May 23, 2017

Considering Pharma? Check out the DIA 2017!

pharma reseracherLast year was a big year for pharma at the Doctor’s Crossing. Four of my clients landed great jobs in pharma and I attended the inspiring world-renowned pharmaceutical conference – The DIA Global (DIA – Drug Information Association).

One of my four clients had no prior pharma experience and she is now working happily as a Drug Safety Officer for a large pharmaceutical company. She is proof that you can get into pharma without having experience in clinical trials or research. 

In my on-going efforts to learn more about pharma, scout for opportunities for clients, and get a better feel for the community, I attended the DIA’s annual conference in Philadelphia last year. I was one of 6,454 participants and I loved every minute. There was an electricity in the air which I attributed to being amongst so many bright individuals who are passionate about improving the health of patients in profound ways. Before I share specifics about the conference, I want to give you an idea of positions open to physicians in pharma.

  1. Drug Safety Officer  (Pharmacovigilance)– involved with reported side effects from drugs, labeling, SAE’s (serious adverse events). Can include involvement in preclinical studies. clinical trials and post-market stages. Public education.
  1. Medical Monitor – advises on clinical trials, planning, and implementation. Monitors patients enrolled in trials for safety, side effects and suitability for study enrollment and completion.
  1. Clinical Trial Researcher – participates in and oversees clinical trial design and implementation. Actively involved in running trials and design.
  1. Medical Affairs Director– bridge between drug development, marketing, and public education. Involved with medical information, communication, launch and post-market strategies.
  1. Medical Science Liaison –a knowledge expert in a therapeutic area, develops relationships with KOL’s (Key Opinion Leaders) externally, resource for physicians in practice; educational and communications role. Frequent travel.
  1. Medical Writer– prepares regulatory documents, slide decks, scientific articles, white papers, covers scientific and medical conferences, etc.
  1. Regulatory Affairs Director – knowledgeable about FDA regulations, prepares and submits regulatory documents, negotiates for market authorization for drugs and devices, keeps informed regarding legislative changes.
  1. Health Economics and Outcomes Researcher (HEOR) – concerned with the cost-effectiveness of drugs and devices, value, as well as the impact of treatments on patients.

 For a more complete description of these positions for physicians, please click HERE. (Note – the job opening links are no longer active).

Click HERE specifically for the Medial Science Liaison.

Sameer Thapar (PharmD), Director of Global Pharmacovigilance for Oracle, and one of the speakers at the DIA, shared a simple way to think about the complex array of jobs in pharma. He said, “There are the Makers, the Sellers, and the Defenders.”  The Medical Affairs and Medical Science Liaison positions help to bridge these three areas (my addition).

When considering a transition to pharma, you may wonder whether or not you would miss patient care and if you’d feel like you were making a difference in a meaningful way.

Dr. Kelly Curtis, my former client who now works remotely as a Medical Director and Medical Monitor for INC Research said this about his transition, “I find non-clinical work very rewarding and feel like I make more of an impact on the future of oncology in this role than when I was in academia.” 

I personally know a pediatrician who works remotely for pharma and he does a few pedi-urgent care shifts a month to keep his clinical connection to patients.  Although maintaining some degree of patient care while working in pharma is not the norm, some doctors find ways to do this through volunteering, medical trips abroad, or attending in a teaching setting.

The satisfaction from helping an individual patient can shift to helping entire populations of patients. Dr. Larry Brilliant, who gave the DIA 2016 Keynote address, recounted his fascinating involvement in eradicating smallpox and his on-going efforts to prevent and treat blindness in millions of individuals in developing countries. You can read about his amazing life’s work intertwined with his spiritual journey in his hard-to-put-down new book, Sometimes Brilliant

Here are some of the Hot Topics on tap for DIA 2017:

  • Data/Big Data/eHealth – informatics, data integration, bioethics
  • Disruptive Innovation – innovative science, technology and therapies: stem cells, regenerative therapies, gene therapies
  • Medical Affairs – MSL (medical science liaison), medical writing, medical affairs roles throughout product lifecycle
  • Patient Engagement – patient-centric practices, advocacy, culture, tools
  • Safety – best practices, post-market safety considerations, monitoring
  • Regulatory – advertising and promotional laws, regulatory writing, document management, compliance
  • Special Populations – Rare diseases, pediatrics, women’s health, aging
  • Preclinical and Clinical Development – discovery, clinical research, recruitment, clinical trial data disclosure, outcomes, statistics
  • Value and Access – drug pricing, reimbursement, access, real world outcomes

For additional information on the Hot Topics for DIA 2017 please click HERE.

