Category Archives: Blog

Change management in practice in Medical Information

Welcome to this week’s blog. I am excited to be off to the first in person DIA meeting I have been to since 2019. I am excited to see old friends and to make new ones. There is still time for you to sign up for the meeting. You can join us in person in Barcelona, or online. It’s a great opportunity to meet your peers, ask questions and to get involved. I have been on the programme committee for a long time now and this year’s meeting promises to be a really great one.

Topics for today’s blog are informed by the upcoming meeting.

Today’s blog topics:

– Change management in practice in Medical Information
– Innovating Medical Information – putting theory into practice
– Show and tell – secrets to engaging communication
– Secrets beyond the tech for selecting an IT systems service provider

Change Management in Practice in Medical Information

Introducing change is often challenging but it does not need to be. The foundation of a successful change management process comprises a compelling vision, cross-divisional stakeholder buy-in, transparent and frequent communication, realistic timelines and measurable outcomes.

While the basic principles are a given, how you approach change and implement successfully depends on additional factors such as the size of your company, how established your teams are, the number of individuals involved and the urgency of the change.

The COVID pandemic is a great example for how a crisis can facilitate change. Many leaders were sure that remote meetings were ineffective and that working from home would not work for their teams. Then, when there was no choice, companies had to make it work. And it worked. Luckily, most change programmes are initiated in order to generate opportunities for a company and not to react to a crisis. Absent a crisis knowing what tools you can use to make sure your change programme is a success is important.

If you want to hear more about this topic join me for a great session at the DIA Medical Information and Communications Conference on October 5th at 9am CET. I’ll be joined by my co-chair Monica Rojo-Abril, Grünenthal, Elena Molina, Amgen, Chedia Abdelkafi UCB, Elvar Eyjolfsson, Otsuka, together with Gergana Hristozova – Associated Director of Operations, Medical Communications, PPD, part of Thermo Fisher Scientific.

Our speakers will share their expertise and recommendations on managing and implementing change in the medical information arena. We will cover why changing how Medical Information Specialists are trained will transform the role of Medical Information in the future, how to run a change process, and how to work collaboratively with an external partner to outsource Medical Information provision.

Bring your questions, share your experience with us and support the session chairs to make the most of our brilliant speakers.

If you read this after the event, please reach out to me, Monica or our speakers, with any questions. If you want to discuss a change project in your company, I am always happy to discuss.

Innovating Medical Information – Putting Theory into Practice

My co-chair Peter Brodbin, Pfizer and I will be running this session on putting theory into practice. Covering the creation of an MI service from scratch to the progress of Infographics in MI. The session will cover some fascinating topics that are applicable to all of us and the way we are innovating our services.

We have 4 fantastic speakers: Andy Edward Mackay, MS, who will share key considerations in the genesis of a Medical Information Department, he joins us from Idorsia. Gaurav Kumar from UCB, who will share practical advice on implementing IT systems, do’s and don’ts, Celia Wilson, who will talk about infographics and Maria Delgado Catrain from Meisys, who will talk about The importance of the correct usage of Customer Relationship Management for Medical Inquiries traceability.

Join us on October 5th, 2022, from 11:15 – 12.30 CET. If you read this after the event, please reach out to me if you have any questions. I can put you in touch with the speakers, or answer any questions you have on innovating Medical Information across the board.

Show and Tell – Secrets to Engaging Communication

On a recent bicycle trip in France, I asked a pedestrian for directions. We ended up having a lovely conversation, at the end of which she asked me “Why is your French so good, do you speak it at home? Did you grow up speaking it?” I said “No, I lived in Paris for a year, and I speak it regularly, but it’s not a language I spoke at home”. She continued to marvel. It was gratifying. My French today is apparently passable. More importantly I feel comfortable speaking it, despite knowing it will never be perfect. However, back when I was at school I felt differently.

Once our French teacher gave us an assignment. We were to give a 20-minute presentation in French on a topic of our choice. After much consideration I came up with a plan, which would fit the assignment, but which would minimize actually speaking French.

My presentation focused on cake decorating. I brought all the ingredients with me. Then for twenty minutes I proceeded to hold up various pieces of equipment and ingredients saying, “Now you take this” accompanied by a demo of the action and the comment “To do this”. Between cutting the layers, assembling the cake, icing it and piping decorations I suspect I didn’t use more than a dozen words to give my presentation which was padded with lots of pointing. At the end of my presentation the class got to eat the cake.

This story came to me recently when thinking about effective communication and managing change across companies. If you can show what you are trying to achieve, if you can share your excitement for the project, if they can witness it as it takes shape when you talk design and if they know they will partake in the fruits of the project’s outcome, you are more likely to have supportive stakeholders.

Don’t only tell people that your project will be good for them, show them. And, before you start, make sure you know what key selling points for your project will be for them. You can use demos, do role play etc. Depending on the type of project you are thinking of there are many creative ways of showing what you want to do.

Secrets Beyond the Tech for Selecting an IT Systems Service Provider

Last week I took part in a meeting with IT service providers. Together with my fellow board members for the charity the Virtual Doctors, we chatted with various potential partners from around the world. We met a stellar group of potential partners. I have been involved in RFPs for many years but I have rarely experienced such an inspiring day of presentations. Selecting an IT systems service partner is not easy. Obviously, the system itself needs to be fit for purpose, but in order to ensure a good fit, you need to go beyond the tech.

Here are things I’d recommend you consider when making your selection:

  • Experience, reputation and longevity of your potential partner in your field
  • Size relative to your company’s size
  • Client base: if the provider works mainly with huge corporations and your project is small you may not be a priority for them
  • Key employee turnover, which will tell you whether the person you are doing business with is likely to be around for the length of the project

Last but not least, do they speak your language, not necessarily literally, but in general. Is the chemistry between you good? Working on IT projects can be challenging, working with a service provider who understands your needs, will make it so much easier. If you are considering selecting a service provider for IT projects and need support on any aspect of the selection, I’d be happy to share other critical success factors, I’d recommend you consider, with you.

I hope my blog provides you with some useful insights and, as ever, I look forward to hearing your thoughts. And if you have a challenging project or would like to discuss coaching to help you achieve that next level, please reach out for an informal chat.

Very best wishes

Isabelle C. Widmer

Photo by Bankim Desai on Unsplash

What great leaders and the Queen have in common

In the past week thousands queued in line waiting to pay their respects to Queen Elizabeth II’s coffin as it lay in state. Today a nation bids farewell as the state funeral for Queen Elizabeth II, Britain’s longest-reigning monarch is held in London. Queen Elizabeth II reigned for 70 years. Reflecting with a British friend on why republicans and royalists alike revered her, and what it is about her that inspired almost a million people to queue to pay their respects, lays the foundation for today’s blog.

Today’s topics:

– What great leaders and the Queen have in common
– Improve your job satisfaction – a self-coaching exercise
– Interpreting and integrating feedback at work
– Perception is reality – or is it?

What Great Leaders and the Queen have in Common

In a recent discussion with a British friend, I expressed my fascination that almost a million people had queued to see the Queen’s coffin lying in state. The fact that a whole nation and many beyond Britain’s borders felt such a strong connection to someone who they had never met. We reflected on what had made her so popular. The list we came up with included the following:

  • Dedicated to her role
  • Carefully curated public persona
  • Professional – absolute control of herself in public
  • Scandal-free
  • Gracious in all interactions
  • Longevity in role – she and her title were one

As we discussed this, my friend, who trains young teachers, told me she starts her first class with her students with this question “What did you really like about school and what did you hate, what did your worst teachers do and what did your best teachers do?” Once the students have answered this question, she says “Now tell me what type of teacher you want to be.”

My friend said that invariably the most popular teachers had common traits. Students said they most appreciated teachers who:

  • Were consistent and calm
  • Didn’t lose their tempers
  • Didn’t make public judgements
  • Were able to rise above situations

Consistently students said the teachers they liked best were those who stayed in their role, who didn’t confide in their students, who kept their public and private personas separate. Much like the Queen.

This is an exercise that is worth doing, whatever job you are in. So, now I ask you: “What did your best managers do? What did your worst managers do?” And even more importantly “What type of leader are you at the moment? And what type of leader do you want to be?”

Please share your responses with me; I am very interested to know what your thoughts are on this.

Improve Your job Satisfaction – A Self-Coaching Exercise

Most people I coach, most teams I work with, work in science related fields. Asked about themselves, their jobs, their work and home lives, they have nice, consistent logical responses, which have been shaped over a lifetime.

