Category Archives: General
Today in one of my mentoring sessions we were looking at the use of Artificial Intelligence in the pharma industry. This in itself is a fascinating area to look at but equally fascinating was the discussion the topic generated – namely the changing dynamics of the healthcare industry and the pharmaceutical industry’s continued snail pace of change.
As we looked at some of the new players entering the market, such as AI startups like BenevolentAi or the big players like Google and Apple, we discussed how pharma is starting to miss increasingly large value opportunities in healthcare, which tech companies are seizing. Whilst currently much of the pharma industry still remains clearly in the domain of the pharma companies that may change in the future as the industry fails to adapt to changes being driven by technology.
Looking at AI & clinical trials for example – currently clinical trials are very clearly the domain for pharma because of the huge financial investments required but also because of the need for highly skilled and experienced people to work in this area. However as AI makes inroads, for example in molecule identification, what’s not to say that non-pharma companies might look at this area and bring in their technology expertise and just hire / poach the expertise they need to run the trials … or indeed just outsource to the CRO?
This article also gives the nice example that technology will increasingly play an important role in treatment and if tech companies find that the pharma industry is the bottle neck to their products what’s to prevent them just buying their own way in to the industry? Once this happens pharma could potentially face major issues as all of sudden their direct competition no longer comes from another slow, cumbersome pharma company but rather an agile, dynamic and fast moving tech company.
And this leads on to another factor that is also hindering the industry namely how cumbersome and slow the internal systems and structures are. Even when a pharma decides to partner with a start up (which is happening but IMHO not as much as it should be) often the clash between the two cultures proves a major obstacle to the success of the partnership. While a startup will expect to move quickly – and may need to move quickly due to limited funds – they then find themselves with a partner who may expect things to take years (by which time the startup has run out of funds / has lost key people / etc.).
Many people in pharma argue that due to regulations this is a totally different market and it is the regulatory environment that hampers speed I would push back on this. Time and time again regulatory constraints is bandied around as an excuse when it should not be. The length of time it takes for a pharma company to draft and sign off a contract or agreement with a startup for example has very little to do with the regulatory environment but rather with the internal systems and staff.
Another cultural aspect that differs between pharma and tech companies – and again which is only partially linked to the regulatory environment – is the right to fail. Traditionally pharma, like many other industries, will only launch or release something when it is perfect, which contrasts with the tech industry which focuses more on agility and adaption. Many tech companies will launch something as a beta version – so not final – but will then adapt it based on feedback and data. Whilst this approach may not be appropriate for the actual pharma products there are many other parts of the industry that would benefit from this approach.
So will we be losing our jobs to the likes of Google and Apple? Probably not in the near future but if pharma companies continue to only adapt at a snails pace it will become less of a philosophical debate and will move closer to reality. And what is certain is that as pharma tries to deal with increasing costs and prices pressures if they do not start to look at the full value picture of the healthcare industry they will lose out on potential new revenue and value sources – and there are plenty of non-pharma companies lining up to grab this value.
One of my main activities at the moment is supporting clients set up and run Reverse Mentoring programmes. As part of this one of the things I do is lead and support groups of Mentors, many of them digital natives, and part of this includes building and driving an online community for them. Today I thought of starting a Monday Motivation stream and as such I was looking for motivational quotes.
As you can probably imagine the internet is full of motivational quotes – but I actually found quite few were far from motivational. Many of them essentially were telling me to work hard if I want to succeed – not rocket science but I do not find being told I need to work hard that motivational either. For me the motivation is what is driving me to work hard – hard work in itself is not the motivation for me!
I also found some of them could also have a detrimental effect, particular on the younger digital native Mentors who are just starting their careers. Some of them imply that if you only work hard enough you will succeed and everything will be okay. From experience I know that sometimes no matter how hard you work at something it still fails. I also know that sometimes you simply cannot work that hard (for example due to ill health) – what do you then? Does that make you a failure?
I think far more helpful for my young mentors is to understand that working hard and trying is important but also to understand that if your heart is not in it, or if circumstances are unfavourable, you may not succeed … and that that is not the end of the world, as long as you can pick yourself up and move on. One of the most valuable lessons I have learnt is to accept that there are days, or bits of work, that just do not go well – and that I should not blame myself (well unless of course it really was my fault!). I learnt that sometimes it is okay to just sit back and take a breather. Sometimes it is okay to have a lazy day. Sometimes shit just happens – and you will need to find your own way to deal with this, whether it be taking a sofa day or hitting the gym or working harder. Dwelling on what went wrong to try to find the lesson to learn (because these quotes tell us to learn from the bad) sometimes is just not healthy or productive – sometimes we need to just accept, close the door and move on.
