This interview is with Tarun Mahajan, M.D., a healthcare consultant at the Boston Consulting Group. Dr. Mahajan was previously a pediatric cardiologist at the Boston Children’s Hospital, the primary teaching hospital of Harvard Medical School. The interview was conducted by Andrew Chen and summarized by J. del Fierro. (Download the full audio recording of this interview here.)
Q. Tell us about your background.
A. I am 36 years old; I attended college at Rice University, where I doubled-majored in biology and economics. I did my M.D. at the Baylor College of Medicine in Houston. I did my pediatrics residency down there, and then moved to Boston Children’s Hospital at Harvard Medical School to do my pediatric cardiology and electrophysiology fellowships.
After that, I got an MBA from Stanford, and I am now at the Boston Consulting Group as a management consultant.
Q. Tell us how your career path has taken you to your current role, and what were the major thought processes you went through at critical moments along the way?
A. Sure. I think it really goes back to college. I double-majored in biology and economics because I really liked them both. This was in the mid- to late-90s in Texas. At the time, no one was really thinking about combining business and medicine too much.
So as I progressed through my junior and senior years, my advisors, both formal and informal, said I had to make a decision. Are you going to go be a physician, or are you going to go do consulting or banking? I even thought about doing a Ph.D. in economics at one point.
And so, faced with that decision — I had done volunteering experiences, I had worked in hospitals — I said, okay, I really love medicine; I am going to go do medicine. So I focused on that exclusively.
I went to Baylor, had a great four years of medical school, and knew I wanted to do pediatrics because I love kids, and a lot of my friends describe me as a bit of a goofball, so it was a good fit. I had a great three years as a pediatrics resident and I knew I was really wanting to do general pediatrics; I just couldn’t see that for myself.
I knew I wanted to specialize in cardiology, which really attracted me most. I think it was for two reasons. First, there is the combination of invasive — catheters and pacemakers and defibrillators — with non-invasive therapy and treatment. I thought that was really cool.
Second, a lot can go wrong developmentally with a heart during gestation. There are a lot of different congenital heart defects out there., and treating them is actually a very challenging thing to do. It requires a lot of thinking in each individual case, and I thought that was really cool and challenging.
So I went up to Boston Children’s Hospital, did my basic cardiology fellowship and, along the way, I fell in love with electrophysiology, which is the treatment of heart rhythms and rates that are abnormal — diagnoses and treatments. That entails pacemakers, catheters, ablation, doing simple stuff like reading EKGs and ultra monitors, etc.
I chose that path because, frankly, I thought it was really fun and challenging. It was during my first year as a cardiologist that I fell in love with reading EKGs, thinking about the way rhythms work, thinking about working within the body to actually change and heal things that had gone wrong.
So I went through that. It was two-and-a-half years of basic cardiology, a year-and-a-half of electrophysiology. I had a great time. I was getting to the point where I was applying for academic jobs in pediatric cardiology, thinking that’s what I’m going to do.
All along the way, though, I had always had some doubts in the back of my mind, thinking about business. I had double-majored in economics. And several of my friends had actually left medicine for business, and they were all having a great time. My brother had a Ph.D. in electrical engineering, and he actually went to McKinsey after getting an MBA.
So there were some people who had done similar things and they all seemed really happy. So I thought: “Well, this is still something I’d like to do. I think, given my medical background, if I combine that with some really good solid business knowledge and expertise, I can make a really unique impact. And finally, if I’m going to make this transition, now at the end of the fellowship is the time because once I get into an attending physician position, it’ll be difficult to extract myself.”
So that drove me to go to Stanford to get an MBA. I really wanted to get an in-depth understanding of business. I wanted to get that MBA. Stanford offered a great opportunity to really couch that with the combination at Stanford of business, engineering, medicine and all that within the broader university. I thought that was a great opportunity.
And then, at the end, I ended up jumping into consulting. That was an interesting decision. So I had done two internships. One was in the bio-pharma industry; one was in the medical device industry. And I realized that my level of expertise in medicine – just because I’d spent eleven years there – far exceeded what I had in business. And I realized that if I approached a medical device or bio-pharma company at that time, they would be so excited about my medical knowledge that they would treat me as a cardiologist who happens to have an MBA – and that’s not what I wanted at all.