For this reason, I like to take questions away from the cerebral. I ask coachees to draw for me. As an example, a coachee once told me that her job is complex, and that most of the people she works with are not clear on what it is she actually does.

I asked her to draw me a picture. The drawing she made had many different teams, company departments, geographical areas, senior leadership teams etc. all connected with lines. The image ended up looking like a spider’s web of interdependencies. Hard for my coachee to keep track of, hard for me to understand. Her drawing illustrated why her business colleagues found it hard to understand her role.

Another example is from a conference I attended where we each drew our current work roles.

One image was so powerful it has stayed with me. A young professional in her early thirties had achieved rapid progression in her organisation. Telling us about it, she seemed astonished by her achievements. In her drawing she depicted herself sitting on a tree branch, high above the ground. It was clear that she had scaled the tree. The tree she had drawn had only a single branch, which was very high up, and no roots. A single huge thundercloud, in an otherwise clear sky, emanated bolts of lightning snaking down towards the branch she was seated on.

The way the tree was drawn, the absence of an easy ascent, the absence of roots, the threat of the branch being struck by lightning, this young professional was able to communicate her struggle in an image in a way she would never have been able to in words.

While ideally I would recommend doing this exercise with an executive coach, you can also benefit from doing it alone, and assessing it with your partner, a trusted co-worker or a friend. If you want to try this exercise yourself, here is how you would go about it:

Think about the different aspects of your job, the teams you work with, the roles you play, the people you report to. Draw yourself in your role. Draw a figure representing you in each role you play. There is no right or wrong way to draw this. Follow your instincts. Use colour, shading, add as much detail as you want but try to avoid using text. Use your imagination. Ideally do another drawing for your home life.

Remember you are your most important instrument. Understanding yourself, how you show up, why you show up the way you do, and knowing how to get the best out of yourself, while staying true to who you are, is I believe the key to happiness in all areas of life. Many people invest in holidays, training courses, new cars, new experiences, in the hope that these will enhance their life, instead of investing in the one area that will definitely enhance their lives, in themselves.

If you do this exercise, I would love to see your drawing. I will take 15 minutes to discuss these drawings with each of the first 10 people who send me a photograph of their drawing!

Interpreting and Integrating Feedback at Work

Years ago, I went from a customer facing role to an internal role working with internal teams. A commercial colleague came into my office and said to me “Congratulations, you must be so thrilled to no longer be working with customers”. I was taken aback, imagining that his perception of me, was that I disliked working with our clients. Before reacting, I remembered something a coach once said to me “People’s feedback often tells you more about them, than it does about you”. I asked my colleague “How about you, do you enjoy working with clients?” He looked at me aghast and said “No, truly dislike it, the longer I have been doing it, the more I dislike it. I am envious of you being able to change your role.”

Key insights from this interaction for me, remain, to this day; 1) you never know what someone else is thinking, it is best not to try to guess 2) people’s comments about you often tell you more about them than they do about you.

Feedback is always somebody’s perception, a snapshot of a moment in time. You are not somebody else’s feedback. It is worth taking things on board, considering whether you have been told the same thing more than once by different people, and whether you also recognize yourself in the information you are being given. At that point you can take the decision to integrate the feedback and to adapt how you engage for example – or not.

Perception is Reality – or is it?

At work we usually remain in one function for a longer period of time, so it is sometimes not easy to see a project we are championing from someone else’s perspective. When we are static, it is very easy to get wedded to a certain view of the world.

As many of you know I enjoy spending time on my bicycle. On a recent weekend I was slightly annoyed by the cars who blocked my path and the pedestrians who threw themselves in front of my bicycle without looking left nor right.

Later that day I was in my car, and amused myself, by discovering how irritated I was by the bicycles, who didn’t seem to care about any road signs, and the pedestrians, who threw themselves in front of my car with an apparent death wish and no zebra crossing in sight.

Later again, I was crossing the road with a friend, who is not very mobile. We picked a spot with no zebra crossing, as the closest one was a long walk for someone with mobility issues. Again, I found myself impatient with automobile drivers, who wouldn’t let us cross.

Depending on whether I was on a bicycle, in a car, or accompanying a pedestrian with mobility issues my assessment of a situation was dramatically different.

One individual, three comparable situations, three disparate perceptions. A great reminder of how a project is likely to be assessed very differently by different stakeholders in a company.

Worth reflecting on when you are presenting your next project.

I hope my blog provides you with some useful insights and, as ever, I look forward to hearing your thoughts. And if you have a challenging project or would like to discuss coaching to help you achieve that next level, please reach out for an informal chat.

Very best wishes

Isabelle C. Widmer

Photo by Ella Ivanescu on Unsplash

How to lead in times of crisis, remote working

One of the only constants in life is change. One of the good changes is that physical meetings are back. In a month I hope to see many of you at this year’s DIA Medical Information and Communications conference in Barcelona where I will be co-chairing the opening sessions on change management in practice and innovating medical information.

Today’s newsletter topics:
– Change management learnings from how governments handle COVID and the energy crisis
– Why remote working is here to stay
– How to lead in times of crisis
– The innovation challenge

Change Management Learnings from how Governments Handle COVID and the Energy Crisis

Although we know that everything changes, the seasons, our life stages, the political landscape etc., we tend to stick with what we know. What is known feels safe. Even if it is not. Consequently, individuals managing change programs are often challenged with the sentence, “We have been doing it this way for years, and it has worked”. My response to this used to be, “We used to use a horse and cart, we used to wash clothes by hand etc. but none of us want to go back to the old way of doing things”. Perhaps in the face of the energy crisis in Europe I will need to re-evaluate this opinion.

Since 2020 we have been exposed to many changes that we have had no control over. How we interact socially, where we work, whether we can leave our homes to exercise, access restaurants etc. Just as we had grown accustomed to the ever-shifting landscape of COVID management strategies we are exposed to new changes. News coverage of COVID infection rates has been replaced by stories on global warming, and recommendations on how to reduce energy consumption and stay warm.

According to the newspaper, the NZZ on Sunday, Simonetta Sommaruga, the Head of the Swiss Federal Department of Transport, Communications and Energy recommends wearing woollen socks to bed, stocking up on jumpers and spending time cuddling your loved ones. Perhaps with time, the clock will be turned back further, and we will start sharing our living space with livestock as we once did.

For me there are three major insights for change leaders from how governments managed the pandemic and are now managing the energy crisis.

Insight 1: Strive for one truth: During the pandemic, political considerations influenced government pandemic guidelines more than science did. Consequently, there were multiple truths. Multiple truths lead to confusion and highlight a lack of leadership.

This leads to my first insight: Consistent messaging and clarity of objective is key for transformation programme success. When you are running a change programme, ensure you have a clear business objective that is driving the goals of the programme globally. Communicate this consistently to all stakeholders.

Insight 2; Call a spade a spade: During the pandemic it would have been relatively simple to apply a rigorous scientific framework to help understand the virus. This was not done. Again, this led to mistrust and the perception that the absence of a rigorous scientific framework was positive proof that governments were trying to hide relevant data regarding the benefit/risk of mRNA vaccinations. I believe that the reason data was not collected was, sadly, a result of a lack of coordination, forward thinking, and competent planning, not a result of stealth. As the necessity to prospectively collect data is obvious to anyone who is medically or scientifically trained, I don’t however, believe governments can be pardoned for this failing.

This leads to my second insight: Don’t whitewash. Sometimes things go wrong. Sometimes critical opportunities are missed. Perhaps the environment changed, perhaps something critical was not factored in, either way, be transparent when things go wrong. A key performance indicator for large transformation efforts is the trust teams place in the leaders. If there is no trust projects tend to fail.

Insight 3: Envision multiple scenarios and have back-up plans: Like most European countries, Switzerland generates some of the energy it needs and imports the rest. A number of years ago the decision was taken to phase out nuclear power and to replace it with renewable energy sources, while continuing to import energy, mainly from France and as a result, mainly nuclear. Considering the political stability in Europe in the last decades this seemed reasonable. However, the war in the Ukraine and the sanctions against Russia linked to that war, means energy is suddenly scarce. The Swiss government’s B plan is to recommend we reduce the energy we consume, wear warm socks and cuddle more.

This leads to my third insight: Plan ahead using the data you have, envision multiple potential scenarios, have B plans in place for all of them, that way, if the environment you are in changes, you have more to offer than the recommendation to wear woolly socks.