For the Agenda for the DIA 2017 please click HERE.

I particularly enjoyed a panel presentation on “Big Data” with oncologist Dr. Brad Hirsch, CEO at SignalPath Research. Dr. Hirsch continues to see patients as well as work in pharma in the areas of informatics, innovation and gene-based therapies. You can tell he loves caring for his patients, and also being at the cutting edge of finding cures for the cancers that threaten their lives.

If you’re considering pharma, attending the DIA will give you a deep dive into this area, as well as the chance to make helpful networking connections. And your attendance would be an undeniable indication to any hiring authority of your genuine interest in this career direction. This is just one of a number of ways to increase your chances to land a pharma job.

Even though my time at the DIA was beyond busy, especially since I made a point to network at all of the exhibitor booths (pens anyone?), I left energized and uplifted. Call me pollyanna, but I felt that I was among a large group of people who really care about giving patients the chance for healthier and longer lives.  As physicians, and as individuals with loved ones, we know personally how devastating having an untreatable condition is, or having a poor quality of life due to illness. Pharmaceuticals are, of course, only part of the answer to good health, but when nothing else works, the right drug is truly a miracle.

The DIA 2017 will be in Chicago, June 18 – 22. 

 

 

 

 

 

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Using Your Internal GPS for Career Change

Is your internal GPS telling you it’s time to change your career direction? Is it saying “Recalculate! Recalculate!” but leaving you stranded at the crossroads, failing to provide any further instruction?

If so, it can feel overwhelming, daunting, and confusing.

 

give-me-a-map-woman-final

Uncertainty is uncomfortable. It’s natural to wish for some kind of roadmap to guide us through a process of change.

It makes sense that we feel this way. To become a physician, we had every step mapped out for us. Yes, it was quite a climb, but even Everest has a summit and there is one way up. If you don’t give up and make it to the top, you win. There is guaranteed employment, a career with status, and a paycheck.

 

stair-step-cartoon

 

There is a sense of security in such a well-trodden path where the finish line is visible before you even start. However, as our high physician burnout rates reveal, there is no guarantee of happiness. There is no certainty that the rules of engagement won’t change or that expectations will be met.

The shifting sand at the top of the seemingly sturdy staircase has left many considering other options. Instead of using the staircase that guided us, we now have to create our own path.

If we were wired like Lewis and Clark, we wouldn’t have gone into medicine. We’d be bushwhacking with Sacajawea by our side, discovering new lands – not practicing evidence based medicine.

But in spite of our predilections, we may find ourselves staring into a great expanse of non-clinical career terrain, wondering where even to take the first step?

Since we don’t have the prefab staircase outside of traditional practice, we have to use a different approach. Siri had the right idea. We need to use our internal GPS. We need to be able to listen to ourselves and hear our own guidance.

The connections may be a bit rusty if we’ve had to push down that inner voice in service of our career. It may take time to start hearing our true inner voice and what we need and want. When we start to listen, we might be confused by the presence of two voices, one coming from fear-based thinking (The False Self) and the other coming from trust-based thinking (The True Self). Here are some identifying characteristics to distinguish the two:

The False Self – fear-based and self-doubting

  • Sees problems rather than possibility
  • Jumps to the “What if’s” – what could go wrong
  • Is accompanied by anxiety
  • Sells your abilities short
  • Has to see all the steps before starting

The True Self – confident and trusting

  • Focuses on possibilities rather than problems
  • Is able to imagine success
  • Creates a sense of calm internally
  • Does not over or underestimate your abilities
  • Is comfortable taking steps without having all the answers

How do we turn up the volume on the True Self and mute the False self?

1. Start noticing anxious, fear-based thoughts. Write these down and note the frequency.
2. Look at the fears objectively and see if they make rational sense.
3. Take stock of all you have already accomplished and the challenges you have met.
4. Give yourself permission to accept whatever feelings you are having. Get curious about their origin, rather than judging them.
5. Practice mindfulness or meditation techniques to help quiet and train the mind so it is not so reactive.
6. Do things you enjoy and love. This will awaken the heart, which is part of the internal GPS
7. Believe in the value of your individual uniqueness. Embrace your path and don’t worry if it doesn’t look like anyone else’s.