I wanted to be able to combine them and make a really effective impact, really driving a company, having an impact on the company’s direction, having an impact on bringing products to market and improve patients’ lives. So I thought about it, and I realized that consulting is probably best.
I was looking for a very intense experience, almost a “residency in business” that would enable me to get really into the details, not worry about being treated as a cardiologist, just someone who’s slogging through PowerPoint and Excel, dealing with business problems.
The goal – this sounds glib but this actually went through my mind – was to get as comfortable reading financial statements as I am reading EKGs. And I think I’ve finally gotten there, at least something approaching that point.
So now I’ve been at BCG for two years and am having a great time.
Q. When did that gestation period begin when you started thinking, “I wonder if I should keep going down the medical path, or try something else?” And how long did it take before you actually decided to go to business school?
A. I think it was probably at the back of my mind for a long time — reading the Wall Street Journal, keeping up with business a little bit, having some vague idea of what was going on. That, actually, was really a lot through medical school and residency. But it was only when I got to fellowship, interestingly, that it really began to take shape, and I think it was because of a lot of things.
First, from a personal standpoint, that was around the time that my brother started to make the transition. He’s an older brother, someone I respect very much. So I said, “Okay, that’s something to think about.”
At the same time, some of my friends who had been in medicine made the transition. It was clear they were having a good time, so that played a role as well.
Finally, I think there was a little bit of exposure to the business side of medicine during cardiology fellowship. So, pediatrics isn’t a very profitable market for anybody, for the most part. There are a couple companies who specialize in very specific diseases that can make a run in pediatrics. But during pediatrics residency, I never really had much exposure to any of the companies. I actually think it’s a good policy — we didn’t have any drug reps and certainly there are no devices that could impact the lives of children and general pediatrics residency to think of.
But once I got to cardiology fellowship, and especially in electrophysiology training, we certainly had the representatives from Medtronic, Boston Scientific, St. Jude and Johnson & Johnson coming through and telling us about catheters and telling us about these devices.
And I began to wonder about what was all the business behind those devices that I was using every day that were so incredible and cool. I just started talking to them a little bit, learned more, and I thought, “You know, that could actually be a really cool thing.”
One of the reasons I chose the MBA was I can go get the MBA, and if I find out it’s not for me, I can always come back to cardiology. This gives me a little bit of an “out,” but I have not regretted my decision to leave for one moment since. I had a great time.
Q. You also did a corporate development internship even before business school.
A. That’s right.
Q. Was it challenging to persuade folks on the business side that someone who had such deep science and medicine training could adjust into the business world? How did you persuade them?
A. That’s something that was actually very difficult and it was part of what really drove me to go into consulting.
Yes, I had an internship in corporate development at a bio-tech company before business school. I thought that would be a good idea because I wanted to get some basic grounding in the way business works and understand some of the terminology before coming to business school. And it certainly gave me that.
The challenge was two-fold. The first was getting people to respect me, and actually, that was not a huge problem at that particular company because the Director and the Vice President both came out of medicine or science.
The Director had a Ph.D. and had actually run his own lab at Harvard, and the Vice President, who was trained as an internist, had some great training on his own before going to Wharton and then coming to bio-pharma industry. So that was a rare opportunity and it was a really good learning experience for me. So that was not really a problem.
Q. That internship was at Millennium Pharmaceutical?
A. That’s exactly right. It was at Millennium – great company.
The problem was that you come in with eleven years of medical experience, you think you know everything. Then you realize you actually know nothing. And I really didn’t know anything going into that internship from a business perspective. That was an important learning experience.
I think there are two sides to establishing that relationship when you’re making a transition. First, achieving that buy-in, which in certain circumstances can be easier than in others, but it’s also making sure you have the knowledge and expertise and that you have the credibility to do so.
So that first internship was the right environment and everyone was great to me, but I don’t think I had much to offer them. I learned over the summer; I really did. But when I started, there wasn’t much to really convince them to give me a lot of responsibility. That was a challenge. It was just building the responsibility on my own and then convincing them.
The second internship was also a great experience. It was at Boston Scientific in their pacemaker and defibrillator division – great people, great experience. But again, I’m a cardiologist; this is a cardiac company. So how do I persuade people that I am, in fact, also a businessman? They treated me very well, but I wanted to make sure I would be treated as somebody who was truly equal in both. And so, that’s again what drove the decision to go into consulting.