I also learnt that sometimes you just have to work through the bad – and that it will not get better no matter how hard you work at it so you have to find ways to motivate yourself through it. Hard work does not always lead to success but is part of life. You need to find your own personal, and ideally non-work related, thing to motivate you through the bad days, whether it be a holiday of a lifetime or that new dress you want. You also need to balance your motivators with big things (the holiday) as well as small short-term achievable things (such as the dress).
Finally working in reverse mentoring I think it is also important to understand that what drove success 10 years ago may not be the same thing that drives success today or that will drive success in 10 years time. The meaning of “working hard” and how we work has changed considerably, and will no doubt continue to change. In the past working hard might have a meant a 9-5 day working in an office but today it could mean more flexible schedules and working remotely. Today’s leaders will need to start leading differently to deal with the changing dynamics driven by technology and societal change. Whilst we need to learn from past and existing leaders, equally today’s leaders need to learn from the younger generations because that is where future success lies. That is what makes reverse mentoring such a valuable tool – and this is what motivates me to work hard in this space.
This morning I was reading about the difference in opinion between Apple’s Tim Cook and Facebook’s Mark Zuckerberg on whether AR or VR is the future. In my opinion they are both the future in their own different ways and for different audiences.
As an owner of a Samsung Gear VR I have to say that I think VR is pretty cool and can imagine it will only get cooler with newer technology. The opportunities for VR are huge, from gaming, to education to healthcare. I particular like the way VR is bringing hope and relief to patients, for example through sensory therapy for burns patients (the use of VR therapy during bandage changing saw a significant reduction in pain).
Currently though VR is still somewhat the domain of gamers and tech “geeks” like myself. With the advent of cheaper headsets this may change but will VR ever become a mass market concept? There I am not sure given the “isolationist” nature of VR – namely that you have a headset on which immerses you in the VR world but at the same time can “remove” you from the real world and real contacts. I am not sure I can imagine the masses sitting around in their own world with their headsets.
AR on the other hand exists in the “real” world, being simply augmented over reality. AR offers benefits in the same fields as VR, namely gaming, education and to a degree health too. However the lack of full immersion can also make AR less impactful that VR. What AR does offer however is the merging of technology and real world in a way that people can potentially enjoy together. AR is no longer a new technology though and we also have not seen it take off to follow the hype that surrounded AR a few years back. We also see AR still being used by individuals in their “own” worlds like the Pokemon gamers. This could of course change with new uses and versions of AR, and AR could become something used by the masses in their daily lives, either individually or in groups.
Both technologies offer great hope and opportunity but in my opinion both will always remain more for the young or tech savvy rather than technology for the masses. Both technologies have been surrounded by masses of hype that, to date, has not lived up to expectations. I suspect both these technologies will slowly become part of the norm in certain situations, such as in sensory therapy in hospitals, quietly and without great fanfare, while much of the hype will vanish or move onto the next new technology. But who knows ….
In December one of my main client contracts will come to an end and as such I have been slowly starting to think about what I will do next year. Much as I love living in Zurich it is a very expensive place to be based without a permanent job so I am toying with the idea of moving somewhere cheaper. Having also just had my heartbroken by a Swiss chap I am also less happy here than I was and contemplating a move.
Traditionally people would move based on where their job is and for many the first move abroad is the result of a job offer. This was true for me too – the first time I moved abroad as an adult was an office transfer from the McKinsey London office to their Zurich office. Since then I have become a veritable frequent mover and have lived in Switzerland 5 times, Spain twice, Denmark once and London twice. Most of the moves have been work related but not all, and not all by choice. Some would say I’ve had my fair share of bad luck with work – redundancy, the brand I was working on failing in PhIII, interview & reality not matching up, etc. – but I like to think of it as good luck. It is thanks to my luck that I have had this truly interesting career, with a breadth of highly relevant experience, with multiple organisations and in multiple countries.
It is thanks to this experience that I am also able to seriously consider not only what my next job will be but also seriously think about where I want to work. Unlike when I started my career, today, thanks to the blend of my experience, area of expertise and technology, I can contemplate moving anywhere in the world. I no longer need a fixed office or a permanent 9 – 5 job or even be based in the same country as my work / client. I can seriously consider becoming one of a growing number of digital nomads.
This freedom and flexibility is behind the growing number of people becoming digital nomads. Many of them are millennials not yet ready to settle down and wanting to travel the world but there is a growing number of seasoned professionals, like myself, who place increasing value on this freedom and flexibility. Whilst many of the jobs these digital nomads do are as developers or content creators, and not always particularly senior, times are changing. One of the roles I do for example, reverse mentoring, I can do extremely well remotely (in fact it is sometimes easier to share a screen remotely rather than squish around a physical screen in a room together) – all I need is good wifi. For other work that requires me to be face to face it is generally easy enough to hop on a flight. In fact it may even be cheaper for clients to have me working as a digital nomad, and pay for the long haul flight, simply because I can charge less per diem if I am based somewhere like Thailand as opposed to Switzerland.
