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Darshan

Hey everyone, welcome to this DarshanTalks podcast. I'm your host Darshan Kulkarni. It's my mission to help patients trust the products they depend on. As you know, I'm an attorney, I'm a pharmacist, I advise companies with FDA regulated products. So if you think about drugs, wonder about medical devices, consider cannabis or obsess over pharmacy. This is the podcast for you. To clarify, stating the obvious, this is not legal advice. It's not clinical advice. This is not medical writing or regulatory advice. I do these podcasts because they're a lot of fun. And I find myself learning something new each time like with today's guests. So it would be nice to know if someone's listening. If you like what you hear, please like, leave a comment, please subscribe. If you want, you can find me on DarshanTalks on Twitter, or just go to our website darsan talks calm. This podcast. This podcast is awesome as always, but we have a special guest. And our special guest today is and I correct me if I'm wrong CEO of literacy is that is that probably doing so well? How would you introduce yourself?

Catina

Oh, I'm Katina O'Leary, I'm the president and CEO of health literacy media. We're a health literacy nonprofit in St. Louis. But we work around the world. We're a young nonprofit, we think of ourselves as sort of a scrappy startup that's hoping to transition to something stable over time, but we work hard with companies big and small to help them communicate better with people they serve.

Darshan

So So I guess that takes over the rest of my introduction. But so if you are in medical writing, if you are trying to get the right medical writers, if you're trying to connect with patients, and have a conversation, this might be exactly where you want to be, because you might hear more about how these conversations are taking place. Today's topic I really want to get into is the discussion on focus groups. So I think that's going to be really kind of interesting. But before we before we talk about that contino quick, let's talk a little bit about what you just said, which is you said that you see yourself as a scrappy startup is that fair. But when I think of the word startup, I think of someone who started like two weeks ago in their basement has computers all around them. It's them, their dog and some friend that they folded to being there with them. So I'm specifically thinking of Steve Jobs in Apple and how he started Apple, or Microsoft and Bill Gates and how you started that. But you're not a small company in that you're not two people trying to make make do something you've been around for a little bit. So can you talk a little bit about that? How big are you guys who's there?

Catina

Yeah, so there are 13 of us. So we're not big, and we're not small, we're right in the middle. I love that number, I love to be under 20, I find that when we get over about 20 people, and we start to build in layers and hierarchical sort of sort of hierarchical levels and we lose touch with each other, we start to build things that we don't have connections to necessarily so that, I don't know, 12 to 20 range of people makes me really happy. But we're pretty small. And we think of ourselves as a startup that actually started three times. I think, I think three is what we're counting. So we were formed by the Missouri foundation for health a little over a decade ago. And the purpose of the work that the foundation created us to do was to help raise the health literacy levels in Missouri. So our whole focus was to be a nonprofit funded by this foundation that really focused on Missouri partners. And we were given money directly from the foundation. And we were allowed to use those resources to help people in Missouri, we could provide services to hospitals, clinics, education systems, anybody that had a health related goal for free, right, that was our whole thing. We could go out and give them whatever they wanted. We could do talks, we could be in the community, we could build coalitions. We could host health literacy roundtables, we could do anything we wanted, and we had money to pay for it from the foundation. And it was fantastic. It was a lovely experience. We gave it all away for free, people wanted it we were able to really sort of build capacity. We did things like hard journalists to put health literacy related news stories together and give those to newspapers all around the state. We worked with the health department's to collect data on health literacy levels among community populations. We were We were the sort of driving force for that. And then about five years into that first series of activities, the foundation leadership changed. And they shared with us that one of their goals was to shift how they funded other nonprofits. And they determined that it wasn't appropriate for them to continue to sort of see nonprofits that weren't self sufficient, sustainable. And so our job was to sort of recreate ourselves without their resources. So we were really lucky because Because they allowed us to have a transition period. So we had several years of transition where we had a diminishing annual infrastructure grant from the foundation. At the same time, they also allowed us to apply for grants from the foundation, which we hadn't been able to do before, because we couldn't compete with other community agencies who didn't have are our main resource for infrastructure support. So we started to apply for their grants. And what we realized is that there was no way we were going to convince all these people who begin services for free in Missouri to pay for it. Like that's just a non starter, they'd gotten it for free for all those years, they had no money, they had no interest, they felt like they'd gotten what they needed, particularly when they didn't have a lot of resources to pay. So at that point, we determined with our board that we no longer had to also focus on the Missouri foundation for health catchment area. So when they gave us infrastructure, money, we had to stay within their region. So then we all realize that Missouri is not our area anymore, Missouri is our area, but it's not our only area. So we started to push out the boundaries. And this is sort of version 2.0. So we started to figure out where were the opportunities to partner outside our Missouri community, without stepping on the toes of our friends who were also doing health literacy work all over the country. So we didn't want to go out and go after other people's business in an ugly way, because we really try to be friendly in this space. And so to most of our partners, so we looked for states and communities where no one else was doing health literacy work. And we really started to build partnerships with large organizations around the country to help us support their work. So we were in sort of 2.0, we had a little bit of foundation money, and we started to build support from other industry. And that phase lasted for about three years. And we were just getting stable and coming out of that phase, and we hit COVID. So COVID happened, and everything sort of rolled back to sort of uncertainty and insecurity. But we've spent the last year really formalizing the internal structures that support our finances, making sure that our relationships with, you know, banking partners and other things, we're really strong and stable in building business continuously. And now, not just in the US, but internationally. So we have global partners as well. So now we're finally on the other side of this transition. And we're able to support ourselves in a in a sustainable, rational, reasonable, not panic inducing way, I don't wake up at night anymore worried about payroll. And so you know, this is sort of version 3.0. And we're just now getting to the stable part where we feel like we're, you know, a real company who can manage ourselves and be in charge of ourselves. And we're not just sort of, you know, in a do gooder role, where we're trying to sort of support other people and sort of convince them to do health literacy. We feel like we're really, you know, strong on our business practices, as well as our internal practices that are related to our programs. Does that make any sense?

