June 26, 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.



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.




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.

Marriage Counseling: What to do When Only One Person Wants to Go

couple arguing pixabay

“Honey, we need to go to marriage counseling.”  Wince.  Grimace.  Silence.  Just hearing those words can make a spouse shut down and look for the nearest escape route.  Sometimes in my work with clients it becomes evident that marriage counseling could be helpful.  The challenge is usually not in the client acknowledging that the marriage needs help, but in getting help for both partners – together.

It is understandable why there is reluctance on behalf of one or both partners to go to counseling.  Getting help means that problems have to be faced and dealt with, and tough decisions may need to be made.  Some people do not see therapy as an option, and others have tried it with mixed results. Because it is not uncommon for one person to be interested in couples counseling, while the partner refuses to go, I decided to interview a marriage therapist for some recommendations.

Claire Miner, Ph.D., LPC, is a Gottman trained marriage counselor in Austin, Texas.  Dr. Miner believes that almost all couples can benefit from marriage counseling.  Even in the best marriages, couples have rough patches and good marriage counseling can provide guidance and constructive tools for maintaining and deepening a healthy relationship.  Unfortunately, the many demands of life, careers, raising kids, paying bills, etc., often take precedence over a couple tending to their marriage.

“On average, couples wait 7 years after they start experiencing problems before they seek counseling – and it can be a lot longer than that.”  says Miner.  “For some couples,” she continues, “by the time they get to me, it is too late to save the marriage.  “Sometimes people come in and just want their partner to be fixed.  I try to get them to defocus on their partner and more on their own behavior. “ states Dr. Miner.   When the emphasis is on having a good relationship over “being right” or winning an argument, couples stand a better chance of working through their differences, according to Miner.

Dr. Miner offered some indicators that a couple may need counseling:

  • When you start feeling prickly with each other
  • When you can’t let things slide off your back
  • When there are more negative than positive interactions
  • When you are feeling disconnected emotionally
  • When there is a lot of conflict
  • If you don’t “fight well” – you get gridlocked or the fights escalate.

In the scenario where one partner wants counseling and the other is refusing, Dr. Miner suggests that the person who wants to go find a couples therapist and go on their own. Through counseling, the person can learn to change her behavior and this will impact the partner.  She can also learn to cope with the things she can’t change in the relationship. Dr. Miner adds that the person going to therapy can “…be a role model and engage in different behaviors to show that something positive is coming out of the therapy.  You don’t want to nag your partner.  You can express that you would like your spouse to go and try the therapy at least once. “

Once the decision is made in favor of counseling, the next step is to find an experienced therapist.

Here are some suggestions for finding a therapist:

  • 1. Word of mouth – even though there may be reluctance to ask friends, or other trusted individuals,
  • they are often one of the best referral sources.
  • 2. Check with local counseling centers for referrals, such as a university counseling center or therapists who would refer to marriage counselors.
  • 3. Try the Psychology Today website for a partial list of  counselors by zip code.
  • 4. Have an introductory visit with several therapists to assess for rapport and compatibility.

And lastly, here are some books on the topic of relationships:

All You Need is Love and Other Lies About Marriage: A Proven Strategy to Make Your Marriage Work. By John W. Jacobs, M.D.

Why Mars and Venus Collide: Improving relationships by Understanding How Men and Women Cope Differently With Stress.  By John Gray   (also available in audio CD).

The Seven Principles for Making A Marriage Work:  A Practical Guide from the Country’s Foremost Relationship Expert.  By John Gottman. 

Our relationships can certainly challenge us in major ways. But at the end of the day, they are also what matters to us the most.




Meditation – More Than Just Sitting Around Doing Nothing!


meditation with words pixabay

10 years ago a friend gave me a CD that launched me in a wonderful new direction: Breathing: Mastering the Key to Self-Healing.  I was intrigued by the concept of how powerful the breath can be in changing our physical, mental and emotional states.  I started reading about how meditation uses the breath to focus the mind and wondered what this Eastern practice could do for a white girl from Jersey.  I bought some meditation books and wanted to have everything that this practice seemed to offer:

  • A quieter, less distracted mind
  • An ability to be more present with others
  • A more relaxed nervous system
  • The chance to actually hear my inner voice
  • Better health
  • And the many other benefits attributed to meditation (click here)

I loved reading these books.  And I secretly hoped that I could derive the benefits without actually having to meditate.  I didn’t have the time to sit on a cushion and do NOTHING!  Nor did I want to be alone with all of the mental clamoring.

So I read a few more books, and in the meantime I continued to have trouble sleeping at night, kept getting colds, and felt stressed most of the time.

Then I saw an article in the local paper featuring the various meditation programs in the area.  OK – no more excuses.

