Darshan
Hey everyone, welcome to another episode of DarshanTalks. I'm your host, Darshan Kulkarni. It's my mission to help you trust the products you depend on. And when I be should also include you should trust the people who actually talk to you about the process that you should depend on, and that you depend on. So that's what today's conversation is going to be about. As you know, I'm an attorney, I'm a pharmacist, and I advise companies with FDA regulated products. So if you think about drugs, wonder about devices, consider cannabis or obsess over pharmacy. This is the podcast for you. I do have to say I'm an attorney. So this is not legal advice. Both my guests and I are both pharmacists, this is not political advice. I do these podcasts because they're a lot of fun. I find myself learning something new each time, that'd be great. It'd be great to know if you actually are listening. So if you like what you hear, please like leave a comment, please subscribe. And you can always find me on Twitter at DarshanTalks, or just go to our website darsan puffs, calm. Our podcast today is gonna be really interesting, because we've had this guest multiple times, he's always a joy to have on. He's always super busy. So I'm always surprised that I can get him because he's always doing like all these different things. We're going to talk a little bit about some of the things he's doing. So if you are in medical affairs, if you are trying to figure out should you be in medical affairs, let's listen and you might find something new might find something to discuss. And our guest today, just just to be clear, is the founder of a CMA. He can be reached out on LinkedIn. And he's actually very, very accessible. Surprisingly, because he's so busy. So he is very, very accessible. And I'll flash some links on how you can reach him as well as we continue. But our guest today William Solomon, how are you? Hey, Darshan,
William
how are you? Glad to be back?
Darshan
Good. First of all, is it Solomon or Solomon? Solomon? It is okay. Got that? Right. Oh, I didn't trust my own instincts. Okay, good to know. Yes. So so let me let me ask you this question. You've been really busy. We've had these conversations. Rather recently. We The last time we spoke you were actually going to the Attorney General's offices, you're talking to them? I don't know if you're free to talk about what are they often looking for? And why did they reach out to you for some purpose?
William
Yeah, that's a great question. Yeah, I think the last time we were meeting, I was about to go down to the US Attorney General's Alliance meeting. And so, you know, one of the big things unfortunately, in the US last two years, that's been a major concern for for the US government, the federal and the state level has been the opioid crisis. And you may have seen, you know, I've done a lot of different television shows, like Fox News and others to talk about this issue. It's, it's a real big problem in the US, it's actually had been a big burden on the health care system cost wise. And so I was invited by the US Attorney General's Alliance, to talk about the importance of establishing standards for the professionals that work in the pharmaceutical industry. Specifically, you know, that we're very focused, of course, on medical affairs and medical science liaison professionals. And as you guys you know, that's that's what we do, that's kind of our bread and butter at the CMA is what we focus on. So I was very honored to be invited there, you know, I got to meet a lot of cool people. And it was really interesting, you know, because the, the government, they're very much aware of what the role the MSL is, in terms of engaging doctors and how impactful they can be. So I always tell folks that I talked to in the industry, it's really very important, actually, now more than ever, to consider independently certifying and accrediting your team. Because it's really a way to mitigate risk. And it's a way to ensure that you kind of cross the T's and dot the i's in the event, you know, God forbid, you're under an audit or something, you can say, look, you know, we actually ensure that our medical team is meeting certain kind of minimum standards. And so that's why, you know, it's what we I was about to talk about, and they were very receptive, very interested in, you know, still having those conversations.
Darshan
So, so you're having these conversations, when when you're talking to these attorney generals, and this, you're talking to them about the value? What is the pushback you get, do you do they see industry and just paint you in the same light as everyone else? Or do they do they even First of all, let's start from the beginning. Do they think that industry is primarily full of bad actors? Let me ask you that question. Or because they only see the worst parts of the worst, right? So how does that work?