Q. The Boston Consulting Group has a tradition of hiring people with enhanced backgrounds. But I imagine doctors are not terribly common there, so was it easier getting into consulting with a Stanford MBA, or was it similarly challenging coming from a medical background? How did you persuade them that you would be able to handle the role?
A. Sometimes the big three firms make a bigger push to hire M.D.s and Ph.D.s. When you talk about the big three, I think McKinsey has been doing that for a long time. They’ve done a great job. I think BCG and Bain, to some extent, they have only focused on that more recently. I know they’re both hiring a lot of M.D.s and Ph.D.s at this point. It’s something they view as valuable, especially in something technological, especially in healthcare.
In my case, the problem wasn’t convincing them that I could do the work mentally. I think I had a strong resume. I had spent two years at Stanford. I had some good work experience. So I think they were comfortable with that.
Their main concern was, “You’ve done all this medical training. You’re a little older than our typical first-time applicant. Are you going to be able to handle the work load?” And they could see from my experience that I could probably handle it, but “Are you willing to handle the work load?” is also another question.
There might be a little bit of entitlement perhaps. “You’ve already put in your time. You’ve put in those long residency and fellowship hours. Do you want to do this again?” And that was actually challenging for me to convince them that, in fact, I could.
Q. So what did you say?
A. I was honest with them. I said I like working hard at things that are fun and interesting and challenging. I’m happy to work hard. I think my past experience has definitely shown that. I’m more than happy to do it again. I was couching it as, “I’m willing to work hard if it’s interesting and challenging, and if I learn, I get something out of it as well.” Couching it in terms of what I get out of it, too, makes it a little more real for them, I think.
It makes them understand, “Okay, this is someone who has thought this through, as opposed to someone just saying, ‘Yeah, sure. I’ll work hard. That sounds good.’”
I made it clear that I wanted to get something out of this as well. And so establishing that, in fact, there is a two-way communication and two-way exchange, I think, did a lot to convince them.
Q. If I were to shadow you for a week or a month in each of your roles — in your residency, in your fellowship, and now in consulting — what would I observe?
A. That’s a very good question. So, residency and fellowship — both of them are built on month-to-month rotations.
I’ll talk about the more specific in-patient classic experiences you get – so classic, in-patient, non-ICU rotations. As a resident, as an intern, as the low-man on the totem pole, you come in at 7:00 a.m. or maybe 6:30 a.m.; it depends on your specialty. It depends on the hospital.
At Texas Children’s Hospital, for pediatrics, we typically came in at around 6:30 a.m. or 7:00 a.m. and you see the patients that are assigned to you. You examine them. You generally check in with the intern who has been on call overnight, and you find out what has happened to those patients.
You go examine them. You talk to them. Hopefully, you are able to talk to their nurse, figure out what’s going on. And I can’t say enough about how valuable nurses are, especially to interns and residents, especially as interns, because you really don’t know what you’re doing.
So you talk to them and then you examine the patients. In pediatrics, you inevitably talk to the parents as well, which is a great communication lesson, to be honest.
Then you present the patients on rounds. You talk about, “Bobby is a five-year-old with such and such diagnosis. He has been here for three days. He’s improving or declining in x, y and z areas. This specific exam overnight is unchanged. Any relevant studies overnight showed x, y, z. This is our assessment for today, and this is the plan I’ve arrived at.”
So it could be additional testing. It could be calling in consults from other services. It could be perhaps, hopefully, discharge. It could be some combination thereof. That’s a classic day on a pediatric rotation.
After you’ve presented on rounds, you actually carry out what you’re expected to do. You call your consults. You order your tests. You talk to the primary physician. You go back and have a conversation with the parents. You are called, obviously, if there are problems with any of your patients.
When you are on call overnight, the way it was at Texas Children’s Hospital, or at least when I was there — it was a 36-patient floor — you are responsible for all 36 patients. So for any patients who are admitted, you have to do a full historic physical. And for all 36 patients who are already there, you are responsible for a cross-cover, which is taking care of them and their problems, when they arise. That’s a classic intern residency experience.
As a first and second-year cardiology fellow, you spend all your time doing basic procedures — cardiac catheterizations where you put catheters into the heart, doing interventions, doing analysis on data. But you also spend a lot of time doing ICU, and you spend a lot of time supervising cardiology in-patient service. It might be interesting to talk about the cardiac ICU.