In addition, whether living through changes imposed upon us during a pandemic or managing the anxiety that accompanies reorganisations at work, the Chinese proverb, “When the wind blows, some build walls, while others build windmills” serves well. Fighting change is much harder than finding a way to benefit from it, to live with it, to grow in it.

I’ll be exploring change management in more depth at the upcoming DIA Medical Information and Communications meeting in Barcelona, where I will be co-chairing a session on the practice of change management with Monica Rojo-Abril, Medical Information Officer at Grünenthal. I hope to see you there.

Why Remote Working is Here to Stay

The pandemic taught us how much is possible when we have no choice. Years ago, I remember finding a memo that had been printed out, I assume, on the wrong printer. The memo said, “We absolutely cannot let our staff work from home, because we won’t be able to ensure they are doing any work”. The pandemic demonstrated that this was wrong. We used to think that conferences and meetings could not effectively be held remotely. During the pandemic we learned that this was wrong too. While companies are trying to get employees back into the office, I suspect that as prices for electricity and fuel increase dramatically, countries ration energy use and the rising cost of living impacts many people, companies will need to continue to support remote working.

How to Lead in Times of Crisis

According to an article on forbes.com there are some key guidelines to being effective as a leader during a crisis. I summarize the key points below, with some considerations added:

  1. Think first: take the time to reflect on a position before providing direction.
  2. Collaborate with your teams to identify different options: the more minds you apply to a problem, the better your solution will be.
  3. Act decisively: discuss all options, but remember you are accountable for the decisions you take. When you have decided on the course of action, share the decision with your teams and act rapidly.
  4. Remain positive without sugar-coating – be honest, be frank. Talk about what you can do, not what has been lost. Communicate that you are confident you will weather the storm together.
  5. Be humble and courageous: Crisis situations, as witnessed during the pandemic, require fast decisions, based on the data that is available to you at the time. When you make a mistake, own it, ideally before everyone has heard about it. Compromise on plans not principles.

You can read the full article here

The Innovation Challenge

Real innovation is hard. Many years ago, I was working on a research project. As we wrote the publication and submitted it for review, my manager said “Isabelle, nobody has ever published on this before, what happens if we are wrong?”. I answered, “That’s the whole point of research, you do the experiments in triplicate, you check your data, and then you put it out into the world for others to build on, or to refute”. I was excited because I had discovered something new and potentially ground-breaking, and I couldn’t wait to find out whether or not I was right. My manager was mainly concerned that he might look foolish.

Innovation is much easier to achieve when:

  • you have little to lose;
  • you are in a flexible environment;
  • business is going well; and
  • the political environment is stable.

With true innovation, I mean radically doing things differently to how they have been done in the past.

The pharmaceutical industry is not famous for rapidly adopting new solutions to old problems, even when those new solutions make a lot of sense. I am thinking about structured data bases across an entire company as an example here.

Given that fostering innovative research is hard in huge global pharma companies, pharma giants in recent years have started to expand their portfolio by purchasing innovative start-ups, or by separating out their R&D unit to perform early-stage research with limited influence from the commercial business on early R&D decisions.

In the current environment I think it is realistic to expect more barriers to innovation, as budgets are restricted, workforces are reorganized and companies stick to the tried and true in an effort to defend rather than to expand. However, just because something is hard, doesn’t mean it cannot be done. How you pitch your innovative project is key, especially now.

I’ll be discussing how to innovate medical information at the DIA meeting in Barcelona., where I will co-chair a session with Peter Brodbin, Director of Medical Information Effectiveness, Pfizer. You can find the meeting agenda here.

I hope my blog provides you with some useful insights and, as ever, I look forward to hearing your thoughts. And if you have a challenging project or would like to discuss coaching to help you achieve that next level, please reach out for an informal chat.

Very best wishes

Isabelle C. Widmer

Photo by Ella Ivanescu on Unsplash

Why to do now What your Career Needs Next, how to Rethink your Approach to Talent Management

My past weeks have been filled with visits to the Intensive Care Unit. I have spent a lot of time with my family. Everything is changed and somehow the world doesn’t feel real. There is beauty and sadness. It is as though for a moment time is standing still.

Today’s newsletter topics:

– Rethinking your talent pool – new challenges demand novel solutions
– How to ensure project success – key tools – RACI
– Doing now what your career needs next
– Adapting to thrive in new environments

Rethinking Your Talent Pool – New Challenges Demand Novel Solutions

The average life expectancy in developed countries is 76 for men and 82 for women. Thanks to modern medicine and healthy lifestyles many older individuals are still both willing and able to contribute to society in many different roles. However, as life expectancy and health in old age increase, companies increasingly send their older employees into early retirement while lamenting the absence of available talent to fill open positions.

Lamenting the fact that old models are no longer fit for purpose doesn’t solve the problem companies face. In fact, I would like to offer the hypothesis that the old models, populated as were historically with individuals representing a very limited segment of the global population, were never fit for purpose.

Simone De Beauvoir wrote in her book, The Second Sex, paraphrased again: “How can a woman prepare children to perform in a world in which she herself has no role to play beyond the bounds of her home”. To paraphrase for industry “how can companies with homogenous leadership develop, market and sell products to effectively target a heterogenous market?”. History shows us that obviously this is possible. However, might these companies do even better if the leadership was more diverse? The answer to this question is known.

When old solutions no longer address new problems, pragmatism dictates new approaches are needed. There may be a lack of the type of talent companies used to hire. However, there is not an overall lack of talent. Data from the Swiss market shows that finding a job in your fifties is almost impossible. However, older employees bring with them experience and knowledge of an industry and how that industry has developed. Experienced leaders with mature personalities may also be exactly what you need to help develop your next group of leaders.

In the words of a friend of mine in his sixties, “I have built markets, been responsible for huge teams, and accountable for million-dollar budgets, I don’t have anything left to prove. What I want to do now is support the next generation and help them develop their talents”.

A global insurance provider has recognized this. The company offers senior leaders the opportunity to resign in stages, to work well beyond the official retirement age. In this way the company ensures process continuity and the transfer of knowledge.

How to Ensure Project Success – Key Tools – RACI

I recently published an article on how to run panel discussions. This was well received, making me decide to publish more how to articles. Project success depends on communication, but also on being very clear on roles and responsibilities. Many projects fail because the focus is on getting stuck in, getting things done, not planning for success at the beginning.

At the start of any project consider doing a RACI matrix.

After you have defined the scope of your project, identify which functions will be impacted by the project, this includes any individuals who have the power to support or derail your project. RACI stands for Responsible, Accountable, Consult, Inform. For each project activity, list whether an individual is responsible, accountable or needs to be consulted or informed. For each activity, pick only one option. Once you have listed stakeholders and their roles, decide how you will keep them engaged in your project. For big projects, consider implementing a project structure that includes working groups, steering committee groups etc., and plan regular meetings with these groups.

Many projects have been derailed because key stakeholders were not engaged early on in the process, don’t let this be you.

Doing Now What Your Career Needs Next

Enjoying what you do is wonderful but knowing where you are going is key.

It is all too easy to get lost in daily business. You might be saying to yourself “I have so much work to do, I don’t have time to take training courses”. However, sometimes less is more. Above all, you are your most important resource. Your company may restructure, you might find yourself looking for a new role, knowing what you enjoy and where you want to go with your career is, therefore, more important than ever. Things to consider as you plan your career:

Do’s:

  • Team structure: Do I enjoy working as an individual contributor or would I like to manage a team?
  • Management: What aspects of managing a team would I enjoy, which might I struggle with?
  • Key Drivers: What activities do I enjoy in my work? Which activities do I enjoy less?
  • Career Track: Is the job I am doing now the one I want to do for the next five years, if not what other jobs in the organisation might be interesting for me?
  • People and culture: do I enjoy working internationally or locally?
  • Company size: Small, medium sized or giant. Where am I happiest?

Take training courses in line with your interests. Interview others in your company that are in roles you find interesting and find out how they got into their roles. If you are at a crossroads in your career, considering your next step, or at the beginning of your journey and considering joining a pharmaceutical company, I’d be happy to have an informal chat with you to discuss if coaching might be right for you at this time.

Adapting to Thrive in New Environments

Global warming is now a reality we can experience day by day wherever we live on the globe. Many species face extinction due to climate change. Species that will be able to survive are those that will be able to adapt to a new environment. A recent article in the Scientific American hypothesises that some species will survive climate change due to the way they have incorporated genes from other species in their genome.

