Lessons on Leading Through Uncertainty in Pharma

AI is not necessarily going to replace people. However, people who do not learn how to interact with AI and technology will be replaced by those we do understand, appreciate, know how to work with AI and other technologies. And by the way, the AI, I don't hear it anymore, but there was a time when some people spoke about augmented intelligence rather than artificial. The intent of that was really to how do we as humans use that to our advantage, to be more efficient, to do things quicker, etc.

etc. Yeah, to maybe be alerted to things that we didn't think of immediately. So there's a number of examples already where within the industry and specifically in medical, where AI as a tool has been used for efficiency, right? Around, for example, oh medical legal regulatory review, the MLR of documentations.

This episode of Pharma Sessions is sponsored by Xunt, makers of the X1 reporting platform. Welcome on today's episode of PharmaSessions. I'm thrilled to welcome back to the show Danny Duplessis, a globally recognized medical affairs leader, mentor, and coach with nearly three decades of experience across multinational pharmaceutical organizations. So Danny has many career accomplishments, including leading metaphares at companies like Kioa Curin and major leadership roles at GSK, been highly influential with maps.

But some say, Danny, let me know how often you hear this, that his greatest accomplishment was actually being the first ever guest on pharma sessions. So that was that was 49 episodes ago. It felt appropriate to bring Danny back for episode number 50. Today we're going to talk about leadership in a rapidly changing world, the evolving role of Metaffairs, how to ensure patience remain at the center of everything that we do.

I'm so glad I get to say this for the first time. Welcome back to the show, Danny. You're our first repeat guest. It's a pleasure to be back, for sure.

You know, we've been interacting for quite some time, you and I, uh, and then with unfortunately gaps in between, but it's a pleasure to be back. Yeah, just to be to be clear. So it's uh more than three decades, unfortunately, not almost three decades, that I've been in the industry. Doesn't feel like it, but here I am, and thank you so much for uh for the invitation to come back.

Well, absolutely. I've really appreciated the the friendship that we've grown since the show. And honestly, you agreeing to be the first guest because when I started this, I didn't know if anybody would be willing to talk to me, and I didn't know if anybody would be willing to listen. And fortunately, both things have the answer's been yes to both of those.

So I appreciate you helping me get going and then just all of our conversations I always leave feeling so elevated over the years. I also am looking back on that first episode, realized that I'm still wearing the same shirt sometimes from four years ago. So I did think it was time to refresh the wardrobe. So that shirt is getting is getting a refresh uh thanks to that discovery.

Um I'd be the same color, but our shirts and newball. Okay. So just to help the people get to know you, I always like to do a little bit of an icebreaker before we dive in. And my my new question is do you have a go-to karaoke song?

I don't really do karaoke, but if you push me, probably let it be. I would think that's a wonderful ballad. So you must be able to you know sustain a note and really just sing on key. You know, it's not about the verbal gymnastics, it's just just let it be.

Uh, very good. All right. So you've had a really diverse career across pharma, leadership, now coaching. What originally drew you to Metafairs specifically and what's kept you passionate for, as you clarified, over 30 years here, over three decades?

As you know, when I finished school, I went to medical school, you know, so I've always had the intent to make a difference to patients in some way, shape, or form. And after I'd been in in primary care practice, private care practice for a number of years, you know, I got to a point of okay, that's not really what I wanted to do for the remainder of my life. What was your specialty? And uh it was you said it was primary care?

I was GP, yes. I was so at that point when I wanted to do something more, one of the options was the pharmaceutical industry. So I thought, well, I'll go and give it a go and see how it is. At that point, I'd done a master's in clinical pharmacology.

So there was sort of a in my head at least uh an appropriate reason, I suppose, to give it a go. And obviously as a medic, I started in medical affairs as we now know it. At the time it was just medical, like back in the early 90s. And and yes, I've had numerous uh opportunities within medical, did distance in marketing and sales, went back to medical, had an opportunity in pharmacovigilance and clinical operations, and then back to medical affairs, and then more senior roles as my career progressed.