So at Boston, there was a 25-bed cardiac ICU. These patients are very, very ill, and they’re either post-operative from congenital heart surgery or they’re very ill and waiting for medical and / or surgical treatments. Most of them are intubated, meaning they have a tube down and are on a ventilator.
A fair number of them, especially if they’re post-operative, actually have open chests. So essentially, the chest is still cracked open, covered with the sterile surgical dressing because you have to wait for the swelling to come down before you close the chest. A lot of patients were on varied intensive life support — ventricular assistive devices, dialysis, all sorts of things.
It was a really intense experience, and as first-year fellows, you were literally on call by yourself typically from 7:00 p.m. until 7:00 a.m. It was an amazing learning experience and very, very challenging.
You were responsible for every patient in that ward and you’ve got to figure out anything that goes wrong. You can always call someone, but it was really your call on what you’re going to do. So it was very intense. So you take call by yourself, and in the morning again, the other fellows come in; they help with whatever tasks you may have and then you run rounds.
At Boston, it was the post-call person’s responsibility to literally run all twenty-five patients in that unit – so tell everyone what happened overnight, what interventions were performed, how their labs were looking and arrive at some sort of a preliminary plan that is then approved on rounds by the attending and senior fellow.
It was an amazing learning experience in terms of prioritizing because three kids can be doing very poorly at once, in terms of thinking about plans on your own and in terms of communication because you have to, as quickly and concisely as possible, present twenty-five patients on rounds. It was a great experience.
Q. You mentioned that talking with parents in a pediatric rotation was a great lesson in communication. Could you tell me what that means and what you learned?
A. Yeah, sure. Anytime a child is hospitalized, the parents by nature are going to be emotional, and so very often you have to communicate not necessarily terrible news, but bad news.
Even if you tell the parents that their child has a very mild or moderate case of pneumonia, or has gotten dehydrated because of a bad case of gastroenteritis, and the child needs to be hospitalized for a day or two — that in itself is bad news for a parent.
Most children go through childhood without needing hospitalizations out of the ordinary. It’s difficult for parents to deal with. So a lot of times, parents of the healthiest children break down because they’re just not prepared for it.
Dealing with parents who actually have chronically, critically ill children is another challenge in itself. Yes, these parents are well aware of the routines and the mechanisms of a hospital or an ICU, but they’re understandably frustrated.
I can give you an example. There was a child who was critically ill, who had a very complex congenital heart defect and who had been operated on at several of the other leading centers in the U.S. It wasn’t going anywhere, and so they brought the child to Boston as a last resort.
The child was operated on and came out of the O.R. at around 6:00 p.m. I was the on-call fellow, and around 1:00 a.m. the child began to crash. Essentially, it involved me manually having to push in with all my force — and I’m a reasonably big guy — albumin and blood as fast as it could get in because I had to maintain this child’s blood pressure while it was crashing.
The parents had been through a lot, which was extraordinarily frustrating. They didn’t know what was going on. There had not been — and this may have been partly my fault because I was busy all night — adequate communication with them. They were frustrated.
I’ll never forget. His father is a huge, huge guy. This isn’t an exaggeration; he could literally be a professional wrestler. As I was doing this, he was literally in my face. At one point, I’d probably used three syringes already, which were pretty large, I put my hand on him and said, “Sir, I need to do this right now, or things aren’t going to go well.” Putting it in the immediate sense made him back off a little bit.
And then as soon as his blood pressure was stabilized, I went and talked to him. Thankfully, the ICU was slow and I was able to spend fifteen or twenty minutes describing exactly what we thought of his defects, what the plan was, why his blood pressure just crashed, why I had done what I did, what we were looking for in the next four to five hours and what we would do if things went in various directions.
And then, perhaps more importantly than anything, I said, “Do you have any questions or concerns?” And both parents cried for a good fifteen minutes and just talked. It was clear no one had really listened to their frustrations in a while. It’s an important lesson in medicine; it’s an important lesson in communication, in general.
It was very rewarding, especially because the next morning, when the other ICU fellows finally arrived, I was able to go downstairs and get some breakfast in the cafeteria. As I came out, I saw the mother and father.