I chose a center close to work and showed up in exercise clothes for my first class.  The instructor gave some simple guidelines for using the breath to let go of distracting thoughts and told us that a successful meditation did not require clearing the mind of all thoughts (Phew!).  Success, we were told, is when you don’t get up and leave before the bell rings.  I have to say, despite the outward simplicity of meditation – I was after all just sitting there and breathing – the whole experience was utterly exhilarating.  In the 20 or so minutes of meditation,  the monkey never stopped bouncing around in my mind, but I could tell there was something very powerful to this process.   I had hope.

And I was hooked.  Since that time I have kept up a fairly regular mediation practice and have attended a number of meditation retreats.  I sleep better, have better health, and have much more choice about the thoughts that predominate in my mind.

For those wanting to try meditation, I recommend Sharon Salzberg’s new book, Real Happiness: The Power of Meditation:  A 28-Day Program. There are practical instructions as well as an accompanying CD with four guided meditations.

Here are some tips I offer to my clients:

  • You don’t need to find 20 minutes a day to get started.
  • Beginning with even 5 minutes twice a day has benefit!
  • More important than the duration of the meditation is the practice of taking a moment to slow down, to be aware of the breath, and reconnect with yourself.
  • Taking a few minutes in your car once you arrive at your destination is an easy way to find 5 minutes for meditating.
  • If meditation seems “far-out” to you, know that it is now being taught in a number of medical schools and is used by professional athletes as well as military personnel.

Please feel free to share any of your own suggestions for finding time to meditate or simply reconnect with the present moment.





Help for Burnout – Relationships are Key

stress hands pixabay

You know you’re a nerd when it’s Friday night and you just finished watching a DVD on physician burnout.

Yes, that’s me.  I’ll admit it.  And it’s not the only one of its kind in my DVD collection (not sure if I should be revealing this).

Lately in my blogs I have been writing about physician burnout; what it is, what causes it, research on spit and burnout, etc. Enough. One can get burned out on burnout.  Time to start talking about how to prevent the problem.

The DVD that consumed my Friday evening was,  “Resilient Physicians and Medical Organizations”, featuring psychologist and author, Wayne Sotile, PhD.

Dr. Sotile, who has helped thousands of physicians and their families cope with stress and burnout, reveals what he has found to be a key factor in reducing the risk of burnout:

Relationships – mutually enhancing, positive relationships.

Having a strong family support system, a close circle of friends, harmonious work relationships, and strong community ties, all contribute to an individual’s resiliency in the face of high work demands.

While this seems so obvious – naturally we are happier and more fulfilled when our relationships are strong, the catch is that when we under a lot of stress, our relationships tend to suffer and this can start a downward spiral.

When I reflect on my own career, the time when I was coping the least well with stress was also when my work and personal relationships were sub-optimal.

Knowing that strong, healthy relationships can be protective against burnout, provides an extra incentive to make this a priority in a one’s life.

So maintaining and nurturing strong relationships is key in preventing burnout.  What else helps?

Establish Priorities – take time to step back from your busy schedule and look at your life as a whole.  What is going well?  What do you want to change? What is the relationship between money and time? Ask yourself, “If nothing changes, how will I feel in 10 years?  What regrets would I have?”

Self-Care – I know to many this sounds self-indulgent and it’s not what we’re taught, but in order to keep giving to others, you have to replenish yourself.  How are you doing with regular exercize, sleep, eating healthy, and personal time?  Do you have your own physician?  Taking good care of yourself is not a luxury, but a necessity.  Here is a link for an upcoming renewal retreat for doctors through the Osler Symposia, May 14-20th.

Protect Your Time – Doctors often have a hard time saying “No.”  Your role is to help others and there is so much need out there, as well as social obligations.  When your time is requested, instead of immediately committing, you can pause to evaluate your priorities and see if this is a, “Yes! Yes!” as opposed to a, “Well, I suppose I can.”

Find Creative Outlets – after the steep learning curve of training, practice can become fairly routine.  Developing new interests or skills can help, such as taking an art or music class, teaching, writing, or participating in a medical mission.  A dermatologist I know started teaching a class on skin conditions in popular films, and found a wonderful way to add richness to his career.

Seek Out Emotional Support – Doctors traditionally keep their burdens to themselves, and practicing medicine can be emotionally traumatic. The benefits of being able to share one’s experience in a safe environment cannot be over-estimated.  Talking with a trusted spouse, friend, counselor or peer mentor can help.  Some cities have physician support groups, or you can start your own or join a confidential online group, through The Heart of Medicine.

Explore Work Options – Do you want to reduce your hours? Stop doing OB or surgery? Take on an administrative role? Get involved in the EHR initiative in your hospital?  If you are feeling stagnant, it may be worthwhile to consider redesigning your job.  What might breathe new life into your career?

Now, you maybe saying, “I’ve tried to go part-time and my organization says it’s not cost effective!” Or,  “Unless the system changes, no amount of touchy-feely unburdening or after hours hobbies is going to do me any good!”

I hear you.  Preventing burnout is going to take a village, and a significant part of that village is the healthcare system.

My next blog will be on the role of the healthcare system in helping to prevent burnout.