From the article “Hybridization gives species a way to quickly swap their best genes as if they were like trading cards. Rather than being detrimental, liaisons between two species serve as a mechanism for rapid genetic upgrades and might set up advantageous events for many kinds of animals and plants. So, while many or even most individual interspecific hybrids might not always be reproductively successful, genomics clearly indicates hybrids are sometimes, or even frequently, able to find a partner and reproduce, eventually blending their novel combination of genes with one of the parent lineages.”

In recent years, companies restructure and reorganize at an alarming rate. The Scientific American article made me think about the types of individuals who will be successful in the new organizations.

Working hard and being productive is not, unfortunately, a predictor of longevity in organizations. Working hard and being productive, as well as understanding senior leaders and ideally cultivating relationships with these leaders, however, definitely is predictive of longevity in organizations.

So, while animals incorporate genes from other species in order to survive in hostile environments, humans in the ever-changing world of business, could do worse than to have an in depth understanding of what drives their management team, thus being able to speak to these key drivers, and showing flexibility to a changing world. That said, this approach only works if you can stay true to yourself at the same time.

I hope my blog provides you with some useful insights and, as ever, I look forward to hearing your thoughts. And if you have a challenging project or would like to discuss coaching to help you achieve that next level, please reach out for an informal chat.

Very best wishes

Isabelle C. Widmer

Photo by Philipp Torres on Unsplash

Key Tips for Effective Panel Discussions, Codes, Regulations and Compliance

I hope you have had a wonderful summer holiday and are getting ready to head back to the office full of energy!

To help you get started, today’s topics are all practical:

– How not to fail at anything in biotech & pharma
– Key tips for effective panel discussions
– Global, regional, local regulations, codes and compliance
– How to demonstrate integrity

How not to Fail at Anything in Biotech & Pharma

Success is elusive for large and small pharmaceutical companies. While the challenges big and small players face are similar, start-ups have no pipeline to cross-fund failures and are often dependent on one key investor. I sometimes mentor biotech start-ups and I recently presented and managed a panel discussion on the topic “Why biotech start-ups fail.”

Start-ups attract investors by having an excellent idea or product, for which there is a market. The product needs the support of a good team and a realistic strategic roadmap to get the product to the market.

Start-ups often fail due to flawed financial strategy, inexperienced management, lack of requisite skill sets (clinical trial planning, biostatistics, knowledge of regulatory requirements etc.) and bad timing. In my experience, projects in pharma companies fail for similar reasons. Investors invest because they see a huge upside potential to their investment. Senior leaders invest in projects that will lead to a competitive advantage, reduce costs, or reduce risk.

Start-ups often fail because they lack the experience and expertise in house to be successful, and they don’t know enough about the gaps they have, in order to be able to identify the skill set they need to bring in to support them.

Projects in pharma often get delayed because teams rooting for them struggle to communicate the benefit to the business in a way senior leaders understand. When projects do secure funding, it is sometimes hard to deliver, because teams are under resourced or inexperienced. A friend of mine once said, “You don’t learn how to fly a plane by reading an instruction manual, you learn from an experienced instructor.” In other words, it’s not possible to compensate inexperience with intelligence, success depends on both. In order to succeed, it helps to be humble, to accept you cannot know everything and to bring in experts from within your business, or from outside to help you succeed.

Key Tips for Effective Panel Discussions

As a moderator, a key skill is the ability to tease out topics that will interest the audience, summarise different opinions and share key output. Obviously, it helps if you know the topic well. Recently a friend asked me to teach her how to run engaging panel discussions.

Having run many panel discussions over the years I am happy to share the tips I shared with her with you too.

Do’s:

  • First, know your audience. What do they want to know, what are their pain points? Ask registered attendees before the meeting.
  • Second, choose your panellists, aim for diversity: backgrounds, opinions, age, gender, race, geographical location and personalities.
  • Third, have some questions prepared, ask your panellists what they would like to talk about. Weave in questions from the audience.
  • Fourth, engage the audience. Use polls if you are running an online panel. Engage the audience directly if you are in a room with them.
  • Fifth, summarise key points, tell the audience who to go to with further questions after the event.

Be open to spontaneous interjections, follow-on thoughts, and manage the discussion with a light hand. If it suits your personality, inject humour into the conversation.

Things to avoid include: 1) not asking each panellist to answer the same question, this becomes very boring for the audience, it’s an interrogation not a discussion and 2) not asking the audience to provide you with questions and then to not ask your panellists a single one, this is a mortal sin.

Remember you are there for the audience! If you follow the above suggestions, you cannot go far wrong. If you need an experienced moderator to help you run a panel discussion, I’m also always happy to help.

Global, Regional, Local Regulations, Codes and Compliance

Many of my customers work in global roles, some also manage marketing material compliance and face push-back from affiliates regarding what is permitted locally and what is not. Ever since researching European codes and regulations for a book a few years ago and training teams on compliance and promotional review, I have found this topic fascinating.

There are too many aspects to cover here, however, it’s an important topic, so instead of a summary of key points, I am sharing some questions for you to reflect on.

Did you know that in some countries you can use real patients in your materials but in others you need to use actors? Are you aware that some legislators consider the depiction of smiling patients in advertising materials misleading? Did you know that what constitutes evidence to support your scientific claims is not necessarily identical in every country? Have you ever thought about when you can start advertising a product, is it A) following regulatory approval? B) following regulatory approval and reimbursement? What about linguistic requirements e.g., when can you share materials in English, when does it have to be in local language?

Food for thought.

Naturally, I could have just asked you whether you know the answer to this question:
“Are you permitted to give HCP participants to an educational event run by your company a wine bottle as a parting gift?” but that would be too easy!

Key take-away: understanding the legal requirements to do business in different geographical locations is truly as complicated as we always thought it was.

How to Demonstrate Integrity

A research team spent years working on a project. Finally, the results were published. However, after publication, the team discovered that the results were in fact invalid, due to early cross-contamination of the bacterial strains they had been working with. The team could have kept this insight to themselves, being as they are dependent on external funding which depends on their ability to publish. Instead, they retracted the paper. You can read the full article here

I hope my blog provides you with some useful insights and, as ever, I look forward to hearing your thoughts. And if you have a challenging project or would like to discuss coaching to help you achieve that next level, please reach out for an informal chat.

Very best wishes

Isabelle C. Widmer

Photo by Fab Lentz on Unsplash

Why Hospitals Should Integrate a Medical Information Approach

Today’s topics:

– Why hospitals should adopt a Medical Information approach
– Why biotech start-ups fail
– Making clinical trials more accessible for people with disabilities
– Age is just a number

Why Hospitals Should Adopt a Medical Information Approach

In the past weeks I have been a frequent visitor to the local hospital’s ICU. The level of medical care is incredible, as is the access to interventions, day or night, and the skill level of the teams I have encountered. Witnessing what skilled HCPs practicing modern medical science can achieve is: “it’s all for the patient” in action.

However, due to staff rotations the medical team changes frequently. Consequently, we have rotating physicians to interact with. This means conversations are often repetitive and, as resilience is waning 12 days into an ICU stay, the entire family is noticing the strain. This is not to complain as the nurses and doctors are fantastic. However, the hospital has a lack of qualified staff due to a combination of summer holidays and illness and translating intensive care medicine into lay language takes time and energy, which the doctors on duty don’t always have. Hence, after meetings with the medical team, my family often turns to me with any unanswered questions.

When I was a clinician working on a ward, I had more time than the ICU doctors. I would draw diagrams to explain interventions and disease. I would draw hearts and lungs, kidneys and livers, explain how blood circulates, and what happens when “things go wrong.” I used plumbing analogies frequently, I still do, they are extremely helpful. I have used medical analogies with plumbers too. The analogies work well both ways I have discovered.

Medical Information teams communicate complex information in stakeholder adapted terms. After my experience of the past weeks, I think an analogous role in an ICU could be beneficial. An experienced medical doctor, or nurse who takes on the role as point person for families to engage with and who is able to communicate complex content simply. Having a dedicated liaison could provide continuity of communication, while engaging families and also freeing up highly skilled ICU personnel.

The need for accessible scientific communication with which to engage laypersons is common across disciplines. A recent article in Nature (published 19th July 2022) highlights this for the climate science field. Farmers told climate research expert Jessica Eise that what they need is straightforward tips on how to adapt to a shifting climate. Eise reviewed the literature and found little information to address real-world needs. Addressing the gaps, however, is critical in order to work across disciplines and stakeholder groups. You can read the article here.

Why Biotech Start-Ups Fail

On the 26th of July, I will be speaking and chairing an online seminar hosted by Nanobotmedical on top reasons biotech start-ups fail.