And again, this father was a frightening dude. He literally walked up to me, and I started to back away. But he walked up to me, put his hand on my shoulder and said, “I just wanted to thank you because no one has ever talked to us the way you did last night, and that means a great deal to me and my wife.”
It was a very, very touching but also a very instructive episode. Just listening and communicating, even if it takes some extra time out of your day, is extraordinarily important, no matter the setting.
Q. So it sounds like being transparent about all the information that you know, and explaining the “why” behind things and then just turning it back to them and give them an opportunity to share their thoughts and ask questions — those are the key lessons.
A. That’s exactly right. I don’t think you can stress enough the importance of just listening and saying, “Is there anything you want to talk about?” If you have that time, it can be immensely rewarding for them and for you.
Q. Is there a story or an example that you can tell me about that most shaped your world view as a physician and perhaps influences even the way you work in business today?
A. Yeah, actually at Stanford, in the business school, we have something called the “talk series”, where you’re invited to talk to your classmates about an experience or something that really matters most to you.
I spent a lot of time talking about my experiences as a pediatric cardiologist. But I talked a long time about one patient in particular.
I still remember very clearly. This is a patient who had a very complex congenital heart defect and who had gotten cardiac surgery by the world leaders as an infant at Boston, and had a rough early childhood, but then really stabilized for most of her childhood and early adolescence.
But the way that her physiology works, by the time she hit her late teens, things started to go downhill. And they went downhill in a way that bizarrely coincided with my cardiology training.
Let me explain that. When I was a first-year fellow, I spent a lot of time, as I said, manning the in-patient cardiology unit, taking charge of that unit, making sure those patients were okay. That was when this particular patient, I’ll call her “Kim,” started to go downhill and started getting hospitalized in the unit.
As a second- and third-year fellow, I spent a lot of time in the ICU and in the catheterization labs, while Kim continued to worsen. And so, Kim was in the ICU a lot. She was undergoing cardiac catheterizations a lot. So I saw her a lot; I got to know her family well.
Finally, the last year and a half of my cardiology fellowship was in electrophysiology, or heart rhythms. The last thing that happens when your heart starts to fail is you start to get dangerous arrhythmias. Your heart, the architecture starts to get distorted because the blood isn’t flowing properly; you can think of it that way.
She spent a lot of time on that service, and again, I was the fellow, so I got to know them very well. And then literally, right before I left fellowship, she actually did pass away. I was actually on-call for electrophysiology. When a patient with a pacemaker or defibrillator dies, you don’t necessarily have to turn off their device. I mean, the patient is gone. The electricity might be flowing, but it’s not doing anything. You can’t really do much. If a patient is dead, the pacemaker doesn’t do anything. It just fires, but it doesn’t activate any muscle. But still, it’s comforting for the family to know that there’s not a device in there that’s still ticking.
So the last thing I did for her at Boston was I went in at 6:00 a.m. and turned off her pacemaker. (holding back tears) It was actually a very difficult experience because I had gotten to know her really well. And I had seen how technology – how surgery, how catheters, how pacemakers – had failed her. (choking) So, that’s really what inspired me most and continues to inspire me to this day.
Q. How do you think that’s affected your outlook on the kind of physician or the kind of business person you want to be, going forward?
A. So it was relatively late in my cardiology training. I’d already decided to leave cardiology at that point. I was still trying to be the best cardiologist I could be. It didn’t really change that much there. I would always just do whatever I could for the patients. But it very much instilled in me a sort of underlying theme or goal for my career.
I’m going to tell you something else here about Stanford. I love Stanford, as you can tell. When you apply to Stanford, I think anyone who has ever applied to the business school, especially at Stanford, is familiar with “Essay A.” On the application, it’s a seemingly simple question: “What matters most to you and why?” And that’s it; you just answer whatever you can or whatever matters most to you.
And people take that question very seriously in admissions and in the school itself, and among students and applicants. When you get to Stanford, you talk about it informally with your friends.
And throughout those two years, instructors, professors and deans occasionally remind you not to forget about what you’ve written in that essay, to go back and read it and make sure you adhere to what you’ve in fact written, because it’s something that mattered to you a great deal once upon a time, and to not get distracted by the lure of money or other material goods, to not get distracted from your goal.
So in my essay, I wrote specifically what mattered most to me was the health of patients with congenital heart disease, which was very much informed by my experience with Kim. I wrote this before she passed away, but she was very much on my mind as I wrote that essay.
