements in healthcare management today.
You’ve probably already seen why that’s so important; heard the repeated calls coming from the American Association of Colleges of Nursing warning of impending shortages of adequately trained nurses, seen average wait times in the industry for an appointment grow to nearly a month in some cases, and yet, in the midst of all this demand and a global pandemic, you’ve watched more than 260 hospitals and health systems lay off thousands of professionals and struggle to obtain basic supplies. And all of that against a constant backdrop of challenges such as dealing with information security issues, issues of healthcare inequity, and in some parts of the country, a near total lack of access to even basic healthcare resources.
There are no absolute solutions to any of these issues, and certainly no easy ways to fund and implement some of the ideas we hope will mitigate the problems. But one thing is absolutely certain: a good many of the leaders in the healthcare industry we’re relying on to gain ground toward workable solutions will be doing so with a DHA in their back pocket.
Research Versus Reality: The Differences Between a PhD and DHA in Healthcare Administration
Like many fields where you’ll find two different types of terminal degree, there are both similarities and differences in healthcare administration doctorates. Your choice of whether to pursue a PhD or DHA will definitely depend a lot on the career path you intend to follow. But more to the point, it will depend on the vector you want to work from as you bring your experience and expertise to bear on solving the most pressing issues in healthcare today – whether it’s from the back rooms and lecture halls of research institutes and universities, or from the upper ranks of executive leadership in the healthcare systems and facilities where the rubber meets the road:
Doctor of Healthcare Administration (DHA) – A DHA is considered an applied doctorate, which means that it is focused on taking the evidence available in medical, organizational, and policy areas and using it to directly solve problems in healthcare. DHA-prepared healthcare leaders also engage in research, but it’s directed toward investigations into real-world issues and a pursuit of solutions to those issues that will actually pass the test when applied in actual healthcare systems.
Doctor of Philosophy (PhD) – A PhD is a research-oriented degree that is designed to equip graduates with the tools and skills to conduct original research and to publish in the field, pushing forward the state of knowledge in healthcare administration generally. PhDs are usually headed toward teaching or theoretical research positions after graduation.
Healthcare is a field that closely mingles education and the application of knowledge. You don’t have to look any further than residency training to understand that. For that reason, you’ll find plenty of Healthcare Administration PhDs managing hospitals and filling executive roles in the industry, and DHAs who work as educators and spend their days engaging in research. Many hospital systems are closely affiliated with universities, so it’s not surprising to find executives who are also professors or researchers, and both degrees can land you in those positions.
A DHA, however, is definitely considered the more appropriate degree to prepare for leadership positions in administrative roles in the healthcare industry.
How to Select the Right DHA Program
Beyond the DHA/PhD divide in healthcare administration, you’ll also find that a number of other types of degrees can lead you into the upper ranks of healthcare management. Those include:
These degrees certainly have their place among the most respected advanced credentials in the field, but the DHA has the most specific focus on this particular line of work.
Some DHAs have different tracks available. Unlike in master’s or bachelor’s programs, these are usually less about where you choose to focus your future education and more about what your previous education has been.
That means funneling students into one of two tracks, generally, depending on their previous education and experience:
Track for MHA grads and current healthcare leaders – To avoid taking up time with basic healthcare administration topics that you have already absorbed if you earned an MHA or similar degree, or currently work as an executive in the field, this track forgoes those courses and allows you to focus exclusively on advanced coursework.
Track for professionals from backgrounds other than healthcare – Designed for interprofessional healthcare leaders, this track includes the advanced, but essential level of healthcare administration education that would typically be part of an MHA. This allows practicing clinicians or managers in fields like information technology or finance to get up to speed and enjoy all the advantages of a DHA.
Most DHA programs take around three years to complete. You will tend to be taught in small groups, with less than twenty students active in a given program being typical. But that means you will get a lot of one-on-one time with your professors and advisors.
Should You Consider an Online DHA Program?
If it’s been a while since you earned your undergraduate or master’s degree, you might be surprised to find that online doctoral programs have become standard, with traditional, on campus degrees quickly becoming the path less traveled.
That’s because the kind of flexibility and format offered by the online, or blended, hybrid approach is perfectly suited to the kind of student most often pursuing a DHA – currently employed, with family and other obligations, very limited free time, and unable to easily relocate for years at a time.
And the general level of tech-savviness and high-speed internet access has grown to the point where almost anyone can take advantage of online degrees.
Most online DHAs are not entirely and exclusively online, however. Occasional in-person meetings in the form of limited on-campus residencies or symposiums make sure you still get the benefits of face-to-face interactions with fellow students and professors, which is really the only remaining selling point for a traditional on-campus experience.
Getting into a DHA Program
Competition is fierce to get into top-end DHA degree programs. In addition to beating out other prospective healthcare executives looking for slots, you also have to contend with high standards from the schools themselves: the highest caliber candidates are the most successful graduates, which reflects well on the school and draws in even more qualified candidates.
To be successful in the admissions process, you’ll need to come with the right academic ability, work experience, and personal qualities and characteristics.
The typical admissions criteria include:
Some programs that accept interprofessional candidates will also accept a professional degree, such as an MD or DDS, in lieu of a master’s or experience in healthcare administration.
Other schools will look more carefully at the specifics of your graduate course work as it applies to the field, ensuring you have the right basis in economics, finance, statistics, or organizational development to pave the way into doctoral studies.
Program Accreditation and Reputation in DHA Programs
Accreditation is the process by which academic programs are evaluated by an independent third-party to establish their validity and competency in the field they are teaching. All major American universities hold a basic level of general accreditation from one of the seven major regional accrediting organizations endorsed by the Department of Education and the Council for Higher Education Accreditation (CHEA).