And why did I sort of, in spite of doing a few other things, why did I keep on coming back to medical affairs? Because it felt closest to the patient, to be honest, right? Because that's really the end user of medicines or devices or diagnostics for that matter at the end of the day, like in at least the majority of cases. That's why medical affairs for such a long time, there was always something to do, something new to do, I suppose.

And I feel like it's so fascinating. People that I talk to that have gone from actually practicing medicine to med affairs, is like it's you're striking this balance between impacting patients at a very deep level individually, or on the other side of the spectrum is maybe influencing a sliver of that patient care, but doing it at scale. So just emotionally, psychologically, which gate clearly the doing it at scale resonated with you. Have you thought about that before?

And and what about it specifically drew you? Yes, I have indeed. And I think it's a very good prescription that you have, right? So I know now, not then, but I now know after a variety of courses and I suppose reflection that my personal purpose is to make a difference.

If I have to put words around it, that's what it is. Now, exactly as you described, Jonathan, within the industry, it's uh potential to impact a broad group of patients or sub-populations, depending on what one is working on. But the unexpected thing, I think, for me was actually as I progressed in my career and started managing a clean call, was that there was the opportunity to also make a difference to my team members. And I think at a very early stage, that's probably where the seed for coaching was also planted, right?

So it was an unexpected opportunity to not only make the difference to people who are living with certain conditions, but also just to people, maybe at the beginning of their career and and helping them to be as successful as they can be. I think that that is the part of running or taking a leadership role in almost any organization, certainly not pharma specific, but very, very quickly you start to understand how important it is to bring other people up and to help them advance their skills.

So let me tell you a very topical, well, at least for me, for my own life. So, as we were talking before, we my wife actually opened a yarn shop in in our little town, Roboth Beach. High Tide Fibers, check it out, hightidefibers.com if you're into yarn and wool.

And what she's found, even with a very small amount of employees, and these are people that are super nice, super friendly, is they're selling like a quarter to a third of what she sells on any given day. And it's I think it's because or the the working theory is that she has this like passion of hey, I went through, I curated all this stuff, I've used it all in the past. I know that this person raises this type of sheep in Portugal or whatever. Like she gets, she has this enthusiasm that carries through.

And then the question is, how do you train people and communicate so that one, they're getting the their knowledge is increasing, but two, they can deliver a message in an impactful way. And that to me is like the universal challenge of anything that's communication space, and certainly medical affairs is. Absolutely. You know, it's sort of maybe a different way of saying the same thing is you know, getting us into this whole idea of storytelling and how important that is, right?

To get a moss uh a message across so absolutely critical. Yes. It's also funny, just the more time that I spend in the space, and also when you look at the research about what people remember, it's like statistics are important. And certainly in medicine, you can't go shy away from the statistics, but it's really, really challenging for our brains to walk away and remember 18 different stats versus the story.

There's a reason that you know Greek myths persist and they're still making best-selling uh movies and books, uh, children's books and adult books about this because the stories persist. So, how do you, when you're working with a Metafairs team, how do you help them strike that balance between communicating the science and we'll call storytelling? Really good question. So, over the years, this notion almost of the scientific narrative has started appearing in some places.

And in the beginning, there was actually, interestingly enough, resistance to it to say, well, you're not telling stories, it's fact, it's science, right? It's data. But I think over time people realize that it really is about how you deliver the message and how you make sure that you bring the impact on patients or the expected impact on patients, how do you bring that alive? You know, what is the so what of the data?

Or say it in a different way, what is the clinical application of the scientific data that you have? Yet another way to say this, well, so what? Okay, so here's the data, randomized controlled trial, this is what we've done, here's the p-values. And then in the beginning, way back when I started my career, a lot of people said, Yeah, but now you need to talk about the real world evidence, even although it may have been for many different things at the time.