I’ll share insights from CEOs of successful start-ups and include learnings on what investors look for when identifying promising new companies. Topics will include: getting from an idea to a product, financing, clinical trial set-up, regulators, building a team, communicating with stakeholders and timelines.

The challenges are complex, and in today’s economic climate, financing is not as easy to get as it was in the past. Join me, together with Jason Marks, Alexander Lagerman and Andrii Koniukh from Nanobotmedical. You can register here.

Making Clinical Trials more Accessible for People with Disabilities

According to the CDC, around 25% of US adults live with some form of disability. BMS is partnering with the non-profit organisation Disability Solutions, to create a new initiative titled: Disability Diversity in Clinical Trials DDiCT). The program’s initial focus is to identify a set of recommendations to improve access, enrolment speed and trial participation for people with disabilities in clinical trials. The article was published in Endpoints News and you can find the entire article here. I recently posted an article on how Eli Lilly Canada is making web content more accessible for people with disabilities, you can read more on my blog here.

Age is Just a Number

I sometimes encounter the conviction that older individuals are not as flexible, enthusiastic, open to change or willing to learn, as younger individuals. I have never believed this to be true, as I’ve met narrow-minded younger people and creative, open-minded people in their eighties and nineties, for whom age is just a number.

Often in interviews with older employees, who question a project approach, it transpires that their questions are based on experience in a discipline and an organisation and not due to change resistance. More often than not, their questions are critical and relevant.

A young entrepreneur I spoke to recently champions diversity in his team because he believes that a diverse team will give his company the best outcomes. He has employed a 60-year-old as his sparring partner at the top of the organisation. The entrepreneur told me “My sparring partner challenges me every day, it is hard to deal with. However, his challenges really focus my thinking.”

Motivation and interest are more important predictors of behaviour than age, I have found. Case in point, my 81-year-old mother streams films on her IPAD, texts family and friends all over the world, and recently set up an online account to sell items online. Something I have never done. After receiving the item, the buyer wrote my mother an enthusiastic review and commended her on her beautiful wrapping.

In a short story, Camus wrote something along the lines of; “just because someone is wearing clean socks does not mean he has dirty feet.” To paraphrase, “just because the individual questioning your project approach is in his fifties doesn’t mean he is wrong.”

Key take-away: Curiosity is not age dependent!

I hope my blog provides you with some useful insights and, as ever, I look forward to hearing your thoughts. And if you have a challenging project or would like to discuss coaching to help you achieve that next level, please reach out for an informal chat.

Very best wishes

Isabelle C. Widmer

Photo Credit Isabelle C. Widmer elytraconsulting

A day In the life of a telemedicine provider, digital health technology and on listening to patients

Last week I was in Brighton for a board membership meeting of the charity I am involved with, called The Virtual Doctors. We discussed how to improve healthcare access for more people in Africa. Currently we are working with Malawi and Zambia, and we hope to expand to more countries in the future.

Healthcare provision is changing, how patients access healthcare is changing and this will naturally impact how pharma companies interact with key stakeholders. Today’s blog focuses on digital health, telemedicine and our need to put things in boxes. I also share a story about patience, patients, time and love.

Today’s topics:

– A day in the life of a telemedicine provider
– Let me put you in a box
– Digital health and technology Tyto care
– Patience in a room without time

A Day in the Life of a Telemedicine Provider

A colleague sent me an article from the website Second Opinions on how physicians perceive working as telemedicine providers.

Topics of the interview included the pros and cons of working remotely, key challenges that are faced when managing remote patients, key personality traits that make a physician likely to enjoy working in and succeed in remote settings, as well as information on scheduling visits, and long-term patient care. One physician also listed the key factors he checks to make sure he can trust a telehealth company: 1) ensuring the company follows corporate practice of medicine laws 2) checking ethical billing practices 3) ensuring the team is mindful of patient and provider needs.

Benefits of providing remote care include a better work-life balance, as visits can be scheduled to fit with other commitments, this translates into the ability for healthcare providers to spend more time with their young families. Key differences between remote work versus seeing patients face to face included the observation that patients seen remotely appeared to be more focused and less stressed. The doctors hypothesised that this might be, because they were being consulted in the safety of their own home. In addition, some doctors observed there are fewer no-shows for digital appointments than there are for face to face.

Asked whether performing 100% telemedicine would work to manage most patients, some doctors said they preferred to offer a mix of services, including seeing patients face to face at least once in order to perform a physical exam, but then doing follow-up visits remotely.

One of the most challenging aspects of providing telemedicine, according to the doctors interviewed, is that it is hard to know if you missed something unless you are also the patient’s primary care physician. I would suggest that this is true for any specialist providing support to a patient for a specific condition, even face to face. You can find the entire article here.

Let me Put you in a Box – on Labels

A few weeks ago I was asked “Are you Swiss or German?” I replied with a question: “Why do you ask?” The response was: “I am trying to figure out whether you are Swiss, neutral, with no strong opinions about anything or…” the speaker, paused, reflected, and changed the topic. I smiled. The speaker has known me for a while, and he realised he didn’t need to know my nationality to know the answer to his question. Putting labels on people and situations helps us manage uncertainty and leads us to believe that once we have assigned a person, a situation or a company to a mental folder, we don’t have to think about that topic again. What we believe of other nationalities often falls into this category.

Naturally, I label situations too. Sometimes, I find myself sharing a thought from one of these old mental folders, and as I speak, I realise that I no longer believe this thought. While it’s always a surprise, it is also a wonderful way to learn about how my thinking has changed.

Labels and gender pronouns are also very much a topic of the moment. A friend told me his child has refuted male/female pronouns, on one level the desire to live a life that is free of the constraints of societal gender expectations seems to have played a role in this decision. I could very much relate to what he told me.

The world is complex, ever changing and overwhelming and so we put things into boxes in the hope that that will make things simpler. It’s a natural impulse and helps us make sense of things around us. However, it’s important to remember, boxes are a crutch.

With the exception of cornflakes, the world isn’t made to fit into boxes.

Digital Health and Technology TytoCare

Healthcare is changing and there are not enough healthcare professionals. This is true for many African countries where in rural areas there are few trained physicians, but also increasingly in every other country. Telemedicine is one way to get healthcare to patients.

Since the Covid pandemic, telemedicine has been booming, but even before, for example in Switzerland, you could reduce your insurance premiums if you called a telemedicine service before visiting your physician. The telemedicine provider triages you to the correct speciality. This weekend I experienced telemedicine in my family. My mother called the telemedicine services and explained my dad’s health. The conclusion the remote doctor reached was absolutely different to the one I and a medical colleague reached. This highlighted to me how much you can miss when a non HCP is reporting symptoms and you can’t see the patient.

One of the challenges of remote consultations is of course that a doctor cannot easily examine a patient, which in the example of my father would have changed the remote diagnosis dramatically.

An Israeli company, TytoCare, has come up with an elegant solution. TytoCare provides a telehealth platform along with an integrated exam kit that incorporates a tool that can function as an otoscope, a stethoscope, and a camera that can take close-up photographs of skin lesions as well as photographs of the oral cavity. This tool is provided in a hard case.

TytoCare is used to support patients with chronic conditions. Patients can perform self-examinations using the toolkit, the data is then saved in the TytoCare app and can be submitted to their physician for further assessment prior to an online consultation.

TytoCare could also help provide improved healthcare for rural populations by giving health workers in these communities the ability to share exam results with more highly trained specialists and to get a second opinion without having to refer patients to hospital. The approach is also used to support community nurses who, when visiting patients, would like a second opinion and quick access to a doctor.

I recently saw a demo of the system. The tool seems intuitive to use, the software pretty straightforward. It is another interesting approach in making healthcare accessible to more patients. Link to Tytocare website.

Patience in a Room without Time

Recently I lost a friend. Eva was vivacious. A force of nature. Despite a degree in psychology, she never stopped working as a nurse. Eva was passionate about so many things. She was loving, supportive, opinionated and fiercely loyal to her patients, her friends and her family.

In the last months as I visited her, I watched the light, her light that always burned so brightly, fade from visit to visit. As I sat by her bed, I asked her if she would prefer me to be silent or if she would prefer me to talk. She said, “I am too tired to talk much, but I am happy to listen.”

In those few visits we didn’t talk about death, we talked about life. We talked about families, friends and our childhoods and work experiences. Despite her fading energy, her spirit was still fiercely alive. She was so present with me, despite her exhaustion. As she lay in her hospice bed and I sat beside her, our conversation covered the same topics we would have covered in a bar; the setting was different, but our friendship was the same.

