What is it Like to Work for a Pharmaceutical Company?

Is working for a pharmaceutical company a career option you've thought about pursuing? In this column, Barbara Linney interviews physician executive Edward A. Kaufman, MD, about his 20-year experience working in the pharmaceutical industry. He talks about how he held a series of jobs for SmithKline Beecham's clinical labs business and lived in a number of places. He describes his background and how it made him an attractive candidate for the position, why he sought out the pharmaceutical industry the nature of the work, and some of the projects that he has been involved in. He gives examples of physicians who have joined the executive ranks at GlaxoSmithKline and what made them such high-caliber candidates for top leadership positions.

KEY CONCEPTS

* Working for a Pharmaceutical Company

* Career Opportunities for Physician Executives

* Making a Career Transition

* Valuable Skills and Background

* Entry Paths to the Commercial Labs Business

Edward A. Kaufman, MD, went to work for SmithKline Clinical Laboratories (SKCL) 20 years ago. He has held numerous positions for them as the parent company evolved into SmithKline Beecham (SB) and now GlaxoSmithKline (GSK), created by the merger of SmithKline Beecham and Glaxo Wellcome. I began the interview with him by asking.

Q. What is it like for a physician to work for a pharmaceutical company?

Kaufman: Some physicians come into the company to practice medicine and look after the health and safety of the employees. These physicians are trained in public health, occupational health and safety, or rehabilitative medicine and are interested in preventing and treating the disorders that people working in businesses or in manufacturing plants develop. And, of course, they're interested in preventing and treating the diseases that all of us have and understanding their impact on the workplace.

The second, larger group pursues research in areas like infectious disease and anti-infectives, central nervous system medicine, or cardiovascular medicine. They may conduct basic pharmacological research or large-scale clinical trials on compounds being tested in humans. Most of these physicians end up making a career of research, but some move into other areas once they see the opportunities that exist.

The third group is comprised of physicians like me who are interested in the business of medicine and have an entrepreneurial bent. These physicians help a product or marketing team understand how specialists think when they are in the office, how they respond when they see certain kinds of patients, and what leads them to make a decision about one drug or another. They help the company support its products once they get to the marketplace. An endocrinologist might be assigned to a product marketing team supporting Avandia[R] (rosiglitazone). A cardiologist might be working on a cardiovascular team; a psychiatrist working to support Paxil[R] (paroxetine); a neurologist supporting the central nervous system group.

Finally, there is a fourth, elite group that comes in through a narrow funnel of academia. These physicians have made their mark in science and medicine and have also distinguished themselves by managing large departments within complex medical centers. Theirs is not a common entrance path, but it demonstrates the caliber of people who come in to lead the organization.

Tachi Yamada, MD, came in as head of SB's health care services division, which included the laboratories and supported an effort we had underway to evaluate laboratory data as a source of information on the health of populations, and is now the President of GSK Research and Development. A gastroenterologist by training, he did a great deal of primary research, is a textbook author, rose through the ranks of the University of Michigan, was Chairman of the Internal Medicine department, and Physician in Chief of the University of Michigan Medical Center before coming to SB five years ago.

Jim Niedel, MD, GSK's Chief Science and Technology Officer, was a distinguished hematologist-oncologist and made his way through the ranks at Duke University Medical Center and came into Glaxo at a high executive level. Peter Traber MD, the head of clinical pharmacology and experimental medicine for GSK, was the interim dean at the University of Pennsylvania School of Medicine and the CEO for the University of Pennsylvania health system.

Q. What brought you to SmithKline Beecham and what do you do?

Kaufman: I am a pathologist by training and early in my residency became interested in the business of medicine. I was influenced by the chairman of my program, who had some industry experience, frequently spoke to us about costs and benefits, and was interested in what makes one diagnostic product a commercial success, and another one, not. Soon after I finished my residency, I went to Stanford University Graduate School of Business as a full time MBA student. My interest in pursuing an MBA came about, in part, because I had observed that physicians and administrators were often at odds with one another. It struck me that it would fall to physicians ultimately to bring some management sense to the practice of medicine. I had practiced pathology for a couple of years. My mentors said I was throwing away my career, and I wasn't so sure I wasn't doing just that. In retrospect, I've been happy with the decision.

I looked at many opportunities, including pharmaceutical firms investment banking, and venture capital firms. Some of the management consulting companies were starting to develop health care arms back in 1980. However, I thought I owed it to myself to explore the commercial laboratory business, since my primary interest was in clinical pathology. I went to work for SKCL as General Manager and Medical Director of a small clinical lab in Chicago, which grew from a $3 million to a $20 million lab in a few years.

I then came to Philadelphia as the head of business development and strategic planning, writing the strategic plan for a couple of years as SKCL went through a number of acquisitions. Clinical labs grew from about $60 to 70 million in annual revenues when I joined to $1.5 billion when I left a year ago. I was also the company's representative to the American Clinical Laboratory Association, which represented the labs on various government issues.