So it was efficacy and effectiveness sort of came about in the late 90s or so on. And that's really particularly important. We also know that uh if we look at randomized controlled trials, important as that may be, you're sitting with a patient population that actually is very specific and not real life, right? It's sort of so many things have been excluded so that you can really focus on impact on this specific uh disease.

But sometimes I think uh the industry at the blotting that we're actually talking about individuals, people who things happen to them with them. So it has to be an holistic approach, and that's one of the biggest uh changes, and I think that's one of the reasons why real-world evidence and real-world data really has become important, not as an alternative to randomized controlled trials, but complementary to like to really pull the data story through what does that mean? What is the impact, and who does it not work for potentially?

So the ability to tell that story to healthcare providers, prescribers, I think is particularly important. Here's the data, and this is what it means, right? Now, storytelling theorists will tell you that you need to think about it, how are you gonna do that? There's multiple trainings for sales forces to talk about the patient and starting with do you see a patient who come in with a cough or whatever?

And what about this? And sort of leading the conversation. Medics believe they don't have to do that. Not true, actually, from my perspective.

And again, so much of this is kind of universal, but you're the foundation is understanding the science, right? It was and understanding the data. And what that allows you to do in a perfect world is improvise is the wrong word because you're going, it allows you to have a conversation where you're providing structure and you're not just a robot reading off a script, you're actually responding to the human in front of you, but you're able to bring them to the place where you're hoping to go or at least talk about the things that you want to talk about.

And I see this all the time in the people that I have to train on my team, for example, where it's like, hey, we have a platform, you can demo it. The first step is you kind of need to know what happens when you click each thing, but it's not quite good enough to just be like, hey, look, I click this and then this chart pops up. Isn't that cool? It's like, no, I click this and this chart pops up, and in your words, so what?

And what is the impact of that? And you actually need to know that second level or third level, the impact of each aspect of what you're telling. And that's what allows you to deliver a story. Absolutely.

And I think you know, they there's a really good reason why the term scientific engagement came about, right? Scientific dialogue is part of that as well. And then you start putting things apart and say, what does dialogue mean? It's not a one-way let me tell you, it's not reading from the script, it's a quite ascension, like like we are having, right?

And it goes places and it should go places, and sometimes appropriate response might be, I don't know. But I'm gonna look into it and I'll come back to you as much as you can. Or it's a really good question. I've had that before, and we do not have data at the moment, or whatever the situation may be, but it's still it is a conversation, it has to be a dialogue, an exchange of views and an exchange of opinion.

So let me ask you this question. My assumption is that, like anything else, there's let's say you're you're running a Metaffairs organization, there's probably some type of a bell curve of the people that are doing a really good job of this and the people that need some growth help, need some help. It seems like a tricky thing to pull up Viva and figure out who my best storytellers are. How do you identify that, capture that, and train across the organization?

In general, Viva only captures activity. It does not necessarily capture quality, right? That is starting to change, by the way, with AI. And depending on what people actually put in there, it's possible to have some analytics in there and even predictive analytics, right?

It's a whole separate conversation. But the best way really to understand that, uh, at least from my perspective, is first of all to understand from the people who an individual is interacting with how is that interaction, what is working, what is not working, right? And there's the notion of observation, right? So anybody who's in a sort of a field role or external-facing role, or I think it is appropriate sometimes for somebody to go along, to go in as an observer, to give feedback, to be a coach, right?

And there's a variety of people who can do that job, right? It might be your direct line manager, it could be a colleague, it could be somebody else. You know, it doesn't really matter. But there's there is that opportunity to observe.

Now, again, as technology evolves, I know there are some companies who's playing around with recordings of the engagement and then from the analysis after that. So definitely a field that is likely to change going forward, but there is a need to actually have more specific data on how effective is that interaction? What do we want to happen? Is there an expectation of behavioral change, for example?

Like, and then, of course, there's another part which is around people development. Back to coaching, is how do you then help people who may not be as effective as they can be, right? Which then, as I say, take us down a coaching bonus edge. If you've been enjoying the conversations here on Pharma Sessions, you should know they're made possible by the team at Excent.