As I think of her now, the memory of her is strong, and I am grateful for the time I was able to spend with her. One visit I said, “Eva, a friend recently said to me, Isabelle, have you thought about the friends you have lost over the years?” I told her that this question had made me sad. Eva replied, “It’s true, Isabelle, you may have lost friends, we all have, but think of all the ones you have gained.” Eva was one of those later-in-life friends, and her vehemence, despite her weakness, touched me. I still smile at her wisdom, the memory of her saying this, and the love she was able to give me in that moment.

On that visit Eva told me that there was no clock in her room. She said, “I am too weak to hold my phone anymore, I cannot unlock it. I sleep a lot and when I wake up, I never know if it is morning, afternoon or evening. I feel disorientated, I am really struggling.” Back when I travelled to San Francisco I remember arriving in my hotel room, having a nap and then waking up in twilight, looking at the LED figures outlining 04.00 on the bedside alarm, frantically trying to figure out if it was 4am or 4pm. I could relate to how Eva felt in her hospital room. A room that had apparently fallen outside time. I said, “Can’t the nurses put a clock up?” She said, “Ha, they said it is a philosophical question that they have been discussing for a while in team meetings and that they haven’t yet reached a consensus.”

I mentioned the situation to another friend. This friend said, “But she is in a hospice, why does she need to know what time it is?” The answer is: it doesn’t matter, she does. Patient needs are not abstract, philosophical issues, they are real. When patients tell us what they need, we should listen, even if we don’t understand. In general, perhaps we should focus less on why someone feels a certain way, if it’s hard for us to understand, and instead just try to listen and respond appropriately. Eva died on Easter Sunday.

I hope, as ever, that my blog provides you with some useful insights. I look forward to hearing your thoughts. And of course, if you have a challenging project or would like to discuss coaching to help you achieve that next level, do reach out and we can arrange to chat.

Very best wishes

Isabelle C. Widmer

Photo by National Cancer Institute on Unsplash

A Case Study in Patients, Patience and Bioethics, all you Have to do is Change

Last week I enjoyed a bike ride through France with a fabulous group of people. In the group we had a nurse who referred to herself as the princess, and her husband, an entrepreneur who left home at sixteen to travel the world and went on to build a successful business. There was also a lawyer and, lastly, a singer who went from opera to performing on Broadway; she entertained us with songs on our last evening.

Today’s topics:

– When you are in the right environment, magic is possible
– How your approach can influence the outcome
– A case study in patients, patience and bioethics
– All you have to do is change

When you are in the Right Environment, Magic is Possible

Something we are not taught at school is that, while getting good grades and working hard are essential to success in our jobs, getting on with other people and the environment we are in, are also very important factors.

Last week I visited a monastery. The chapel is famed for its great acoustics. Visitors are encouraged to whisper to each other to experience how well sound travels. Finding myself alone, I started to sing. I used to take singing lessons; I have been told I have a beautiful singing voice and it is something that I enjoy, but I do it rarely. And as I sang in that chapel, I did not want to stop. The way my voice sounded in the room, clean and pure, clearer than I have ever experienced it, made me want to stay and sing. To experiment with different melodies, to marvel, at how even the softest notes filled the entire room.

Working with the right team and in the right environment can bring out the best in us. Naturally we need to work on ourselves too, in order to bring the best of ourselves to our work, in the same way a voice needs to be trained in order to perform at its best, but the combination of our best effort and the right environment can lead to incredible results.

How your Approach can Influence the Outcome

A few years ago, I renovated my flat and had a new floor installed. I had my doubts about the result of the work, but the company foreman assured me that it had been fitted well. I reached out to the owner of the company. He came to my house, had a look at my floor and said, “I am terribly sorry, we have done substandard work for you, please accept my apologies.” Later that night he called and said, “I have discussed the situation with my partners. We have agreed that we will redo all your floors for you. Whenever it suits you, just tell us when you want us to start.”

On my bicycle ride through Cognac and Normandy I met an American litigation lawyer who focuses on the construction industry. I told him my story. His response? “No, that is impossible, that never happens.”

Often our expectations of a situation impact the outcome. Going into situations expecting a no, influences how we communicate, which in turn influences the reaction we are likely to receive. There is a German saying: the way you shout into the forest, dictates the echo you will hear.

A Case Study in Patients, Patience and Bioethics

I once gave bioethics training to a group of senior medical affairs leaders from emerging markets.

I presented a case study with the blessing of a close family member, who had been enrolled in a clinical trial at a Swiss university hospital.

The trial protocol required quarterly bone marrow biopsies. Two years into the trial, a friend who is a practicing oncologist, told me that PCR is the method of choice to monitor CML, not regular bone marrow biopsies. I called the hospital to ask why they hadn’t adapted the protocol. They said, “You are correct, however we like to have access to the data and the cells, so we didn’t amend it.” It took another few years for them to amend the protocol. My relative decided to remain in the trial despite this, because he had grown to trust the team who was managing his treatment. Years later my family member was informed by phone, “Your CML has progressed, please double the dose of your medicine starting from tomorrow.” When I called the hospital asking to speak to the physician in charge of the clinical trial, I was told there wasn’t one. When someone called me back, they started the conversation with: “So you are the difficult family member? Well, I have some good news, your relative’s CML has not progressed. Please inform them they don’t need to change the dose.” Years later, when progression finally did occur, my relative informed me that a bone marrow biopsy was not planned. I called the hospital again and was told: “We thought a biopsy would be tough for an older patient to tolerate.” I asked if they had discussed it with my relative, they said, no. So, the decision was taken without discussing the pros and cons with the patient.

I used this case study as part of my bioethics training because I know the case intimately. The message I wanted to convey was: if this happens in Switzerland, it can very possibly happen elsewhere. I wanted senior medical affairs leaders to see how things can go wrong. And to highlight that if we want patients enrolled in clinical trials, we need to make sure these things don’t happen.

The reactions in the room were varied. The discussion was rich. However, one reaction I received that remains unforgotten, because it astonished me, was the following: “You realise you cannot sue the pharmaceutical company who produces the product?”

Putting patients at the centre of what we do makes sense for the patient, but it also makes sense for the business. Focusing on the patient ensures that clinical research is tailored to patient needs, and that the products that are developed address the real problems not the ones we think are important. This in turn will impact how a product performs in the marketplace. Focusing on patients is an ethical imperative that also makes absolute business sense. It seems obvious to me, however, the lesson I learned that day is that it is still not obvious to everyone. Not the doctor, who called me an annoying relative, nor the individual, who called my relative to tell him, that his cancer had progressed, and not the medical affairs director, who thought, I was interested in making money out of my relative’s predicament, when the reason I shared it, was to highlight areas, where there are gaps, in the hope, that anyone involved in research is sensitised to potential issues so that less patients will experience what my relative experienced.

All you Have to do is Change

As an executive coach and a member of the ISPSO (International Society for the Psychoanalytic Study of Organizations) team dynamics, personal growth and career advancement interest me. As we all know we cannot change others, we can only change ourselves.

Knowing what we want to change can be easy. Test results and 360-degree feedback forms are useful tools here to support the identification of areas for growth but using this information to achieve meaningful growth can be challenging, unless the feedback makes sense to the recipient. For example, telling someone based on 360-degree feedback test results that they need to be more empathetic, more outgoing, communicate better, have more gravitas, etc., in order to be a better leader, is ultimately rarely useful because behaviours, that are exhibited at work, are behaviours that have been developed throughout years of living, and in all aspects of a person’s life. In addition, nobody works in a vacuum.

In order to change anything, an individual can benefit by exploring not what they want to change, but ultimately why. Questions that can help include: why do I interact in this way? How does my behaviour impact me and others? How do others perceive me? How do I perceive them? And the biggest question of all: do I truly want to change? And why? How will a change in this area lead to an improvement in my life overall?

These questions are critical to understanding both behaviours and motivation. Unless changes occur within, none are sustainable.

I hope, as ever, that my blog provides you with some useful insights. I look forward to hearing your thoughts. And of course, if you have a challenging project or would like to discuss coaching to help you achieve that next level, do reach out and we can arrange to chat.

Very best wishes

Isabelle C. Widmer

Do you Work for Good or bad Pharma? Unplug and Play

Only 213 days to the end of the year. Sounds like a lot, but if you deduct weekend days (60) you realise just how quickly time is passing.