Darshan

It does, it does? It absolutely does. Let me ask you this question. You said that you're no longer in the do gooder role. Most people kill it to be a do gooder role. However, you now work with what some people would say. And I disagree strongly. But some people would say the dark side, you work with pharma companies? What has that change that difference meant for you, as a smart small company going from? We're trying to give, essentially give money away good, give good data away to where we need to be self sufficient. We can continuously be in the will pay for everything roll. We need to work with pharma. What does that transition look like?

Catina

So there are a couple things. First of all, I want to be clear, we still are in the do gooder. So we're a bunch of public health do gooders who mostly just want people to embrace this. However, when you're in that position of, you know, trying to convince somebody to just take this on, and there's not so much value that you would even pay for it. It's a hard sell, because people think, well, if you're not charging for it, what was why is this important? Why is this good, you know, you don't even believe in it enough to put a price tag on it. So it's a hard sell to convince people to integrate it. It's also precarious. So that feeling of at any moment the the foundation funding, the other set support, the grant could fall, and you lose the ability to help all your partners. So you know, we want to be do gooders, we absolutely are sort of these public health do gooder nerd type folks, but there's a stability with working with larger partners, certainly, and having an institutionalized relationship with them as well. And you know, we really struggled with what it meant to transition to have more of a relationship with pharma. And as you say, the dark side for a long time some people on our board were concerned about how that changed who we are. Fundamentally the way that I think about it is there are a lot of good people in pharma. A lot of good people that are trying really hard to do good things. their expertise is often not in communication. And it's very often not and getting feedback from communities. Because of the way that pharma and regulations work, there's often a firewall even. So they're not able to go talk to people and understand what people need to know and hear, we can help with that, as a function of the way that we work, we're able to ask questions that they can't ask, we're able to help them create materials that explain more clearly, we're able to insert ourselves in a facilitation role sometimes, to help writers and directors and leaders in pharma, who are trying to do really good, and push back against business folks, and lawyers and other people who may have different, you know, a different approach or a different level of concern. So we're able to help them think about things that maybe are beyond the conversation that they're having from a business perspective. So we're often providing the user feedback from the end user in the community that helps them say things like, Well, you know, just because the language has been challenged, and been upheld by court, you know, these people are telling us they don't understand. And at some point that's going to, that's going to kick in the bottom right, you need to pay attention to this. And so we're really able to help them make things better and stronger and more clear. And I think that's our mission in a way. So if we can sort of bring good communication to medicine, we can make it safer, we can make it more transparent. We can pay people, we can help people feel more trust, we can generate transparency, there's a whole bunch of stuff that health literacy can do. I had a great conversation with a different group earlier this week. And they mentioned, you know, like buzzwords, patient centricity, things like that. These are all the buzzwords and, and I said back to them, you know, I think health literacy is a strategy to operationalize that buzzword to really bring patient centricity to life and make that real, and make it more than sort of cool jargon that industry uses to sort of feel good about it. So that's really what we're trying to do. And it's not changed how we think about our work, in many ways, because we find those partners who are interested within pharma and other places, and we support them, so it grows. But it has had, it's changed. Maybe the way we position sometimes. So we don't position as sort of a little company who's afraid to ask him, you know, we don't talk about money. And we don't think about those things. Now we we sort of position like, you know, other companies do, whether they're for profit or nonprofit that have a value around their work that that's important for the work that you're doing, too.

Darshan

So let's explore that a little bit. And I sorry, I'm sorry, I really wanted to get the full focus group. This is so interesting, just the way that the way you operate. I'm what I'm hearing you say, and again, please feel free to correct me if I'm wrong. But what I'm hearing you say is that you're going into pharma companies, and you're operationalizing patient centricity. And as part of that discussion, it's not just pharma companies, in fact, if anything, pharma companies were one of the different partners you've worked with, with the other types of partners, and do you find yourself acting as a bridge between patients and these partners, or partners and other partners, both.

Catina

So we work with a ton of partner so far is certainly one. We work with hospital systems, we work with state governments, public health groups in state government, we work with clinics that are large and small, we work with foundations. So I mentioned the focus group work that we've been actively working on in the past couple of weeks or months. That's what the foundation called longevity organization. And so the longevity foundation is completely focused on lung cancer related education and materials to support lung cancer patients or family members who people who are at risk. So all of those groups are our partners. And we absolutely at times bridge back to communities in the patients. But other times, we bridge between partners, and partners bridge between us and other partners as well. So that's one of our strategies is we try to be good partners. We're really interested in this work. When I'm mentioning sort of public health, medical writer do gooders, we get excited about this. And when we work with other people who are equally excited, they feel like we're excited about their work. These are good relationships, they want to introduce us to their friends. So we sort of keep growing in that way. It's very rare that we work with someone wants and don't work with them again. And also don't work with people that they know, that's sort of the web that's built here. And even to the point when people leave their jobs and go to other companies. It's pretty frequent that within you know, three or six months we'll get a call and say okay, I'm at so and so now. We'd love to talk to you about what we did it so and so because, you know, now we're here and they really need this too.

Darshan

So so one of the beauty of beauties of what you just mentioned, instead of being a bilateral relationship as bilateral, bilateral relationship between two organizations, you actually worked with a spider's web where different connections that you weren't necessarily seeing when that initial connection was established. I guess my question for you, and this is speaking as a man with a hammer, everything looks like a nail, how often do you get that legal pushback? How often do you go? Look, I recognize that there are some risks. When you're having an off label, can we have conversation? There are some risks when you are trying to almost semi market something, but it's not marketing. It's, it's in that unknown space in between, it's not scientific discussion, because that will be to scientists. It's not advertising because I'm not trying to sell you anything. It's somewhere in that middle public health space. How often do you see yourself fighting as lawyers? What are they usually saying? And what is your pushback? And how do you sort of, generally speaking, address this?

Catina

Yeah. So you know, I think it varies. You know, the culture of the company really drives how often we hear from the lawyers. So early on, when we worked with the state government, we heard from the lawyers a lot there. And they were really specific, we didn't notices and things that people get related to their benefits. So like, you know, people get food stamps, for example, they get a notice that gives them information. The lawyers are really persnickety about those notices. And And again, these are the lawyers that say things like, well, this has been tested in court, it's been upheld this language works, why would we change that? We spend a lot of time saying, why would you change it because people still don't understand it. So so let's help you think about some other options. And that's a slow conversation, that's a really slow conversation. And it's not about the people, it's about the culture of state government, and organizations like that things move slowly. There's a conservatism. And, you know, there's perhaps sometimes different opinions about who's the primary audience and who were really working to please. And other companies, you know, we see in a lot of our pharma partners, the conversations move very differently. So the lawyers will come in to sort of support conversations. But there's often a lot of pushback on things like informed consent. So when we start to talk about consent language, that's where we have a lot of concern and certainty. And what we find at times is that people will say, okay, it's fine, you can work on all of this part, all of this language is free and clear. But you may not touch this part, this part is the part that we hold sacred, and we're not gonna allow anybody to mess with it. And at some point, we may decide to do so. But this is off limits. And so what we ended up doing in those cases is we fix everything else. And we give them recommendations about the language that they're holding to the side. And then we hope over time that it sort of moves, and one of the things we find is when we audience tests, particularly after versions of consents, where we've changed all the language that they allowed us to change. The only thing that patients and community members will speak out about is the the language that they didn't let us touch. And then we get a lot of feedback about why does this sound differently? This reads like into voices, we don't understand what you're trying to say, if you're trying to trick me here. The company's trying to trick me, what are you trying to hide? I was all in to do all this stuff, it didn't even matter to me that you wouldn't do these terrible things. And this medicine is terrible. And all these things, I was all in until I read this. And I thought you're going to like hack my identity and steal my data. And I don't know what you're going to do to me, but I don't trust you anymore. So we're able to sort of test that give them examples of how that's perceived, and what that means for their sort of brand identity, people's feelings about the company, people's feelings about participation. And that moves them a little bit, often start to see like, Oh, this has an impact. And people read this and they feel scared. And we've been able to share data to after fixing language like that, and testing it where people say things like, when I look at the same consent form, and the language has been made friendly, based on some of these health literacy principles, people say things like, you know, I trust this company so much, I really want to be part of trials that they're, they're sponsoring because I know that they have my best interest. Um, you can do all that in a change of a couple words. And so that kind of data really changes. Lawyers minds, right? Because their goal is their goal is to do good to fundamentally, they're just afraid, little more conservative.

Darshan

That that is so fascinating. Just Just a couple words. But are you doing this using focus focus groups? Are you doing this as it happens and venue sort of responding and getting feedback? How is that usually working for you?

Catina

Yeah, so we do both. So so we often when we get to create materials, when we work on something like the informed consent, we typically ask for focus groups, and we typically asked to do two rounds. So if people can afford it, we suggest around where we look at the current version, and we get feedback from community members about what they have trouble with, and what the real challenges of the current version are. Then we use that version or that feedback to create an updated version that's health literate and accessible. When we come to agreement with all the internal powers that be about a version that's appropriate, we then try to go back and test that, again with community members, and get feedback again, to see how the documents improved. And so that language, were able to share and give feedback. So this is really important when they've not allowed us to review the whole document, which happens a lot. But it's also important for the language that we create, because you know, every company is different, every community is different, when we start to think about little things that, you know, we think makes sense. We often hear from people Oh, you know, in my disease condition, you know that those words mean something else that feels really scary. You know, we don't like we don't like the way you're talking about that. And so it's really important to be able to shift to that.

Darshan

No, no, what I'm hearing is sort of a one way communication. When you're talking about going towards the patient, and you're asking for feedback from the patient. Do you find yourself using that same skills, that same technique to educate, for example, state governments, and going Let me tell you more about sort of what you're thinking about and what and you're about to pass legislation on this? Here's what patients are really thinking. So it's almost an advocacy role, as opposed to a or educational role, as opposed to let you hired me to do the job for you?

Catina

Yeah, I mean, I think there are some opportunities to do that, in government, one of our, you know, closest government relationships is here in Missouri, and I would just say, you know, it's no secret, if you look at the maps, the Missouri government's pretty conservative, and some of the values that are, you know, very specific to our government, and our leadership right now have less to do with, you know, feedback from community members. And so while we like to provide that feedback, I think, you know, there's more of a focus on personal responsibility and some other sort of code words that aren't connected necessarily to patient's intricity, or, you know, public service, some of the public health code that we do, and I'm trying to be really polite about this. But there's some challenges with, you know, there's some challenges politically, with how people feel about these kinds of messages. And so, you know, here locally, we get to do a lot of great work with, with people in the state government offices to help make materials more accessible. But moving the policy forward, is maybe at a standstill. I mean, you know, to be honest, like, we're in Missouri right now. And, you know, the communities have had ballot initiatives twice to make a constitutional amendment related to Medicare expansion and, or Medicaid, I'm sorry, and the state government didn't fund it, right? So we're now in a lawsuit to try to figure out if the state's gonna be forced to put money to Medicaid, given that the public has voted twice to do so. And we don't know what's going to happen. Right. So that's context for the kind of work that we're trying to do when we can't get money for Medicaid, when the data is really clear that Medicaid expansion saves lives and cost less and is an overall boon for a state based on all these other states that have done it before us, we still can't make that happen here.

Darshan

You know, have you ever used your tools where you now take that information and make it understandable and bite size to state legislators to go, here's the data that supports expanding Medicaid? And And how has that been received? I know, you pointed out that there is a perception of, of sort of pain, personal responsibility, but But obviously, there are different viewpoints in this whole situation. So how has that again, we're not pointing to any individual legislator. But just in general, how is that been received?

Catina

Yeah, in Missouri, it's sort of a non starter right now. It's just, you know, what I would say is, I'm not sure that people don't understand. I think that there are just political forces that are beyond individuals. willingness to consider anything outside some pretty specific viewpoints right now. These are smart people, I don't think that it's an issue of understanding, I'd like it to be an issue of understanding and then we can just remove the blind spot, but the politics are really Stark here

Darshan

right now. Is it different in other states as best as you can tell, or have you just never looked?

Catina

Um, I think so. I think that there's a variability I mean, if you look at this, the maps across the country for, you know, any of a number of issues, I think, you know, there are states that are more liberal and states that are more conservative and Missouri's at the end of one of the most conservative states, right, like we're, we're very, very, very conservative, very and very fixed on those ideas. We have a lot of challenges we have, you know, a lot of rural communities, farm communities, communities where there are some specific concerns about, you know, rights that are maybe a little different than other communities. As a social worker, I think it's also fair to say, you know, Missouri is conflicted and always has been, you know, we're a community or state that didn't really deal with, you know, the the reality of slavery, like we were the Missouri Compromise, right? We didn't make our decision. You know, we all feel differently here. We can't reconcile sort of who we are and how we feel about things as a state. And I think we're still struggling with the reality of being really divided. Which looks like this art.

Darshan

Fair enough. Fair enough. As you know, we usually aim for about 15 to 20 minutes, well, already well past that. Because you're just a great conversationalist. Um, what do you mind if we ask you four questions? Okay, that's the first question. Based on our discussion. What is one question like to ask the audience?

Catina

Oh, wow. I would, I would love to know what my blind spot is here. So I'm a social worker, I have a really specific way of thinking about things. If I've got a blind spot here, and we could do something better to move a conversation along and somebody is hearing it, I love to hear it. I would love to know.

Darshan

I usually try to answer the question. I'm trying to go do I know a blind spot? You're speaking? I don't think you have a blind spot. I think you have a perspective. And you're passionate about that perspective. And I, as you said, You're very intelligent person. It's not that your perspective is wrong. It's just someone else has a different perspective. I'm not sure you have a blind spot. But we'll see if the others agree or disagree.

Catina

Yeah, I don't know that. I said I was intelligent. I think I said they were intelligent. But I think we're all I think we're all smarter people. Right? That's the thing.

Darshan

You did say them. But I actually said that, I think you're intelligent as well. That was my point. Um, the second question I have, during this podcast, we ended up discussing a bunch of different things, though, one of the questions I would want to ask is, in the last week, what is something you've learned?

Catina

So I've spent, I spent the last three or four days analyzing data from a series of focus groups that we collected, and we talked to patients and, and people who have lung cancer, and who are having targeted therapies, immunotherapy therapy, they're having some pretty cool treatments. And I hadn't thought about that I hadn't thought about what that really meant for them. But to hear patients talk about what it's like to sort of go into the hospital for a cough that sounds like pneumonia, and find out pretty quickly that they have stage four lung cancer, and then learn, okay, I've got this cancer, I need to figure out what to do. They go get a biomarker test, often, the biomarker test says, This is what your cancer is, and this is how we treat it. And there's this whole other treatment approach that you know, has changed their life. So they've gone from, you've got a little cough, do you got lung cancer, you may die to you know, you've got this fantastic new therapy based on your genetics, your biomarkers, and you know, it's a game changer for people and I just hadn't put that sequence together in my head. I was familiar with immunotherapies. I was familiar with biomarkers, but the reality of what that meant for a patient, you know, one patient talked about, you know, I went in to the emergency room, I got diagnosed while I was there, they had a sample. So they went ahead and did biomarker testing. We were asking about how you think about these medicines and how people make decisions and what they need to know. And he said, I didn't even think about it because it was, you know, immunotherapy or casket, right? Like, I didn't even think about it, I very much thought that I would die. Everybody thought I would die. And here are these years later, you know, after using this medicine, I'm alive and healthy, and not even, you know, this is not the thing that defines me in any way whatsoever. I hadn't thought about that. And it was just so inspiring and so powerful.

Darshan

That's amazing. I think it's, this is a totally different pathway. But that's sort of the journey we all shared in the last year and a half where we start off with COVID is gonna kill everyone. Uh huh. There's hope to were immunized and we don't have to worry about it. So it's a similar journey, but I imagined cancers somehow more cute.

Catina

Yeah, I mean, I think thinking that you have a cold or pneumonia and finding out, you know, yeah, stage four lung cancer. They say it's a joke. shock. Yeah, yeah. But anyway, so they've been fascinating stories, and I just, every time I get a chance to hear real people, I think it's just such a gift I love when people feel like they can tell us their stories, and then use that to help us, you know, explain things better and tell the story better to other people. And that's the whole goal is, you know, we want to make sure we know from people who've really had an experience, how to communicate this to other people who are at a different point in the journey.

Darshan

You're a professional storyteller. That's awesome. Let me ask you this other question, um, what challenged you this month?

Catina

You know, this is not really a work challenge, necessarily. But we transitioned again, so my kids were in school all year, and they're now out of school. So I've had the luxury of having a somewhat normal life. But my kids got out of school about three weeks ago. And while we were comfortable with them being in school, we aren't comfortable with sort of universal camps, my nine year olds not vaccinated. And so getting back to this, like, Okay, how am I going to work this summer and keep my kids engaged and do all the things I need to do and they need to do? I hadn't thought about that for a while. So it took me back to the beginning of COVID, actually, where I had to start to think about juggling again, and, you know, I'm hearing all of these big companies say, you know, things like, you've got to get back to the office by September, we're not going to give you the same salary or, you know, whatever these, whatever these decisions are, and it just, it brings up for me that we're not all in the same place. And we really are still at a point of being really sensitive to people's individual and family needs. Because based on all of these, you know, specifics of people's, you know, individual families and who can be vaccinated and who cannot, our ability to reenter the world. Equally is not there yet.

Darshan

Absolutely. Um, so what I'm going to do at this point is I'm going to do a quick summary. So during this conversation, we landed up talking a little bit about how you are a quote unquote, scrappy startup with up to 20 people. She talked about how there are no hierarchies. And as per your experience, 12 to 20. Is that is that magic number, if you will, you talked about the orange nation of health literacy, starting health literacy in in Missouri, and then how you give things away for free, including good journalism to help departments, you, you then talk about you and your team's experiences being a professional do gooder, which I thought was awesome. But then you have to work with what others consider the dark side, but but not necessarily. And that's been your experience. If people are just trying to do good in many cases, maybe sometimes it doesn't work out as well as they'd want. But but they're trying to do good. You talked about some of the roles you play where you help and transparency, and you're helping different stakeholders, including hospitals and state governments and clinics and foundations. And you talked about how you're working with state governments, for example to and sort of lawyers in the context of like benefit planning or informed consent, depending on who the audience is. You talked a little bit about the work you do with governments and the different perspectives. For example, in the case of Missouri, he gets battle against that, that perspective of personal responsibility. And he talked a little bit very, very briefly about focus groups. We talked about how you do want to use two different versions and you try to get to the meeting. But I think that's what I miss anything.

Catina

Now, various conversation as usual,

Darshan

you're always a good conversationalist. Let me ask you this question. If people want to reach you and they want to work with you, how can they find you?

Catina

So you can go to our website health literacy dot media, health literacy, all one word dot media, or they can email me see O'Leary at health literacy dot media.

Darshan

Very, very cool. And if you want to reach me, you can find me on Twitter at DarshanTalks, go to our website DarshanTalks comm If you liked this podcast, please like leave a comment. Please subscribe. We'd love to hear from you. And if you'd like to Tina, feel free to reach out to her because I think she's awesome. Tina, thank you so much for coming on. Again.

Catina

Thank you. It's fun talking to you.

Darshan

pleasure as always,

Catina

this is the DarshanTalks podcast, regulatory guy, irregular podcast with hosts Dr. Shaun Kulkarni. You can find the show on twitter at DarshanTalks or the show's website at DarshanTalks.com

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