Whilst being based near a beach does sound wonderfully rosy it is not without its drawbacks. I am actually quite a settled, homey person, and would never have chosen to move jobs or countries this often by choice. However this is the deck that I was dealt and I now also realise that life is short and that home is where you make it. It is also thanks to my autoimmune disease that I have learned to truly value my quality of life.
Whilst I do not see myself being an endless digital nomad at this point in my life I feel it may be a good move for me. I am still young and healthy enough to do this. There is still much of the world I want to explore and new skills I want to learn (like free-diving) but I do not have the resources, or inclination, to take a gap year and just travel. I would like to continue working but travel – the classic digital nomad. Who knows where I will end up – ideally with a permanent job somewhere near a beach 🙂 – but I feel ready for a new chapter in my life and a new journey. And so I am starting to explore my options as a digital native, and in the process replacing the hopes and dreams I had with my ex with new hopes and dreams, and in doing so help my heart heal.
My last post was all about the value of respecting your customers, particularly if you are an airline, and was based upon my terrible experience with Turkish Airlines. To complete that article I should add that my experience with Turkish Airlines continued to be bad including during the flight with some of the most inedible food I’ve ever attempted to eat, old airplanes with seats that did not recline properly and grumpy crew. My holiday itself however was awesome 🙂
As I looked back at this article though I thought it also worthwhile to add my opinion on respecting your customers in the pharmaceutical industry. For too long this industry has been very self-centered and not particularly focused on customers, especially patients (who I also include as customers). Of course the industry is “plagued” by regulation which has made it harder to be as customer centric per se as many other industries. We all know by now that the end of the blockbuster era and the patent cliff ushered in huge change and a shift in thinking for the industry but we are still not where we should be.
So why are we still not as customer centric as we could be? Regulation is often one of the first reasons bandied about for this … “we can’t talk directly to our patients” or “we can’t do that because of regulatory restrictions”. Very often this is however just an excuse. We can still be customer centric and comply with regulations. For starters many patients do not want to hear promotional messages about pharma products anyway so even if we could bombard them with product branded marketing this would still be pharma and not customer centric.
Even where we can do promotion for it to be most effective it should be targeted and try to provide some value to the customer. What is it that a physician needs or wants to hear about? If we develop content – promotional or not – with the customer in mind then we generally see far greater results than if we just stubbornly try to force our message down their throats.
Coming back to the regulatory side of things though I do also believe that it is time regulators also become more customer centric, particularly towards patients. Whist I do not support a US style DTC promotion I also believe that the pharma industry sits on a large swathe of data that would be highly valuable and beneficial to patients, and HCPs. Much of this data is never made available to patients – in part because of compliance but also in part because of the “fear” of regulation and legal action. Counter this with the number of misinformation that patients now have access to online I think there needs to be a change in thinking in how we communicate and share information online. I firmly believe that as an industry (both pharma & regulators) we have a duty of care to make sure that patients have access to accurate, reliable information. We need to drown out the misinformation, and make sure that the correct information is coming in at the top of Google searches, and not hidden away a few pages in.
A second issue is that whilst many patients may never want to know the data, or indeed even understand it, there is a growing number of active and educated patients that do want more information. The informed patient wants to have the data so that they can make their own decisions concerning their healthcare. The days when we as patients blindly trusted what our doctors told us are diminishing. As a patient who has experienced misinformation coming from a specialist, in my case an endocrinologist who told me that the symptoms form my un-managed Hashimoto’s were all in my head, I firmly believe in the movement of the informed patient and the need for patients to be more active in their healthcare. Had I relied on that endocrinologist, and not actively sought my own answers, I doubt I would be here now writing this post as I would probably have either been too depressed or died of heart complications due to over-medication in an attempt to reduce my symptoms.
I think it is high time that all those involved in the healthcare system start to respect patients as decision makers and work together to support the informed patient. How can we make all that data that pharma sits on, that may have no commercial value to the organisation btw, available in a digestible and understandable format for patients. Pharma often has the money and resources to turn the data into content and disseminate it but may not be allowed to – or may not have the incentive to. Much of that data may also have a public health benefit so one could also argue that pharma should not shoulder the burden of dissemination alone. Pharma companies at the end of the day are businesses and if they are not profitable they will go under and that also does not benefit patients.
There are many more questions but there also numerous answers. For starters pharma can start to work more closely with patient associations. Why is it that for many pharma companies the patient advocacy department, if there even is one, is only made up of one or two people?! Whilst we have huge brand teams focused on marketing to HCPs the number of headcount that is focused on patients is tiny by comparison. Pharma really needs to start ramping up in this area.