Today’s topics:

– Do you work for good or bad pharma?
– Unplug and play
– In celebration: one of the best subject lines ever!
– It’s later than you think

Do you Work for Good or Bad Pharma?

Last month, Pfizer announced that it will make 23 patented medicines and vaccines available to the world’s poorest countries on a not-for-profit basis, in a bid to address the global healthcare gap that came under renewed scrutiny during the Covid-19 pandemic (link to the Forbes article).

I mentioned this during dinner to a colleague who works for a large pharmaceutical company. She reacted defensively, saying, “Naturally, this is a great initiative, but we have many initiatives ongoing that facilitate healthcare access for patients in lower-income markets. Financing negotiations are held, and creative financing models are regularly implemented. Unfortunately, outside the industry, people only ever talk about the cost of medicines and the high profit margins.” She continued: “Obviously, we are not a non-profit sector, but then the risks of drug development are high. I wonder why we do such a bad job communicating the good things we do?”

It was an interesting question and it reminded me of my time before pharma. When I said I was leaving clinical work to join pharma, my hospital colleagues said in collective horror, “So, you are joining the dark side?” I remember pointing out, “Without the pharmaceutical industry we would be prescribing willow bark extract, laying our hands on our patients and chanting them better with fervent Oms.” While I experienced both hospital processes and payer interactions as painfully inefficient, I realised fast that my attempts to reduce spending on my ward were doomed to failure.

Healthcare systems are complex. Most people don’t think about them at all unless they are directly impacted. In addition, unless you have worked in one, or engaged with payers, it’s impossible to know how inefficient they are. Also, it’s hard to estimate how much money is wasted due to inefficient processes, as different stakeholders are involved, with conflicting interests. It’s not easy to understand nor identify how best to improve the system. Costs keep rising however, and accepting that nothing else can be done, perhaps focusing on drug prices and the profit margins of the pharmaceutical industry is a practical scapegoat. While I was acutely aware of the inefficiencies of the hospital that I worked at, I also remember my surprise when, on joining pharma, I saw a chart showing the annual healthcare expenditure in Switzerland and learned that prescription drugs represented only 8% of the overall costs.

But back to my colleague’s question: “Why do we do such a bad job communicating the good things we do?” While there are reasons that public perception is what it is, her question on why we don’t communicate better, struck me. So I will share one more story.

At a conference, a fellow speaker said to the audience, “We need to tell our customers that we are not commercial functions, and therefore they can trust us.” I have heard variations of this sentence many times. When I stepped onto the stage, I held up a bottle of pills and said, “If this bottle represents your company, your functions are represented by the pills. Customers will see the company first, the function second. They will trust all of you, or none of you.” And I added, “If you don’t think your colleagues are trustworthy, why should customers trust your company?”

In summary, change starts within. If even employees don’t have a balanced view of the business they work for, it is impossible to expect anyone else to have one.

Unplug and Play

My day invariably starts with this question: “How much can I get done, how fast?” Mundane tasks are handled as fast as possible. When things go to plan, I am happy. Unfortunately, however, things are often out of my control.

In a recent example, my list included the following item

  1. Place an online order
  2. Sign a document in online banking
  3. Cancel a subscription

I expected to be finished in under an hour. Four hours and six conversations with customer service agents later, two out of three tasks were completed.

The problem with my time estimate? I don’t live in an ideal world, where websites have been tested and call centre agents know when their product has technical issues. By noon I was annoyed that I had made almost no progress on my day’s planned tasks.

In the past, I would have sped up to compensate for lost time. Now, instead, I take breaks and do something fun. Stepping away, instead of soldiering on, is much the best approach in any situation where irritation has displaced joy. I have discovered I achieve much more if I take a break to do something fun, than if I force myself to continue, when my heart is not in it.

“Almost everything will work again if you unplug it for a few minutes, including you.” Anne Lamott

In Celebration: One of the Best Subject Lines Ever!

When I joined pharma, there was a beautiful orchid on my desk. I gave it lots of coffee grounds so it flourished. I remember this incident because it was a wonderful welcome to a new company. Another memory is my manager saying: “The day you joined my team was a red-letter day.” As a European I thought this was a bad thing, but she explained, no, a red-letter day is a special one.

As my own manager I don’t celebrate myself much, but sometimes I am celebrated, and it feels amazing. In response to my last newsletter, I received four messages. One reader said he loves my writing. He also keeps asking me when I plan to write a book. The answer to that question is: “I am working on it, but it’s slow going”. Another reader wrote she enjoys my newsletters and that my last one made her think of the film Chicken Run. A third reported that he was: “Giggling like a schoolgirl”, at my MRI experience; if you missed that story, you can find it here (My ankle is not your patient). And a fellow consultant, who is in the business of writing spectacular newsletters, sent me a one-liner: “One of the best subject lines ever!” in response to the title My Ankle is not Your Patient. I adore his writing, so his compliment means a lot. The experience reminded me that it’s important to celebrate yourself, your teams and the world in general. In fact the working world, in particular, would be a better place if there were more authentically spoken words of admiration. And as you can see from my examples, a small act of kindness can mean the world to someone and may very well be remembered many years later.

It’s Later than you Think

The end is nigh. There are 127 working days to the end of the year, in Switzerland, excluding weekends and public holidays. If you are in the US, it’s even less. Whichever way you look at it, the first six months of the year are gone. So, if you are only just getting started on your projects, it’s time to get a serious move on. Here are some classic activities that you can make lots of progress on by the end of the year if you start now:

  • Understand your current customer engagement approach and identify a future-focused multichannel, department and globe-spanning improved approach.
  • Analyse your current med info set-up, identify gaps and plan for a better future.
  • Assess how your company uses data.
    • Where is it stored?
    • Who has access?
    • Taxonomy? Ontology? Is there any metadata?
    • Do you have data lakes or data cemeteries?
    • Are you making use of cross-functional, data-sharing opportunities?
    • Do you know what data might be useful by market? Why not meet with peers in other countries and identify what insights might be useful
    • Identify opportunities to collaborate, plan an improved data management approach and move your day-to-day business away from metrics towards actionable insights
  • If you already have great databases and harmonised data access, discuss how customer insights can be used cross-functionally to better support customers, thereby improving customer-centric business and safer use of medicines.
  • Increase overall efficiency to improve effectiveness.
  • Design, write, review and publish a global SOP, including all stakeholder input and sign-off depending on the complexity of your company and the number of stakeholders involved.

Then again, you may not want to start something new. Whatever you are working on, I wish you the best of luck with your endeavours.

I hope, as ever, that my blog provides you with some useful insights. I look forward to hearing your thoughts. And of course, if you have a challenging project or would like to discuss coaching to help you achieve that next level, do reach out and we can arrange to chat.

Very best wishes

Isabelle C. Widmer

My Ankle is not Your Patient, Patient-centric Hospital Design, Burnout

The last two weeks have been quite demanding. After returning home from my UK trip, where everything that could possibly go wrong, did, my Swiss doctor took one look at my ankle and sent me for an MRI scan. Beyond the doors of my home, pharma is perpetually reorganising itself, the stock markets have taken a tumble, the news – and my emotions – follow the war in the Ukraine, talks on NATO, stagnation and inflation and the individuals I know, who are severely impacted by rising gas prices.

Resilience is important and easy to lose sight of when faced with the demands of the world. The topics I am covering today are influenced by: being a patient, finding direction in a challenging world, and a recent comment on a post about knowing when to change your job.

Today’s topics:

– Patient experience – or my ankle is not your patient
– Patient-centric hospital design. Where do I have to go? Follow the path!
– Is your disenchantment really a burnout?
– What chickens have taught me about global programme management

Patient Experience – Or my Ankle is not your Patient

On a recent trip to the UK, I twisted my ankle. The NHS did an X-ray. I was relieved that it was not broken.

Back home, my Swiss doctor sent me for an elective MRI saying, “It won’t change the clinical outcome but it would be good to know what shape your ankle is in.” Liking to know what to expect and not liking the thought of being inserted into a tiny space, I checked the MRI provider’s website for information. There was information on the team, on the sites, on the history of the company – everything a business would tell you about what they do. There was even a photo of an MRI machine. But no data on aperture sizes, scan duration, what to expect when you have a scan, things to consider, and what to do if you don’t like small spaces. There was no information on open/closed machines, magnetic fields or which machine can be used for which examination. As it was an elective procedure, I considered cancelling a number of times.

As I searched the internet, I noticed a stark contrast between Swiss MRI provider websites and US MRI provider websites. On the latter there was a lot of information for patients.