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com. All right, let's jump back into the episode. Yeah, and the coaching is so critical. I think so.

It's here in the US, right? It's basketball playoff season. Uh, Steph Curry just had an amazing game two nights ago. And he's the best shooter.

Nobody's been ever lived that's better than shooting the basketball than he is, and he works with the shooting coach every day. The coaching is not simply for the people that everybody can benefit from coaching. And this idea of even the best people, right? You have an outside observer in the room and somebody to talk about how that engagement went.

And sometimes it's nothing more than that, but it's hey, what did we think? What went well, what didn't go well, where can we grow? Otherwise, your team and your individuals on the team aren't improving. And hopefully they're receptive to that.

Absolutely. You of course you're right that all of us can benefit from coaching. And it doesn't matter how good we are, right? There's also the this topic of reflective practice, right?

So tell me what that is. At what point did he then get into this habit? If we've had a one-to-one interaction, there was nobody who observed us, there's nobody who can give us feedback. Do we, when we go out, when we go back, when we leave the conversation, the interaction, do we take a few minutes and think, how was that for me?

How did I do it? Is there something that I would have actually liked to do differently? Why? How can I rethink the stuff that I thought was particularly good?

And that in itself is a form of coaching, really, right? It's definitely a form of learning and actually affirmation on what is working and what is not worth. It also talks a little bit to knowing yourself and your strength so that you can keep on intentionally investing in what you're good at. Yes.

So that it remains. So I remember many conversations with people, but yeah, and often yeah, when it comes to performance, the focus should not only be on the stuff that could be better, it should also be on the stuff that is already good so that if it can stay good, so that it doesn't become really low par. And that conversation I think is really important again, in all businesses. This is not unique to medical, right?

It's uh all functions being pharma, and in fact, it's in all businesses. No, that is so true. And I I think back in my own career, there are things where I watched some of my colleagues do it, and I'm like, I wish I could do that, but I'm never going to be that person. So there's there's this woman that I worked with, Amy, who we would go to these conferences together and we were on the vendor side, right?

So trying to make conversations and make relationships with people. And she would, by the time we got to breakfast, she's like, Oh, I met that person in the elevator. I met this person. She is just like best friends with everybody on the floor.

And I'm like, I just cannot do that, right? So I need to find what I can do and lean into my own strengths, right? Work on it, right? Push my comfort boundaries a little bit on the things that I need to grow on, but not spend my days beating my head against the wall because I'm never going to be alive in that situation.

So you're doing you're doing a lot of coaching now then. And this I'm so glad this topic came up. So tell me about. The types of work that you're doing with people in Metafairs and Metafairs organizations now?

So it's a variety of things, to be honest, right? So a few years ago, I qualified through Gallup as a Cliff Constraints coach, which is a really nice tool for team development. So a number of sessions that I've done in the past, not only in medical, by the way, but in pharma at least, is exactly what we're talking about, is how to identify what you're really good at, how to focus at within a team context, how to partner maybe with other people who are better at some stuff. And if I say better, what I mean is when it comes more natural, right?

So less effort, right? So to your point, some people just have no problem chatting to people that they've never met before. Other people like myself, and maybe like, you know, when I get in the plane, I can't wait to get my headphones on because please God, I do not want to speak to the administration. Oh, it's my neighbor.

My neighbor is a conversationalist next to me. But other people just can't wait because what are they going to learn, right? Yeah. And that's not right or wrong.

It's just different. So that appreciation of our differences is some of the coaching that I do. But I've also qualified in psychosynthesis coaching, both on an individual leadership perspective, but also for teams and group dynamics and looking at what is the unset, what needs to happen, is there psychological safety. I've done a bit on resilience coaching and so on as well.

So I'm fortunate that I think when it comes to coaching, we that over the years I've built a toolbox that I can dip into and see what might be most useful, the coachy, right? Because as we know, when it comes to coaching, the answers are within. Like I'm not there to be the answers. I don't know all the answers.

Right. But it is that conversation and that journey to uncover the stuff that we sort of already know at some level, and we can say, oh, yes, actually, that's what I wanted to say. So I don't need the answer. I just maybe, you know, help the journal.

It's like a therapist is not going to tell you, they're going to lead you to come to these realizations as you discuss it and they're your partner in that journey. So right now, talking to people in the field, it seems like there's this feeling that we're in this time where either the role roles are about to change massively due to AI, or they're already starting to change. And that brings along a lot of uncertainty, a lot of people wanting to be proactive and position themselves for to continue and have a long, successful career in this space.

What are you seeing out there with regards to how organizations are feeling? So a lot of discomfort, a lot of uncertainty. I'm sure you're familiar with the the term VUCA, right? Which was uh I'm not no.

Oh well, it came about in the US military actually from Brighton in the 60s, right? So it's this notion of volatility, uncertainty, complexity, and ambiguity, right? So VUCA, and that's the environment we live in, right? It's not gonna change and go away, right?

The the change is yet to stay. I think the speed is really the question, right? It's gonna be faster and faster. And we as human beings, we need to understand how do we manage ourselves in this environment that is uncertain, right?

Because that's what it is. That is the complexity, the volatility, etc. etc. So that's one part.

The other part is technology itself. I've learned something, I don't know, two, three years ago compliment though exactly when, when somebody made the comment about AI is not necessarily going to replace people. However, people who do not learn how to interact with AI and technology will be replaced by those we do understand, appreciate, know how to work with AI and other technologies. And by the way, the AI, I don't hear it anymore, but there was a time when some people spoke about augmented intelligence rather than artificial.

The intent of that was really to how do we as humans use that to our advantage, to be more efficient, to do things quicker, etc., etc. Yeah, to maybe be alerted to things that we didn't think of immediately. So there's a number of examples already where within the industry and specifically medical, where AI as a tool has been used for efficiency, right?

Around, for example, oh medical legal regulatory review, the MLR of documentations, you know, push that through some AI tool of sorts to look at what is happening, right? Some of the insights, there's some tools that look at that to actually understand well, what is happening for, you know, what is the analytics around us. Sure. And how does that become predictive analytics?

By the way, Jonathan, some of this is not new. There's companies where this has been happening for at least 10 years, but it is moving forward. And I think people within medical specifically need to understand that our stakeholders, whether that is healthcare professionals, people who work in access, regulators, even patients, use AI. So we have to learn how to do it as well.

We need to understand where people get their information, right? We need to understand the potential biases in that information, et cetera, et cetera. So we need to be willing to learn, right? Yes.

I have on my other screen, I will read this to you because some people may think I've lost my novels. Congratulations, you are enrolled. You are the newest member of AI in healthcare, from strategies to implementation at Harvard Medical School. Because I need to understand some of it.

Some of the things that I'm still doing in my sort of post-full-time career relates to AI. So I need to have a better understanding of what it is. It's not going to go away. However, we use it to our advantage.

How you know that I think is the important bit. And I think that is of everything, the the greatest certainty is that it is definitely not going to go away, right? So the option to kind of bury your head in the sand is not a good long-term strategy, right? So it is about embracing, and to your point about its being you.

So tell you a quick story. At one point, I was working with a very large pharma and they were trying to come up with a process to use RAI tool to convert a protocol to an informed consent form. Take it to fourth grade, fifth grade reading level, whatever it was, shorten it, make a patient focus. This was years ago, but could not get through regulatory legal requirements.

And what ended up pushing it forward is that they found that the nurses at the site were taking the protocol, popping it into Chat GPT and doing it themselves. And that was like a holy cow moment, and I'll be polite there, of this is happening, right? And so either we get a little uncomfortable with how quickly we can move and adopt technologies and we control it, or you're at the behest of what's happening well outside your walls, which has none of your controls in place. Absolutely.

But I think the important thing for me is um at the moment, at least, in the majority of cases, it's still really important to have a human in that view. Oh, 100%. I do some work at uh at King's College in London who have a master's degree in medical affairs, and there was uh there was a session yesterday sort of for allowing students to do mock presentations on some of the work that they're doing. And on this one slide, I remember this these are people often who have not worked in this crew yet, right?

So one of the students had uh a really good presentation and there was an image that I've never seen before. And you know, it's sort of I've learned over the last year or so also to identify AI generated images, right? So I said, I asked, I said, so is that AI generated? And she said yes.

And I said, okay, so let's just talk about that. So explain to me what effectively what we will prop, right? So she explained, and this is how she started, and so on, blah, blah, blah. And I said, okay, fine, I get it now, but the output is not helping you within the context of what we want to talk about, because it creates an impression that is frankly not really on the money.

Um, and here are the reasons. Now, again, these are students that never worked in the industry, so they're still learning. So, I mean, I didn't mind that. But my point is that we should, as human beings, not get to that point of having blind trust in what is happening, right?

It's the same for never mind AI, but uh, it was always the same for Google and Bing, and maybe even Wikipedia and all of those things, it wasn't always 100% accurate, right? So we need to still retain that ability of critical thinking. Say, oh hang on, I'm something isn't quite right. How do I work with this?

How do I make it better? So I think that uh that really is important for us anyway. Coming back full circle to the the storytelling, right? You you are leaving every every conversation having created an impression.

It's almost like a little mini inflection curve. And the inflection can go up or it can go down, it can go up a lot, it can go down a little bit. And each and every detail matters, right? So so from the story you just told, this person had a presentation where it sounded like was essentially accurate, but there was this did you do your this element of skepticism or distrust that was inserted unnecessarily, right?

And that is something that as you're talking about, like coaching people and growing, right? Those are some of the little things that you are trying to identify and say, okay, overall, good, could have been better in this particular way. I see that all the time. It used to, I think AI is the and I'm not negative on it.

I actually use it all the time. And and I've seen great utility in certain things. There are still some things where when I say it used to be if you saw a lot of m dashes, you're like, okay, did this person actually write it? And now it's there's this framing they have in words where it's not X, Y, right?

Like short sentences, not this, this. And you're like, okay, that's cool. But did you actually read this, review this? Do you believe this?

And I think that that's where you need to not only just be the human in the loop, but you are the one delivering the message, and you are the one who ultimately needs to be standing behind and believing it. And if it helps you get there faster, that's great. But at the end of the day, that is still the end goal is to have a positive engagement. Great tool.

But you know, it's a little bit like I suppose delegating responsibility. That doesn't mean you lose the ownership, just means we ask somebody else or allow somebody else to be things. But the at the end of the day, the buck store has to stop with you, right? From a leadership perspective, at least.

You know, you can't just wash your hands and say, well, it's now it's somebody else's problem because it's not true. And it's the same a little bit with AI, maybe a lot, where you have to retain that ownership of content. Yes. Well, all right.

Well, I feel like we've had a great conversation yet again. So if we're on pace, I think the first one was in 2022. So maybe I can pencil you in for 2030. We'll see where we're at and what you're up to those days.

How does that sound? Absolutely. And you know, maybe you have a conversation with an avatar then, you know, who knows? Exactly.

We'll get I'll get one version of Danny on who we'll see what it is. Yes, exactly. Exactly all right. Thank you so much.

This episode of Pharma Sessions is sponsored by Excent, makers of the X1 reporting platform. And that's a wrap on today's episode of Pharma Sessions with me, Jonathan Kaske. If you enjoyed today's conversation, don't forget to hit follow or subscribe and share it with someone else in the pharma world who might need to hear it. For more on pharma trends, career growth, and business strategies, connect with me, Jonathan Kaske, on LinkedIn.

Until next time, thanks for listening.