Even now, as a consultant, I literally open up my Stanford application every few months and go back and re-read that essay. It’s an underlying theme that guides me as I plot out my long-term career trajectory.
Maybe not right now and maybe that’s an overly specific goal, and maybe I won’t do something specifically related to congenital heart disease. Hopefully it’ll be something related to children. It’ll definitely be something related to bringing products to market that’ll improve patient’s lives. That’s what matters most. It mattered then; it matters now. So that’s what guides me as I think about my career moving forward.
Q. Tell me about your current role at the Boston Consulting Group and what you do there on a day-to-day basis, and how it has perhaps been informed by your experiences as a physician.
A. Sure. Because it’s in my experience, BCG has been able to use me most effectively in healthcare, and I have a lot of experience there — in my experience as a physician and also in my two previous internships. At the same time, healthcare is what matters most to me.
So my experience at BCG has been exclusively in healthcare — across the bio-pharma and medical device spectrum, a little bit of care provider work, but that’s not quite as exciting to me, so a lot more in medical device and bio-pharma. It’s been very interesting, and I’ve learned a great deal.
As far as an average day, that’s very difficult to state. It varies substantially from project to project and even within projects. I can tell you a little bit at a high level about the current project I’m on. Obviously I can’t tell you much, given client confidentiality. But it’s been an interesting project.
So, it’s been with a multinational healthcare client that has operations across the world, and this particular project has been largely focused on some of their stuff that runs out of Asia. So in the first phase of this project, I spent a lot of time in Asia, working directly with key clients and also working with the local BCG team — really intense hours, a lot of time on the ground with the client.
But I think we got to a good understanding of what the client’s chief concerns were, got to know them personally, learned how to interact with them. I began to think a little bit about how to solve those problems.
For the second phase of the project here in the U.S., I’m working with some of the U.S. operations, but still maintaining very close contact with both my colleagues in other geographies as well as the client itself, which is literally spread all over the world.
So it’s a lot of days of waking up very early for 6:00 a.m. or 7:00 a.m. conference calls, generally internally, but we sometimes have client conference calls that early as well, and really getting alignment on what are our goals for the day or coming days are.
After that, I’m actually very independent. It’s a really challenging but also a really fun experience. It’s up to me to think about, “Okay, this is my big overarching problem that I’m trying to deal with this week,” and always keeping longer-term problems at the back of my mind. How am I going to structure my work today to get to that problem and how am I going to structure my problem in the coming week and weeks because I have to be setting that up in the background as well.
It’s very important for me to sit down for a half-hour every morning and think about, what do I need to do today or what do I need to do today that’s going to enable me to perform successfully in the next week or two weeks? What meetings do I have to set up? What reports am I looking at?
Then finally, always in the back of my mind is, what is the ultimate answer for the client? What is my current view on that, and how am I going to get there? That all feeds into each other obviously.
The day itself will inevitably involve calls to other BCG teammates in different geographies. It’ll involve calls to clients, their different offices. It could involve travelling to clients here in the U.S. to talk to people in person or view processes, etc. It varies substantially.
It’s consulting, so a lot of time is also going to be spent on PowerPoint. There’s a lot of that. And a lot of time is spent on writing e-mails as well. That’s certainly the less glamorous aspect of being a consultant.
But I think the really important things about consulting are: first, thinking about approaching problems structurally and thinking through how to solve them; second, thinking about quantitative analysis a bit and learning that. I had no experience building a financial model before this experience, so that’s been great. And third, and also just as important, thinking about communication — communicating verbally, communicating on paper. And I think consulting is a very, very good teacher of those skills.
They try to sell you on this, and it seems a little bit of too much of a sell in that they say, “Oh yeah, you’re going to be in conversations with VPs and CEOs.” Well, that actually is the truth. I’ve literally led meetings with CEOs and SVPs of companies I never thought I would get to interact with. That is a very much trial-by-fire experience, but that’s a great experience I can carry forward. So I think that’s a very important part of things too.
Q. So in other words, a mix of qualitative interviews and meetings, core leadership skills in that regard, quantitative analysis when it comes to building financial or operating models, process analysis, and finally presentation and communication skills.
A. That’s exactly right.
Q. Where do you see yourself ideally going in the future, and how do you think what you’ve accomplished so far will help you toward that goal?