I went back into general management in 1988 and headed the company's Los Angeles laboratory, which included a lab that did clinical trials testing for pharmaceutical companies and provided general laboratory services to Southern California. The lab also functioned as SKCL's national esoteric testing center. The more complicated laboratory tests or those that were infrequently ordered were triaged out to the Los Angeles laboratory. I was the General Manager for this $120 million operation with 1,200 employees--10 percent of the company's effort at the time. Although I used my medical training in all of those jobs, I actually only came back to a full medical job in 1994, when I became National Medical Director. I served in that role until a year ago.

Q. How did you cope with the many moves that your jobs required?

Kaufman: It was not an easy transition for us as a family. As I moved, my contacts didn't change that much. They might change to telephone contacts instead of face to face, but I continued to have contact with many people I had worked with on a day to day basis, and I saw them regularly at meetings as I traveled. My network continued to grow, whereas my wife and children needed to establish new contacts in new neighborhoods and make extraordinary efforts to stay in touch with old friends. It clearly was more difficult for them. All the things that one reads about relocations were true for us.

Q. Having left the laboratory business, what do you do now?

Kaufman: I'm head of corporate compliance for GlaxoSmithKline. In some ways, this is an about face--moving into an area that is typically thought of as a legal pursuit. I am not an attorney; I acquired the prerequisites for this job the hard way--through experience. SKCL had a well-publicized experience a number of years ago in which it was the subject of a government investigation. SKCL implemented a comprehensive compliance program that was incorporated into a corporate integrity agreement with the HHS Office of Inspector General and the Department of Justice. Many of the issues that were an area of discussion between the government and the clinical laboratories had to do with medical necessity.

Because of the medical necessity focus, the laboratory directors and I became intimately involved in addressing certain issues that arose under the corporate integrity agreement with the government, helping to define what constitutes medical necessity and implementing the plan throughout SKCL. Through that experience, really without even realizing it, I began to function as a compliance officer.

In August, 1999, we sold the clinical laboratories division to Quest Diagnostics. I had worked in the clinical laboratory industry for 18 years and decided it was time to do something else. Not long after I decided to leave, I asked SB if I could work in the corporate compliance department for its pharmaceutical business. I started doing corporate compliance a year ago.

Q. What advice do you have for other physicians who might want to work in industry?

Kaufman: There isn't any one entry path that leads to working in the pharmaceutical industry, or any industry for that matter. The physicians have come to GSK in a variety of ways. If someone looked at me as the corporate compliance officer and said, "How did you get there?" it would be difficult to guess the pathway.

At the beginning, I asked at myself, "Where can I best market my skills and combined interests in business and medicine?" There were a number of places I could have turned, but I decided going to the commercial laboratory industry was the logical approach, and I started knocking on doors. I got the names of people who worked in the big labs. I identified their medical directors. Sometimes I wrote to their presidents. I found out who the heads of their human resources departments were. I asked myself, do I have the skills that could work here and is this a company that I would like to work for? How can I position myself and showcase my skills so I look like an attractive candidate?

Companies obviously do a lot of recruiting. They place ads in newspapers. They go to headhunters. But, in general, the most successful relationships between a company and an employee are with the people who basically go and sell themselves to the company. These candidates have identified the company for one reason or another as being a desirable place to work. They are "walk-ons" rather than "draftees."

Q. What are the obvious roles that physicians might play at GSK?

Kaufman: A company like GSK has a strong medical bent. But at the same time, it is populated with people with different functional skills and most of the employees are not physicians. Consequently, it is likely that in thinking of somebody for a position, the hiring teams or managers will think, well, we need somebody with communication skills or human resource skills, or we need a marketer or a financial analyst. They are not likely to think--we need a doc for this job. However, if a doc presents himself or herself and has some of the other skills that the recruiting manager is looking for, they will take a look at that person and give him or her an opportunity to do a job that they might not otherwise get to do.

That is one of the wonderful things about working for a company like GSK--I have functioned in a variety of jobs that I never in my wildest imagination thought I'd have the opportunity to do 20 years ago when I came to work for SKCL. And, I'm not alone in that experience. There are wonderful opportunities that open up if one is willing to think about the ways in which one can apply medicine to these different skills rather than always thinking of oneself as a physician only practicing medicine.

Q. What might you want to say to young physicians con templating a career in the commercial labs business?

Kaufman: I hope I have motivated some young physicians to think about management in a health care field starting at the beginning of their careers, rather than the end. Health care needs good physician managers to restore the balance between good medicine and sensible economics. There is a place for both. Cost efficiency and good health outcomes are not mutually exclusive. It's going to take people who understand that to ensure optimizing the mix.

Barbara J. Linney, MA, is the Director of Professional Development at the American College of Physician Executives in Tampa, Florida and a member of its faculty.