Our Internal GPS = an awakened heart + rational, non fear-based thinking

To get started on your career transformation, you don’t need to enter a specific destination into your GPS. You can start with a commitment you make to yourself. It can be a simple statement such as:

“I want to enjoy my work.”

“I want my work to be fulfilling.”

“I want to have quality family time.”

“I want to make a difference in a way that is meaningful.”

“I want to use my creativity.”

“I want to use my brain more and be challenged.”

Your internal GPS will start to work on the initial steps, and as you gain more clarity, keep refining the destination. Staircase or no staircase, it’s OK to “recalculate” so you end up in the right place – for you.

Google’s Employee Perks – Could It Work For Healthcare?

Google Fridge

On a recent visit to California,  I was treated to an informal tour at Google. By the end of the tour, I was ready to sign on.  It wasn’t so much the work, but I wanted to enjoy all the employee perks.  I would start off dining at the cafe featuring local, organic produce in those trendy California-style dishes. Then, with a little time left on my lunch hour, I would toss my dirty clothes in one of the many washing machines, and hop on a colorful Google bike for a spin around campus.

My brother, an avid cyclist and Google employee, happily participates in the program where Google contributes to a charity of his choice for each day he self-powers himself to work.  I couldn’t believe all the other things my brother told me Google provides. I started getting Google-Envy.

Google Perks:  (Click here for a complete list)

  • Free Dining – 3 meals a day- with a variety of high quality cafeterias and cafes.
  • Free On -Site Laundromats.
  • Fitness Facilities
  • Medical and Dental Insurance
  • Coffee/Snack Bars so you’re never more than 150 feet from refreshment.
  • Employee Assistance Program with free short term counseling.
  • Haircuts on site for $20.
  • Oil Change and Car Wash Services available on-site for a charge.
  • Free Shuttle Service to and from work.
  • Sleeping Pods for napping.
  • Massage Voucher on your birthday.

It would be nice, but naive, to think that Google does this entirely out of the goodness of its Google -sized heart. Yet that doesn’t mean these amenities designed to maximize employee productivity don’t create some valuable goodwill and have other important benefits.

I’ve been thinking about this Google model and wondering what can be applied to Healthcare to counteract burnout and improve moral and patient care.  Granted, Hi-Tech and Healthcare are birds of a different feather, and can hardly be compared from a financial standpoint, but it’s worth having a look. If something isn’t done to improve the day-to-day satisfaction with medicine, more and more doctors are going to be Googling to find new careers.

If I let my imagination run wild, what would a Googlized Healthcare Organization look like in terms of employee perks?  Here’s one possibility with a wellness focus:

Mental Health/Wellness Services
Dedicated Physician and Staff Wellness Program
Assessments for Burnout, Risk for Substance Abuse, Depression, Suicide
Confidential Referrals for Counseling
Stress Management Seminars
Peer Mentoring/Coaching

Prevention/Education
Speakers, Workshops and Retreats on Wellness Topics
Monthly Newsletter
Lending Library

Additional Offerings
Healthy Dining Options
Exercise facility
Meditation and Mindfulness Classes
Confidential Discussion Groups
Yoga
Massage
Stress Reduction Room

This vision does NOT have the healthcare entity footing the bill for all these things.  Many of these services could be provided as a convenience for those who choose to pay for them.  For Google, it has proven worthwhile to have services such as haircuts made more convenient by having a mobile salon on-site.

If a healthcare organization makes physician and staff wellness a priority, the message received by employees is completely different than the, “We have to maximize profits and the bottom line.  Can you see a few more patients?” refrain.  And this is not to imply that the business model of maximizing profits is disregarded in any sense of the word.  Rather, it is an understanding that pro-actively helping physicians and staff to stay healthy and satisfied in their work will pay off through improved patient care, greater job retention, decreased malpractice and an enhanced work morale.

The need to help healthcare organizations better care for its own was not lost on the founders of Physician Wellness Services.  According to the website, they offer a “soup to nuts” array of services ranging from counseling referrals and interventions for disruptive physicians to concierge services for child-care and travel arrangement.