If you earned an MHA degree in the field, you might be looking for DHAs that have received the stamp of approval from CAHME, the Commission on Accreditation of Healthcare Management Education, which is the specialty accreditor handling master’s programs in the field. But CAHME doesn’t accredit doctoral programs, and few CAHME-accredited MHA schools also offer a DHA.
Since you can’t count on this specialty accreditation at this level, you’ll want to do your own validation of these programs. Because they are relatively few in number, reputation in the healthcare community goes a long way. Seek out graduates and administrators in your organization or through professional networks to figure out which school will be the best fit for your goals.
Requirements and Courses in DHA Degree Programs
Many of the courses that you will find in a DHA degree will mirror the courses you find in MHA programs. Topics can include:
But you’ll find that these are merely jumping off points in those subject areas for a more investigative, more open-ended study of the factors and issues that healthcare executives encounter in those matters today. As an advanced student, you’ll be expected to push forward the topics of conversation and develop interesting new points of view just as much as the professors.
Although some programs do offer a focus in a particular area, you’ll find that every DHA program is effectively custom built for the student. That’s because to a great extent, doctoral degrees are tailored to individual goals and preferences. You’ll have wide latitude to drill down into whatever area of study you choose, guided by advisors and instructors who are there more to help you refine your investigations than to channel you into pre-set subjects.
The Key Element of a DHA: Your Dissertation or Doctoral Project
That individuality culminates in the dissertation or doctoral project phase. This phase of your degree is a scholarly research effort that takes the form of a written document that catalogs your original research in a complex healthcare issue, which you will then present to, and defend from, a dissertation committee.
Topics available for this project are virtually limitless, and are usually selected near the beginning of your program. You’ll spend most of your studies with at least some view toward supporting this project.
The differences between the top options are:
Not every program offers both options, but in both cases, you can expect to spend about one year of your program primarily focused almost entirely on this process.
The Cost of Earning a Doctor of Healthcare Administration Degree
Doctoral programs of any sort are not cheap. According to the National Center for Education Statistics, the average annual cost of graduate-level tuition and fees in American colleges has more than doubled between 2000 and 2018.
For a DHA, you can expect to lay down anywhere from $20,000 to around $60,000 in tuition for a complete program, with additional fees and charges for other university services.
Like other types of degrees, you will find a substantial difference in costs between private and public universities. With different cost structures and different organizational relationships, private universities tend to charge more per credit, but may also be perceived as more prestigious.
Many public universities will have different rates for in-states versus out-of-state students, which is particularly important to investigate if you are considering online programs, which can be taken from almost any location.
Executive and Senior Leadership Positions and Salaries Available with a DHA
Despite the high cost of earning a DHA, it doesn’t take much in the way of math skills to find that it’s well worth the time, money, and effort you will put into them. The high-level positions a DHA can unlock come with the highest salaries being paid out in the entire healthcare industry. You will find yourself qualified to step into jobs with titles like:
And you’ll find these positions in a wide variety of organizations in different specialty industries within healthcare. Leadership positions can be found in industries ranging from big pharma to insurers to multi-state healthcare and hospital organizations.
Salaries at the executive level in healthcare vary considerably based on industry, the size of the organization, and the experience you bring to the job. Top hospital executives who negotiate salary packages with major organizations and hit their performance targets regularly rake in millions in compensation. A 2019 article in Forbes found that among the 82 largest non-profit hospitals in the country, only 8 paid their top earner less than $1 million annually. The top of the range went to more than $20 million for one Arizona-based executive.
Of course, not every DHA graduate is going to have the good fortune or ambition to hit that level. According to 2019 data from the Bureau of Labor Statistics, the median annual wages for chief executives in the healthcare industry came to $166,410. And, of course, as the industry continues to expand, so does the need for management; BLS also forecasts that healthcare industry jobs overall will expand by 15 percent between 2019 and 2029, much faster than most occupations, adding 2.4 million people to the ranks, all of whom will need leadership and guidance.
That also ensures that salaries are rising across the board in healthcare executive ranks. As of 2017, according to Modern Healthcare, the annual pay hike for executives at the nine Chicago-area not-for-profit health systems they surveyed averaged 37 percent. And it’s quite likely that pay at for-profit organizations is even higher. Raises are often based on hitting annual and long-term strategic targets in finance, safety, quality, and patient outcomes… all of which are areas your DHA gives you the skills to improve upon.
Salaries vary considerably based on geography and on the size of the organization itself. According to Total Compensation Solutions Hospital Executive Compensation Report from 2019, for example, the average base salaries for top financial executives in healthcare looked like this:
And the same executives could expect an average base of between $602,700 at organizations with revenues over $1 billion annually, with the based scaled incrementally down to $215,100 for those managing organizations with revenues of $50 million of less.
In the executive ranks, not only is your compensation more likely to be based on performance, but it’s also likely to include a lot more than just your salary. Top executives bring home perks like stock options, bonuses, and other advanced benefit packages that increase the value of the position over and above the cash salary.
Resources for Executive Healthcare Administrators
No one gets to the top levels of healthcare administration on their own. You’ll be building a team along the way, some as mentors and guides, and some as reliable subordinates and resources. Networking is and remains an important part of working in healthcare at the senior executive level. And knowing where to turn for answers to common problems faced in the profession can be equally valuable.
There are many organizations and resources out there that can help you out along the way, some of them general to the profession and others very specific to certain specialties. Here are a few to get you started: