Monday, October 12, 2015

Find a Doc

In the past year or so, we've completed a significant number of assignments in clinical sciences, both in big and small companies. Demand continues to be quite high. Roles include very early-stage, translational clinical development experts to late-stage, monitoring and medical affairs profiles. I have a (rather simplistic) theory about why we’ve seen such high demand in recent years.

Back in 2008, when the bottom fell out of the overall economy, early-stage life sciences were not spared the axe. Many companies with very risky technology propositions, or with shaky or unproven management teams, were not able to find funding of any kind to advance their plans. In economic downturns, or what many like to glibly call “a correction,” the purging of entrepreneurs with less than compelling stories is often viewed as a necessary (and welcome) consequence of the belt tightening. But in 2008, even established, development-stage companies felt the impact. Companies with robust clinical plans and pipelines were suddenly finding it very difficult to raise supplemental funding to advance their nascent programs, even those that were backed by leading life sciences investors.

If you’re the CEO of a technology company, the last thing you want to do is cut R&D. So in the face of the spigot turning off, and the need to make cuts, you will be much more likely to leave R&D (relatively) intact and cut the more commercial functions. I propose that this is what happened in the wake of the economic crisis. Over the following years, the R&D engines in these companies kept chugging along albeit, perhaps, at a slightly throttled back pace. Many clinical programs that had been in early development, and in anticipation of additional support, were mothballed.

Fast forward to today. While many are currently sounding the death knell of the most recent of the biotech booms, one can’t argue that over the past few years, venture rounds and IPOs for life sciences companies have become routine, almost mundane, announcements in the trade press. Whether or not it’s the end of the run, a lot of money has flowed into the sector in the past recent years. Those mothballed projects? And the output of the R&D engines? Well somebody has to now take them into the clinic.

We’ve been seeing demand in both big companies and small. Big companies, which had made significant reductions in clinical staff during the recession, are now eager to restock the pond. Since most big pharmas are looking over their shoulders with envy at the others with advanced programs in immuno-oncology, the demand in that disease area is by far the strongest. However, since many small companies are also chasing that grail, and are drawing experienced drug developers out of big companies, it leaves pharma with a gaping talent vacuum. But big companies are far better places to learn the trade – maybe not with formal training programs, but simply being part of an organization with multiple clinical development programs, all at various stages of registration. Thus, they are more willing to take medics out of academia, without direct industry experience, but with knowledge of the process through participation as a trial site. Small companies don’t have that luxury. They need to recruit people who have already experienced the range of possibilities one sees in big companies, and who have seen some failures as well as successes.

My prediction is that the next wave will be for more commercial roles. We’re already starting to see this, but the demand for great medics is still quite high. Whether or not you think the end of the world has come in terms of life sciences funding, there’s no question that financings and public offerings have slowed. In the coming years, I expect to see a return to a more rational funding environment, and a consequent tapering of investment in clinical programs, but an increase in demand for people experienced at taking those products to market. In any case, it has been great fun being part of the latest biotech boom. Those of us with some grey hair have been through a number of these periods of financing booms and busts, so we’re girding for the ebbing that is sure to come. But while we’re in the relative boom, it’s exhilarating to be part of the building of the next generation of great companies.

Sunday, February 1, 2015

Zen and the Art of Talent

When I was in high school, all the cool kids were reading Zen and the Art of Motorcycle Maintenance, so naturally, wanting to be cool, I picked up a copy and walked around with it in my back pocket. I probably made sure the title was facing out. Also, being a motorhead, I thought maybe there would be some cool stuff about motorcycles in it to which I could relate.

When I finally started reading it, I was a bit unclear why all my classmates found it so engrossing. And not being a naturally good reader, I had to struggle through it a bit. If you’re not familiar with it, here’s a description. About halfway through, I started to understand why everyone thought it was so cool. In one theme of the book, it’s the story of a man (the author) and his son taking a cross country motorcycle trip (at times with some friends). But there’s another theme interwoven throughout, in which the topics cover various rather deep theoretical and philosophical concepts, and discussed in part with a character, Phaedrus, which we conclude is the author in a previous life, and referred to in the third person.

Look, I fully admit, I’m no genius. But I do have two cells clicking. And that was true of me in high school as well. I’m here to tell you, it was a hard book to read in ninth grade. Once I finally got through it, I came to the realization that most of my contemporaries were enthralled by the bucolic images of the motorcycle trip, but probably skimmed over most of the philosophical content. I was re-reading some of the Phaedrus sections multiple times, and was thinking I was a nudnik, until I finally had this revelation. My bet (I’ll put money on it) is that most of the kids reading that book couldn’t hold a two minute conversation with you on epistemology or emotivism without drowning.

Last week, Xconomy published an interview with Geoff Colvin, Fortune’s Senior Editor at Large, and author of Talent Is Overrated: What Really Separates World-Class Performers from Everybody Else. Using Tiger Woods as an example, Colvin argues that it’s not talent that leads people to succeed, but “deliberate practice.” He claims that Tiger Woods is successful because he “…had been better prepared than anyone in the history of the game.”


So there are no other golfers whose father gave them a club at 9 months and encouraged them to practice? Even deliberately? If he had originally been terrible/disinterested, would he have become as successful? Is the argument that with enough “deliberate practice” anyone could sing like Aretha Franklin (I’m thinking of American Idol phenom William Hung)?

The Xconomy interview made me immediately think of my experience with Zen. Candidly, Colvin’s thesis sounds to me to be a rehash of Outliers. I keep hearing people cite the 10,000 hours thing as though we could all be the world’s best at something if we just worked on it more. My guess is that they need to read the book again. In his own words, Gladwell says:

“When outliers become outliers it is not just because of their own efforts. It’s because of the contributions of lots of different people and lots of different circumstances— and that means that we, as a society, have more control about who succeeds—and how many of us succeed—than we think.”

My issue with this current cool kid trend of diminishing talent is that it can’t stand up logically. To reduce the problem to the trivial, I would argue that there is no amount of practice, 10,000 hours or otherwise, that would allow a person with one arm to compete at the Olympic level in swimming. Do we agree? If so, then it follows that a person with a severe deformity of one arm might do better, but would likely not be world-class. Still with me? So there are clearly physical limitations to being the best in the world at swimming. As Philip Zimbardo pointed out in the 1990 PBS series, Discovering Psychology, there is almost certainly something about the wiring of Greg Louganis’ brain that allowed him to dominate the sport of diving. I certainly don’t argue that some very successful people have a much more disciplined approach to practice, and that such practice (assuming it’s not reinforcing bad habits) contributes to their success. But to say that Greg Louganis or Aretha Franklin or Bill Gates or Tiger Woods didn’t have underlying innate talent is simply ridiculous.

Another problem I have with Outliers is that, again, in his own words, Gladwell compares the people to whom he refers to a cold day in August. That is an outlier. In terms of people at the top, they are just that – at the top – not outliers. In the 2012 Olympic Men’s 100m freestyle, the difference between first and eighth place was less than one second. Let that sink in a minute. Eighth place. First and third? Just a hair over a quarter of a second. These people are the top of the top, not outliers. They are all highly talented. No doubt – practice plays a major role, as does coaching, nutrition…

In my experience recruiting senior executives, I’ve come across a lot of folks who have had to work very hard to get where they are, and others who “come by it naturally.” Admittedly, the analogy between talent in business and sports can only be carried so far. But given the choice, and all other things held equal, I’d still put my money on a “natural” over someone who needs 10,000 hours of practice to be any good.

I do believe that we can all get better through practice; I just think it’s unrealistic to believe or propose that we all have it within us to be at the top of any given thing. When our kids were little, I was bemused by the parents on the soccer field who were constantly praising their kids, even when they did dumb things like kick the ball in the wrong goal. It’s endemic in today’s climate to try to convince us all that we can be the best. I’m not advocating yelling at 6 year olds for kicking the ball in the wrong goal, but whatever happened to helping them understand that they don’t want to do it too often? This is not nihilism, but realism. In fact, I’m actually quite comfortable knowing that I’ll never be the best snowboarder in the world. I wonder if Gladwell was on one of those soccer teams.