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Darla Moore School of Business

Ph.D. alumnus’ health care experience inspires his research on hospital, physician operations

Aug. 3, 2020

Moore School Ph.D. graduate Justin Kistler has spent the past five years studying how changes in the U.S. health care industry affect hospitals and physicians.

Graduating in May 2020, Kistler focused his Ph.D. in production and operations management. He previously worked in both manufacturing and health care services operations and said he has “always been fascinated by the processes underlying how businesses operate.”

“This interest motivated me to study for a Ph.D. in production and operations management in the hopes that I could research operations problems that, when answered, could be beneficial for operations practitioners,” Kistler said.

Kistler became interested in the management science behind the health care industry while working for a hospital management company and experiencing firsthand the operational changes required to comply with the Patient Protection and Affordable Care Act (ACA) in 2010. Motivated by this experience, Kistler decided to write his dissertation on factors that influence how hospitals and physicians adapt their operations to fulfill requirements by such legislation.

“My dissertation examines both hospital and physician responses to the ACA,” Kistler said. “For hospitals, I find that there are factors present in their operating environments that influence how they comply with policy changes occurring in their industry. If the goal of policy change is to improve the quality and productivity of health care outputs, particularly the health of patients, then I think it is critical to have a thorough understanding of how hospitals adapt.

“Oftentimes we presume that industry regulations will be followed universally by all organizations, but my research provides evidence that there are underlying operational factors that may impact how well policy achieves its goals. For example, state government support or opposition for the ACA and local competitor actions appear to influence hospital perceptions of the value of policy compliance.”

Kistler’s dissertation also provides empirical evidence that specific program components within the ACA are associated with increased opioid prescription rates among hospital-based physicians.

“That is, financially incentivizing hospitals – who often pass these incentives on to physicians – to focus on improving patient satisfaction has led to what I believe is an unintended increase in opioid prescribing, potentially contributing to the opioid epidemic in the U.S.,” he said.

The bottom line, Kistler explained, is that legislative and regulatory changes often drastically alter how companies conduct their business, potentially with unintended consequences. With a more comprehensive understanding of how these changes affect an industry, business scholars and practitioners can improve how they collaborate and interact within their industry.

Kistler decided to pursue his Ph.D. at the Moore School because of the academic rigor and scholarly support provided by the management science faculty. He said that he thinks this combination has prepared him for a successful career in academia.

“The design of the Moore School Ph.D. program has allowed me to tailor my coursework and skill development to my individual career goals,” Kistler said. “This has enabled me to become equipped with the technical skills necessary to thrive in an academic career.”

Also speaking to the camaraderie amongst faculty, staff and his fellow Ph.D. students, Kistler said that he is “incredibly fortunate” to be surrounded by people who are fully invested in his success.

Kistler has accepted a faculty position in the department of supply chain management at the University of Tennessee Haslam College of Business. He hopes to continue developing health care operations research and provide scholarly value to the school’s academic community.

“In the classroom, I want my students to view me as a valuable resource for their continued business development, contributing to a foundation of business knowledge that supports them in achieving their career aspirations,” Kistler said.

-Erin Mooney


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