While concierge services can be nice, I would be thrilled to see some more mental health and wellness resources made available to healthcare providers, and an end to the stigma for using them.  Hair cuts and oil changes can wait.

Medicare Cuts Postponed!

Opposing Medicare Cuts, Ohio AFL-CIO

November 17th was “White Coat Wednesday“, as declared by the American Medical Association (AMA).

“White Coat Wednesday” was the day chosen by the AMA for physicians to contact their state representatives to ask them to stop the proposed 23% cuts in medicare payments.  Unless something was done, these cuts were slated to start December 1.

Thousands of calls were made, and the Senate tonight unanimously passed a bipartisan bill postponing the cut in Medicare reimbursement from December 1 to January 1.  Before the house adjourned, a bill was proposed that would extend the effective date of Medicare cuts until the beginning of 2012.

That is good news for now, but we obviously need more fundamental improvements to fix a broken system and boost declining physcian morale.

Today I have been reading, In Their Own Words: 12,000 Physicians Reveal Their Thoughts on Medical Practice, in which physicians express their frustration and disappointment regrading the current state of medicine.   This gem of a book, written by Phillip Miller of physician search firm Merritt Hawkins, and Lou Goodman and Tim Norbeck of The Physicians Foundation, came out of a large survey of physicians across the country. The survey gave doctors a chance to answer the question of how they feel about being physicians: What would they say if asked to speak directly to patients about medical practice in America today?  The chapter, “Doctor For A Day”, does an excellent job of giving the non-physician a realistic understanding of what it is like to be a doctor in todays’ world.  The authors let the physicians speak for themselves, providing ample statistics.  Many directly relate to Medicare cuts, as well as hundreds of direct quotes from physicians sharing their 2 cents.

A sampling of statistics:

82% of the physicians said that their practices would not be sustainable if Medicare reimbursement is cut.

38% of the physicians would stop seeing Medicare patients altogether or reduce the number of Medicare patients they see.

36% of physicians said that Medicare reimbursement is less than the cost of providing care.

78% believed there is a shortage of primary care physicians in the United States.

60% said they would not recommend medicine as a career to a young person.

A selection of direct quotes: (over 4, 000 physicians wrote comments on the survey)

“I believe most primary care physicians are at the breaking point.  There needs to be a grass roots effort to make everyone aware of this.”

“I put everything I have into treating my patients, but it’s too much work with too little in return.  I am about to lose my family for nothing.  My children have suffered because of time without their dad.”

“Can you imagine what would happen if your plumber handed you a bill for $60 and you replied, ‘I think I’ll just pay you $32?’ In no other profession are services paid for in such an arbitrary fashion. ”

“The current model is not working.  Primary care doctors are tired of the continuous pay cuts, reimbursement games, and endless paperwork.  As we spend less and less time with our patients because we have to fill out prior authorization forms for every third prescription we write, we become more distanced from the heart of it.  There will be a serious healthcare crisis in this country when we walk away. ”

And a simple plea,

“Help”

There was no lack of candid expression from the physicians who shared their thoughts in this survey.  However, it is often only through these types of surveys that doctor’s voices are heard.  Doctors are not usually the ones sounding the horn about their struggles.  Why the relative silence in the midst of significant challenges?  A number of reasons come to mind:

  • Doctors are too busy to do much else besides see patients and do paper work.
  • Doctors in general do not like to complain, even to each other.  It is seen as a sign of weakness.
  • Accustomed to working independently, doctors don’t tend to form their own action groups or unite.
  • Doctors expressing job dissatisfaction do not generally evoke sympathy from the public. There is a widespread perception that doctors are overpaid and have it easy compared to the rest of the working world.

Yes, it is true that being a physician has definite advantages, and many people are having a very hard time economically. However, the reality remains that if things do not change, there will continue to be a shortage of primary care physicians, with increasing numbers of physicians across the board leaving medicine prematurely. The sentiment among physicians I have spoken with is that the situation is going to get worse before it gets better.

Hopefully, that will not be the case.  But regardless, this is a good time to give consideration to one’s practice and see how the picture looks for the long haul, if improvements are slow in coming. What would make the biggest difference for you?  If you could change one thing, what would it be?