William
Well, unfortunately, you know, the opioid crisis, the industry that plays somewhat of a world you can't deny that. No, I don't think they see the industry is full of bad actors, but they recognize that the industry could do a better job and how they characterize information they give to physicians. I think where there was confusion is that they there was maybe not initially I would say two, three years ago, we were first having these conversations and by the way, not just for the Attorney General's even on the hill, you know, in Congress, we were having a lot of conversations, the difference between the sales rep and an MSL people conflate those two right and even till now you still have a lot of healthcare providers that don't necessarily understand the difference. And this is why I'm a big believer in professionalizing our you know, our profession as as a medical affairs professional or an MSL and I and I'm against separating the MSL from a medical affairs professional in general, to me, the medical affairs functions all one unit, of course, the MSL is and field medical sit within that. And this is why you know, even when the board certification and medical affairs was first conceived over six years ago, in the and the thought was that it really shouldn't be a comprehensive program that really oversaw the whole function, because all function is really one organism or one unit that does one or two things, either it's Jay, you're either generating data, or you're communicating data, right? If it's an info call center, or if it's a field medical, or you're generating data, if you are, you know, working in medical strategy or doing HR. So it's primarily those are the primary two functions. And so I'm a big proponent of that. And I and I actually believe that some of the organizations out there that try to separate out these particular functions, I'm against that, and I know that that's controversial, but I'm against it, because I actually think it fragments, medical affairs,
Darshan
which really just to clarify, just to clarify, when you say you're separating the two functions, are you talking about he or msls, or token sales and sales,
William
I'm talking about medical affairs as a whole, and msls. A lot of times we in the industry, we separate those two, but they're really the same thing. MSL is just an extension of field medical. They're not it's not really separate. And that's something that I think is a disservice actually to the MSL and to internal medical. It's actually one, as I said before, it's one unit or one organism. And I, I know that there's some organizations out there that focus specifically on msls. But I think that's a disservice because really, the MSL is for them to be integrated properly, really have to see them as part of the entire medical affairs organization.
Darshan
So let's let's start from the beginning, because I actually have a friend who is a pharmacist and actually had this conversation with her more than a few times. She is a little tired of being a clinical pharmacist in the hospital. And I was like, Well, what else do you consider? And she's like, well, I thought about the industry. And I said, so have you considered being an MSL, the two things she mentioned was, well, I don't really want to be a glorified salesperson. That's basically what our initial thought was, which really speaks to exactly what you were discussing a few seconds ago. And the second thing she worried about is, will I have time for my family at that point? So I guess my question for you is, as someone who is helping with the certification and and in many ways driving the field forward, to really talk about what is possible in this role. Do you have conversations right now about for people who are starting out? Is this the right fit for them? How do you even begin to guide them through that thought process?
William
That's a really good question we actually had a few months ago, we had a blog actually, that actually discussed that is, Are you being an MSL? Are you going into the industry for the right reason? I think a lot of times it's more that they're running away from something they don't like, right, versus going to something that they really understand I completely. I completely get where you're coming from. And I actually like I said, it's a very good question because oftentimes, they're sick of working in clinical or sick of retail. And so they look towards an MSL role because they might think it has better work life balance, I get to work from home and I work flexibility and all that kind of stuff. And yes, there there is an element of that certainly right. There isn't maybe that level of rigidity that you find in a role like a retail pharmacy type role. But the point here is that even when you work as an MSL, it's a kind of a trade off. So while you may not be you know, in a pharmacy or in a hospital, in working maybe on an hourly basis, there's there could there's quite a bit of travel there. A lot of demand, you know from multiple stakeholders, sales clinical, internal medical, your kayo wells. And that, you know, that's that's also pressure, you have an element of the business acumen that involves relationship building and not everybody likes that. Not everybody likes that choosing part. You know, we don't talk about that a lot in medical affairs, the MSL world, but not everybody likes that, you know, I saw my wife, who is a pharmacist. And she's the founder of pharmacist moms, you might have heard of Parkinson's moms. And she, I met her when she was an MSL, right, we're both on my cells. And she hated that she was in part, she was not good at it. And I liked it, I enjoyed going to Kay wells and building that relationship and taking them out to death, right. So it's not for everybody. And I think sometimes where people run into when they get into that a role is they discount that part. But that part is actually a very important part to be successful. Because at the end of the day, when you're going to meet with a caol, it's not just about bringing the data, of course they want that data, they want that information. It's also about that the like you that they'll like to want to meet you. Right, they're taking time out of their day. Remember, reimbursements are lower right now for physicians that see more patients, because he was practicing physicians. And so when they're taking time out of their day, they've got to enjoy sitting with you. And so that that's an important part of it. People need to re
Darshan
import before. So so I'm going to say this, we just have a comment come in from Japan. I'm a pharmacy career coach. And these are truly insightful comments about the field. MSL is often a glorified role people seek because they value that working from home elements you mentioned, what I think is interesting gernon is the fact that William saying the working from home is not as much from home as most people think. And I think this conversation is important that it's outlining exactly that piece of piece of the job that meet people don't often recognize and and i wonder, I don't know if you know the statistics around this, but do you know how many people change jobs out of being an MSL? once they realize this is a core component that yes, we work from home, but you travel a lot?
William
That's that's quite I don't know how many. But I thought that the average for one. And yeah, it's always people, it's a bad sign. Even when I hire people at dcma. If I ask someone, you know, what, do you want to leave your current role? and someone says, Well, you know, they, they've decided to put us back in the office and I want to work from home. That's not a good enough reason, right? Because, you know, yeah, we enjoy working for work. But that can't be the end of the ride. For wind. That's one
Darshan
thing. Well, you say that, though, but for the last two years, isn't that what we just did? Do you think that the role of the MSL is going to change? Because COVID forced us to change in the sense that people are now engaging, and it seems to work? Those are things that
William
I think, some extent it's going to change. But I think what a lot of companies are realizing is that face to face, human interaction is very important. You know, it's not the same as when you meet someone in person versus just doing it virtually, yes, there's some things you can do to get the job done. But there is value there to meeting a person. That being said, though, that being said, a lot of you doctors today, millennials, and the millennial doctors today, they're used to this idea of being able to meet someone virtual, get the information they need in a different way. And they're probably going to be more accepting of that idea. So I do think there's going to be somewhat of, you know, of a shift, but I still think we're always going to have face to face interaction. A lot of the conferences are coming back now. In fact, we're going to be investing next month, the team will be there. And that's an in person meeting, you know, and why is it important for us to be there because we believe, you know, being face to face with with folks and meeting them. That's key to building that relationship. So
Darshan
so so. So first of all, we have a follow up from Japan, where she goes, I'm glad we're discussing how much travels necessary and the need to be an extrovert and schmoozing. There is I guess, my question is, is it necessarily a need to be an extrovert or is it a I don't know is it reveling in what you already know? So what's your take on that?
William
I you know, I don't Not being an extrovert I don't consider myself an extrovert but I I practice over the years how to build those relationships there's there's a way to do it. It's not that you have to be an extrovert but it's it's that you need to be comfortable getting to know people and building relationships and sharing information with people you may not know very well and be you know, having that level of assertiveness and it's not just the data dump, you know, and that's you hit a lot in the MSL world, it's not about going in and just dumping data, it's really going getting getting to know them getting to understand their needs, and and how you can help them. That's that's the keys, how do you bring value and in better inform their clinical decisions? Right. I mean, that's, if you're a good MSL, in my opinion, you're really going in there and making sure that you're providing information to help them make better clinical decisions, ultimately, that's the idea, right? And helping the figure and find ways that you know, you can create a bridge between them and your company, whether it's studies and research, advisory boards, consultancy, whatever that is all those typical things that msos do.
Darshan
So so it's funny, you talk about that, because the the key component of, of being an MSL, in many ways is what you keep describing as this relationship building. However, when I think of the DOJ, I think about FDA, what their FDA, again, to a certain extent doesn't even have jurisdiction over I myself, but that's a very different discussion. The point I'm making, though, is a lot of these governmental bodies are really coming at this with this idea that it should be transactional, you're doing the work, you're helping them make a decision, you're not the one making the decision, and you do that move out. But that's sort of ignores the human element, as I see it, the human element being you have to develop trust that and that trust comes from continuous engagement. But that continuous engagement, I guess, and I'm sorry, I'm sort of doing a soapbox thing. But that continuous engagement starts seeping into the whole direction of are you now being salesy. So how do you guide msls? In in saying, Here's how you can build trust, here's how you avoid being salesy, and how do you sort of help them navigate that
William
will see that goes back to the credibility piece, and you know, and that's why I think professionalizing what we do through some type of credential to distinguish us from sales is important because being being salesy, though the idea of being salesy, what are we actually talking about when we say, you know, you're being salesy, does that mean that I am being a schmoozer? Does that mean I'm, I'm trying to engage you and try to build a relationship? I don't see it that way. I see it that that, that that talent, or that skill is important in many different roles. You can even argue a physician, a good physician knows how to build relationships or knows how to build relationships with her, his or her patients, right? Because that's, that's part of it, right? And you can go online, you read some of those reviews that doctors have, you know, a lot of times it's that patients feel like, wow, this doctor doesn't give me that warm and fuzzy feeling. They're not, you know, sociable, they're not likable, approachable, so that this idea that, you know, being engaging or schmoozing or building those relationships means you're salesy. I totally reject that. I think it's about your competency. If you have the right competencies, and you provide information in an objective and reliable way, you know what you're talking about, then that will come because then I know I can trust you. Because I you know, when I was when I was in pharma, and I used to lead MSL teams, I saw it firsthand. If the MSL was credible, they knew how to present the data properly, they knew the answer in depth questions correctly and accurately, the doctors trusted them. So a big part of that was you have to you have to know what you're doing. You know, I saw people that were very good choosers and kaboodle build relationships with didn't have the science. And that didn't matter, right? They couldn't get in the next time, they had a difficult time accessing doctors because they can't bring the value. So it's it's tooth, you know, both of them work hand in hand, you know that both components are important. It can't be that you have one and not the other. So that I think is something you can't discount.
Darshan
It's really interesting. So what I hear you saying is that the first step to trust with clinicians, is credibility. Is that fair?
William
credibility through your ability to be able to communicate and know the science accurately and objectively and that's what's going to distinct Because you from sales, because sales and going in and doing that, right? They're saying, Hey Darshan, you know, I'm happy to be here, I would show you as a 30% increase here, 20% inside here, that's very different than what an MSL does. So that's the key number. That's the cornerstone, then of course, the building leadership building that's required to keep that going to keep being able to find those areas for kind of, you know, a commonality for your company and help to provide opportunities for collaboration,
Darshan
which, which I think is really interesting. So once you have essentially a formula, that your formula is credibility plus relationship building equals trust. Is that is that absolutely
William
shattered? Is it any professional story one time, a patient told me they went into a doctor's office? And the doctor question, the doctor literally in the office turned around, took out their phone and Google the question. You think that patient thinks that box is credible?
Darshan
But So wait, we've got credibility? Plus, what don't you say? plus, plus relationship building? But I guess my question, what is one thing that's missing? And I'd be curious, what's your opinion on this is? Is it credibility plus relationship building? Plus consistency? And what I mean by that is, how often should an MSL meet with a doctor with a with the, or whoever else in healthcare, to build that relationship is it as, as we just said, transactional? And like, the first time you come in, you come in with your with your PhD pharmd, the MD credentials, and you go, I know what I'm talking about. I was leading Harvard, and whatever. And this is my like, here are my credentials. And you can trust me, or is it? Dr. Smith, let me talk to you about your your daughter, let me talk to you about your patience. Let me build that relationship and then disappear? Or do you need to come in every quarter come in every six months? and have that conversation all over again? What What do you recommend as this, as you develop that?
William
I mean, consistencies absolutely important, you have to you have to go in there on a routine basis, the frequency depends really on the doctor. And it depends a lot of times on your territory and the need, you're going to find that if you have a big territory, your frequency might be very different than if you are in MSL, Manhattan, I see an MSL in Manhattan, and my frequency was higher, you know, for each doctor, because I can get to them much more quickly. But if I had a big territory, which I used to I used to cover the Mid Atlantic, you know, is now going 20 years ago. And in that situation, I couldn't maybe get to every doctor as much as I wanted to. So you have to gauge the situation and the need, but I would say, you know, a general rule of thumb is, you know, once a quarter is probably reasonable. If you can get to each k Well, once a quarter in person, that's great. I would say following up, though, okay, well, at least by email, once a month is important, and providing some type of information. So at least they remember who you are. Because remember, you're not the only game in town, right? You have other msls that are also that therapeutic area, and they're also reaching out. So continuing to follow up with information that they see is valuable, even if it was
Darshan
important. See, that's an interesting question to me, because you're saying, there's other game in town, you need to be front of mind, it helps you build credibility, all of which is critical, which is important. But why does it matter? If there are there's other game in town you're not trying to sell? You're just trying to build a relationship? Does it matter that this clinicians building relationships with others, that it's not like trust gets diluted? So what is your thought process? Why is that important?
William
Because it's it's a matter of share voice. And so even within science, they're still share a voice because let's let's be honest, let's say I'm an MSL in the area of diabetes, and you're an MSL in the area of diabetes with another company, and we both have a product, yes, we're not selling the product. But there is a point of view that we are trying to, to talk about our community, we want you to understand our point of view. You see what I mean? So let's not kid ourselves in that msls don't sell, but msls including all of the medical affairs, their activity helps to provide the context and the foundation for good selling, right because I mean, think about it, if you're a medical affairs, and you decide you, you know, you come up with a great pathway for expanding the label. And now this new indication is is now on the label. So now, once it's on the label, now a sales rep can go out and talk about it practically right once they have the assets. So what you've done in effect is created a more effective context for selling more effectively. So, you know, I think this idea that msls don't sell doesn't negate the fact that medical creates a good context for such as regulatory, you know, and I used to be on the MLR review meetings, medical legal review, you know, committee regular regulatory meetings where we're reviewing commercials, we're reviewing tweets. Now you can argue, you know, why is medical involved in that? Why is regulatory involved in that? Well, because even though it's a direct to consumer, commercial, regulatory and medical need to be involved to make sure that the information is objective, it's accurate, is in sits in the line of record from a regulatory perspective, right with the FDA labeling, but that ultimately helps to sell the drug, but it's doing it in an ethical, of course, in a compliant way. So you can't divorce the two. And again, that's why I keep saying this. That's why, because of these questions, you're asking, you know, it's right, it's To me, it's indicative of the fact that we know in the industry, it's a blurred line sometimes. And that's why we need to professionalize what we do. I can't stress that enough. And this still isn't always controversial, and I apologize. But there is still a lot of old timer folks that have been in the industry, but I'm I'm one of them. I'm one of the old timer, folks. But there's still a lot of folks that have industry for 20 or 30 years that don't want to accept this change that, like you said, where we need to move the industry forward. Let's move forward, what are we afraid of? Let's move forward and do it the right way. Because we don't know everything, we just don't you know, I've been I've talked to people that have been issue for 1920 years, they get board certified, and they'll reach out to us and say, Wow, I didn't realize how much I didn't know. You know, because I know everything.
Darshan
So so I can obviously keep going for a very, very long time. But as you know, I tried to wrap it up a little bit, just to give us a little bit of time. This has been absolutely fascinating. But a couple of questions for you. So the first question based on what we discussed, what would you like to ask the listeners?
William
What I like to ask the listeners, I'd love to know, a lot of they're out there watching, they're watching, if they recognize that. Because it's always surprising to me, when people reach out, they actually don't realize that.
Darshan
Oh, interesting. I mean, I knew it was but I'd always assumed everyone else did too. But you're right. I was making an assumption. So very, very cool. Um, I'll try to put that up as a LinkedIn survey and just see what
William
happens. Yeah, I'd be curious to see.
Darshan
The second question for you. What is something interesting, you've learned over the last month?
William
Something interesting that I've learned over the last one? I would say probably, you know, like we were talking about earlier with some of the work that I'm doing with the US Attorney General general is the level of damage that this opioid pandemic has caused among the youth in particular, you know, in high schools, I didn't realize you know, how much of a problem it was spread nationwide, it's really not just, you know, in lower socioeconomic kind of areas, but it's really widespread and even more kind of middle upper class communities. And I guess I didn't realize that I didn't realize it was an impact
Darshan
after admit, I didn't realize I know it's the numbers are staggering, but until you can place context about them. For me, at least the numbers don't explain how bad it is. So it's fascinating to me that you're saying that my next question What's something that made you happy over the last week?
William
Something that made me happy laughing anything personal professional,
Darshan
anything? absolutely anything?
William
I would say we love traveling great, great day with my family. Get a lot of kids and you know it's hard to get them to agree on and so I got them over the weekend. I do the water to seven degree I want to do the same things that we're doing fun for me it was nice to see all in all five of the kids.
Darshan
That's really really cool. I have to say though, I didn't know you had five kids. I'm surprised none of them have interrupted any of our conversations.
William
Surprise. Surprise, they actually will knock on the door and it's always like at the worst time but they're pretty good. They know When I want to call or something so
Darshan
good for them. And I have been flashing this throughout, but how can people reach you?
William
Like you said they can reach out to me directly on LinkedIn. And I'm always happy to give me a bunch of questions. Like, can anyone we have a team is always happy to answer any questions about a board certification I'm going to share with you the industry you can also reach out to me about acm.org as well, well. My wife, she's again, she's never my better half, but my wife Suzanne. She's someone that's very passionate about the area of pharmacy as well and, and the role that you know, women have played in pharmacy, especially over the last several decades, you know, in terms of how they've grown. I mean, I don't know if you know, but women pharmacy now have become dominant. And it's been great. It's been great. I think it's professional.
Darshan
I thought they've been dominant for years, but I would actually I should probably if I asked to interview your wife at some point, I'd be really one of the interesting. Yo, apparently jennens proud to be a pharmacist mom because of her. Yes. Nice. Thank you, Jen. I'll have to tell her message. Oh, this was amazing. As always, thank you so much for coming on. I'm looking forward to having you back again soon. So thank you everyone for listening and, and stay tuned for that.
William
Thank you very much to our channel, always a pleasure.
William
This is the DarshanTalks podcast, regulatory guy, irregular podcast with host Darshan Kulkarni. You can find the show on twitter at DarshanTalks or the show's website at DarshanTalks.com