In turn though regulators may also need to re-assess that pharma patient partnership model. Not all diseases have a patient association but there may be online groups and individual patient experts. How was can facilitate partnerships here for the benefit of all parties? How can we all work together to find a model that supports patients, is compliant but also does not bankrupt pharma? I think the answer lies in the question … we need to all work together! We need to start talking more to patients, and include regulators in those discussions. We need to put patients firmly in the center of the equation, along with HCPs. We need to not only start listening more but also start being more active in driving the change needed to do this. Only then will we start to see an industry that is truly respecting its customers and meeting their needs.
This time of year is often a time of reflection. It is a time of thinking about what you really want for Christmas – what items go on that famous Christmas list. What are the things you would really love Santa to bring you – and being Santa you can wish for whatever you want.
This year there were some practical things on my list – including an electric blanket and a pasta making machine (both of which I got – yay!). There were also though some wishes and hopes on the list. I have one wish every year and that is for donations and miracles for the dogs in the Bucov shelter that I support through Hope for Romanian Strays. With now over 1500 stray dogs living in the shelter (with an original capacity for 700 dogs) and of those over 300 puppies, there is never enough funds to help them all. The authorities do not provide enough food for that many dogs so it is up to us, and our supporters, to provide the additional food and care to try to keep the dogs alive. There are constant medical and emergency cases, like newly born puppies or injured dogs dumped at the shelter gates – essentially being left there to die. My wish did partly come true as thanks to some generous supporters and fundraising the dogs did get a Christmas meal. This is of course a drop in the ocean but at least they did not go hungry on that special day.
My other Christmas wish this year relates to work. Having left ZS in March I have gone back to working as a freelance consultant, culminating in an extremely busy December. However with my contract coming to an end in January I am again looking for the next opportunity. Whilst I would love the stability of a permanent job, the reality is there are not that many permanent roles for someone with my level of expertise and seniority. I also have such a huge passion (and depth of experience) for my area of specialisation (healthcare digital and social media strategy) that I have no desire to even consider anything else (except perhaps animal rescue!). I do also love the flexibility that working as a freelance brings and so I am putting feelers out again for some more contract work. As always it is a balancing act between finding new opportunities and meeting the requirements for the current contract – and this is one of the down sides of freelance work. I will have to start looking for the next opportunity whilst working flat out on the current contract – and find time to rescue dogs and take care of my health and personal life. I’m tired already just thinking about it! And so I make my wish and I hope that one of my tweets or posts ends up fortuously in front of the right person at the right time and I end up with a new contract for 2016. Fingers crossed ….
Linked to the above wish is another work related wish – a new laptop in the shape of the new Mircosoft Surface Pro. Sadly this is not a wish that Santa was able to grant this Christmas because Microsoft decided that Europeans are second class citizens compared to the US and that we have to wait 6 months to get our hands on this new shiny gem. My wish will have to continue being a wish only until March when I hear the Surface Pro will finally go on sale in the UK. Annoying.
My final big Christmas wish of course has to be health related. If you follow my posts then you know I have an autoimmune disorder called Hashimoto’s. I think most patients with autoimmune disorders wish for improved (or at least stable) health. When I am happy and love what I am doing (and get plenty of sleep, eat well, etc.) I have no issues whatsoever with my condition. Sadly if I get over-stressed, sleep badly, or slip up on my food (e.g. eat something with Gluten in) I end up feeling pretty pants. Of course I plod on but there will always be a wish for that magic pill to come along and make life easier – or indeed cure my condition. That will stay a wish for a long time though as that is unlikely to happen! My other, more realistic, wish therefore is that more people are educated about the reality of autoimmune diseases, including doctors.
I got to spend my Christmas this year with my family, including my brother who is a GP. I was really saddened to hear that he had no idea the impact gluten (and diet in general) can have on patients with autoimmune diseases. I am not sure if he took my gluten free diet that seriously – I suspect like many doctors he felt that just taking my pills should be remedy enough. This makes me sad as I know the difference lifestyle makes on quality of life, and disease progression, for many patients with autoimmune diseases, but if doctors do not provide information or even support in this area then life just gets that bit harder. There really is nothing more frustrating that having your condition dismissed by your doctor – or indeed your online research either. Yes there is a large amount of incorrect and bad information online, but there is also a huge amount of life changing, accurate information out there. The fact that some of this comes from patients makes it no less valuable or accurate. Afterall how can a healthy doctor really understand what living with an autoimmune condition feels like and who are they to judge how we feel if we make lifestyle changes? And so I wish that more doctors listen to their autoimmune patients and try to understand their needs and conditions better. I wish more autoimmune patients had access to a great doctor like I do here in Switzerland.
If I could have my wish for a healthy 2016 and a new contract or opportunity to come true then I can also help make my first wish come true – I would be able to make a large donation to my charity and thereby rescue the lives of more vulnerable, neglected dogs in Romania. So should you hear of any opportunities (perm or contract) then do let me know … and you can do your bit to help my wishes come true!