Finally, my key question: “If I am having a scan of my ankle, how far into the machine will I be inserted?” was answered by my calling two friends who had had knee scans, considering their height relative to mine, and then concluding with the help of a tape measure that I would be mostly outside the machine.

When I arrived at the site I was stressed and found it difficult to navigate the building; fortunately a friend was accompanying me and helped guide me to my provider. The technician was hurried. I asked him how often patients were nervous. He misunderstood my question and answered, “Oh, I have learned to not let it get to me at all.” As he put me into the machine, I felt like a product on a conveyer belt. When I asked him if I could talk to him during the scan, his answer was: “No, I will be working, so I won’t have time to talk.”

I got the scan results the next day and read them. They were not great. I was surprised by how impacted I was by reading them. When I saw my doctor, he said: “Oh, you shouldn’t have read your results, I would have broken the news to you gently”. It hadn’t crossed my mind to leave the breaking of the bad news to him. In retrospect it would have been a better idea.

It was, overall, an unpleasant experience from start to finish but it highlighted for me that what I need as a patient, is very different to what I need as a doctor; that when I am hurt and concerned, my worries are not technical in nature. It highlighted to me, the madness of developing anything for patients, that doesn’t involve the patient. A patient advocate once said to me, “When you design a car seat, you take the driver into account, so how can you design medicines and not take the patient into account?” You can read that interview here.

What a patient needs, what she desires to know, how she experiences a treatment, what she wants to know about the treatment schedule, timeframe, etc., nobody other than a patient can tell you that. Today it is a given that it is critical to involve patients in the development of any treatment, treatment process or information that is designed to help them make decisions on their healthcare. My experience highlights that not all cultures are equally attuned to this yet and that there is still work to do. This leaves me with two questions: Why is it taking so long to implement changes that are obviously needed and make sense? And why is it that every service provider asks me for feedback and enquires how they can improve their service, except the MRI healthcare service provider where my feedback might actually help improve other patients’ experience.

Patient-centric Hospital Design. Where do I Have to Go? Follow the Path!

Credit: Isabelle Widmer – San Raffaele Hospital Milan

The Italian healthcare system operates in an interesting way. While funding is regional, patients can choose to be treated in any hospital in the country that they like; the hospital then receives the funds from the region the patient is from.
Patients from all over Italy travel to leading research hospital San Raffaele in Milan to be diagnosed and treated. In 2016 I accompanied a friend there.

San Raffaele is a giant. The hospital provides 1.5 million outpatient services and 30,000 surgical interventions each year. I remember being overwhelmed by the size of the car park, comparable to large shopping mall car parks in the US. The size of the hospital was even more daunting; navigating the long hospital corridors was like trying to find your way around Heathrow Airport.

However I was impressed by the hospital’s navigation system. It was simple and effective, with a coloured line for each speciality. All patients have to do is follow that line, without thinking. I remember walking for ages, I remember linoleum floors in sunny yellow. I remember following the yellow line round corners, up and down stairwells and in and out of buildings. Other coloured lines ran alongside the yellow one, splitting off down different corridors, until just the yellow one was left. While in 2016 I admired the system, it took my experience of going for an MRI scan last week, to highlight just how important a simple navigation system is. When I went for my scan, my mind was on my scan and I found it a challenge on coming out of the car park to identify the correct building and floor for the MRI provider. I remember being embarrassed that I couldn’t do it and immensely grateful to my friend who kindly led the way.

Healthcare is not just about the right drug for the right patient at the right time. It is also about making things as accessible as possible for patients, whether in the real world, as in San Raffaele hospital, or on a website, using simple navigation menus and ensuring your medical scientific content is more accessible (more on how to do that here).

Is your Disenchantment really a Burnout?

In my last newsletter I wrote that when you no longer care about your job, it is time to change it. A fellow coach, MD and GM Michal Kazmierski commented on my post saying, “Isn’t it called “burnout”? If we don’t watch carefully, it will slowly and sneakily develop over time until we may find ourselves in a place where both our well-being and health are in danger…” He had me at sneakily.

Our current world is challenging. I meet many individuals who are in companies that are being reorganised. Some are hoping to receive a severance package. Some present their plans for next year to their teams and hear only laughter, after which they conclude that, perhaps in the future, they won’t have a job. Others report that the acronyms are changing, the organisational structure is changing, that budgets and headcount are reduced but that despite all the ongoing changes they are still trying to perform at their old levels.

Being disenchanted is perhaps natural, depending on the circumstances, however burning out is a real risk. One disenchanted individual I remember, did as little work as possible, he spent his days printing out job adverts on the office printer and applying for new positions. He was cheerful, fun to be around and just generally didn’t care about the position he was in any more. He left soon after and went on to have a stellar career elsewhere. Burnout is very different and as Michal writes, burnout happens slowly and sneakily. It is worth considering whether you are at risk of a burnout, whether that tiredness you cannot shake is a symptom of something more than just being chronically overworked.

Some things to consider: do you feel tired a lot of the time? Have issues sleeping because of work projects? Find it hard to achieve recovery after a weekend away from work or a holiday? Find it harder to prioritise your daily activities than perhaps in the past? Are you engaged in many projects with different leads? Do you struggle to say no to deadlines, even if they are unreasonable? Are you generally dedicated, loyal and have a perfectionistic nature? Do you worry about not disappointing anyone? When under work pressure do you reduce your leisure activities so you can focus more on work? Are you more emotional than usual, more easily triggered, more irritable? Do you find it hard to be joyful? Do you feel that a lot of your work life is out of your control, and you have little influence on your day-to-day workload and outcomes? Do you think of changing jobs, but you worry that you wouldn’t have the energy to go to interviews, or to even perform a job search?

Unfortunately, burnout creeps up on you, it’s hard to self-diagnose and so many soldier on. It helps to ask trusted friends for their thoughts if you suspect you might be at risk. It also helps to not look around your department and think, everyone else is struggling too, it’s normal. If you are managing a team, it’s important to keep this awareness in mind in these challenging times.

What Chickens have Taught me about Global Programme Management

If you have ever run a global project, you will have heard a variation of “This won’t work in my country”. Sometimes, you will be told: “It’s against the regulations”, sometimes: “No other company in my market does this”, sometimes: “It’s not a cultural fit with our customers”. If you are running a global project and you don’t hear any of the above from any country, what you will likely discover if you check how your project was implemented, is that something was done, but it wasn’t what you hoped for or expected. As a friend of mine said: “We get global recommendations all the time. We have given up saying, “This won’t work for us”, so what we do instead is say, “Yes”, then implement something else… nobody ever checks”.

Sometimes, global teams feel that the local teams are exaggerating. However, it helps to make sure you understand the objections. Cultures can be very different, and sometimes differences are in such basic areas, that you wouldn’t think to expect a difference.

To illustrate I am sharing my experience with chickens. Once in Russia in winter I went to a big market and bought a chicken. Telling me the price, the salesperson held the chicken carcass up to my face and spread the thighs at me, demonstrating that the internal cavity was empty. As this is how I buy my chickens in Switzerland, I was very confused. I kept nodding and saying, “Da”. Great conversations are not made when the speakers have less than five words in common. I later discovered that in Russia, at that time, chickens were sold intact and that I had bought a more expensive bird because someone else had already eviscerated it.

In another example, in an Ethiopian cookbook that was printed for the Ethiopian market, the instructions for preparing chicken are: kill your chicken, then submerge it in hot water and remove the feathers. Visiting my brother in Hong Kong, he told me his neighbours bought live chickens at the market and killed them in their flats. And an example from a Ukrainian friend, he once told me that during the time of communism he would go shopping and come home saying, “I found a goose” or, “I found a chicken”, because he could never predict ahead of time what the market would have in stock. Having grown up in the West this was unimaginable for me, although when he explained it made sense.

I share these examples to illustrate that differences in approach may not be obvious to you. You may not even think to ask. You may take a certain approach for granted, as I did with my chicken purchase in Moscow. This means you need to ask open questions and allow time for the responses. You need to be curious and open-minded. You need to avoid assumptions. If you don’t ask, you won’t know and if you don’t know you cannot accommodate for local variations, at which point your global project is potentially at risk of not being the full-scale success you’d like it to be.

I hope, as ever, that my blog provides you with some useful insights. I look forward to hearing your thoughts. And of course, if you have a challenging project or would like to discuss coaching to help you achieve that next level, do reach out and we can arrange to chat.

Very best wishes

Isabelle C. Widmer