A. I think my medium- and long-term goals tie back to that underlying theme I just discussed, about bringing products to market, helping patients’ lives. There’s no doubt in my mind that my future will involve that, and so I’m very much enjoying consulting. It’s a great experience, great people.
But as I think again about the medium- to longer-term, it has to be something closer to patients and closer to science. I’m not sure whether it’s going to be in the bio-pharma or medical device industries. I think I could go in either direction at this point. I think my background might lend itself more to the medical device industry, given that I was a cardiologist, but I’d like to keep both options open at this point.
I think it could be a variety of roles there. I think it would be something, hopefully, that really would allow me to mesh science and business — perhaps something in business development, perhaps something in the management of R&D. It could theoretically be product management, as long as it was more of a scientific product. That could certainly be a role as well.
In the medium-term, I’m thinking probably a larger company, but it could be a medium-sized startup as well, something in the range of 100 employees or something along those lines.
At Stanford, I also had several experiences both in the classroom and outside the classroom with a classic Stanford startup – five guys sitting around a table in a conference room, trying to build a company. And I discovered that, at least in that stage in my life, it just wasn’t for me. I personally like things a little more structured. That might change in the future, but I do know at that early stage of startup, it wasn’t me. That was a very important lesson to learn.
In the longer run, I’m leaving all options open. Again, I think about bio-pharma and medical devices. I think there are a lot of interesting options out there, and I’m looking forward to learning a lot about all of them.
Q. Would you consider going back to medical practice at all or do you think you’re probably going to stay in industry?
A. I don’t think I would ever go back full-time to medical practice. I’m actually enjoying business too much. I really do enjoy it, especially that intersection of healthcare and business. That is tremendously enjoyable.
However, I am keeping my license and board certifications active just in case my mind changes at some point down the road, or if at some point, I would like to combine the two – say, four days a week on the business side with maybe half a day at the clinic or something along those lines.
To be honest and totally frank, I don’t think I could ever go back to doing invasive procedures again, unless I went full-time. I just don’t think that’s fair to the patients, for me to be jaunting in for six hours a week and doing a couple of ablations. There’s no way I can be as good or as accurate as someone who does it all the time.
So that’s something I’ve said goodbye to and am quite comfortable with. But perhaps a combination down the road might be fair.
Q. What advice would you have for people who might be interested in medicine, or healthcare business roles, or consulting, and who might want to combine interests in science and healthcare with interests in business, as you have done?
A. I think the first and most important thing to realize is that, in fact, you can successfully combine the two. That was something I wish I knew back when I was in college, because it wasn’t clear to me at all. I think that’s a very important step to realize, that if those are the two things that interest you and they’re actually things you want to pursue, then absolutely think about combining them. I think it’s a very reasonable thing to do.
The second thing I would say is whenever you arrive at that decision, when you want to combine business and medicine, I would tell you to pursue it and not be afraid. A lot of people pushed back on me when I said I was leaving medicine after all those years of training.
It sounds silly, but I’m the only one who knows what’s going on in my head and my heart. No one else can. It was something I really wanted to do, and I’m glad I did it.
On the other end, I had medical school classmates who were thirty-eight years old and forty years old when they started medical school. Just don’t be afraid. People have done it before. People are there for you to talk to, reach out to. It’s something that can be done.
The final thing I would say is, if you are in medicine, or if you’re starting medical school and you’re thinking of combining medicine and business in some way, it’s important to discover the sweet spot for when you should leave or when you should start trying to combine them.
If I met a college student today, there is no way I would ever tell them to pursue the plan I did. It’s a lot of time in medicine before deciding to switch. I have no regrets whatsoever, because it was a process that occurred naturally and because of what I wanted to do. But think a little bit about when you might want to combine that M.D. with consulting or an MBA.
In my own opinion, the sweet spot is after at least a few years of medical training outside of medical school. The M.D. is nice, but if you want to have credibility with a bio-pharma company, with a medical device company, and just as importantly with physicians who align with those industries, it’s important, if at all possible, to get a couple years of training.
Certainly, the best thing to do is some sort of training that enables you to get a board certification, or at least be board eligible because that says to a physician and somebody who knows physicians, “Okay, this is a real physician who has actually practiced, and who can relate to what goes on at hospitals,” because it’s a very different experience compared to what goes on in medical school.
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