062. How to Navigate Other Spaces to Achieve a Work-Life Balance with Dr. Nerissa Kreher

00:05 Dr. Ann Tsung Are you struggling to advance your career and sacrificing time with your loved ones because of endless to-dos, low energy, and just not enough time in the day? If so, then this podcast is for you. I am your host Dr. Ann Tsung, an ER critical care and space doctor, a peak performance coach, a real estate investor, and a mother of a toddler. I’m here to guide you on mastering your mind and give you the essential skills to achieve peak performance. Welcome to Productivity MD, where you can learn to master your time and achieve the five freedoms in life.

00:52 Hello. Welcome to Productivity MD Podcast. And I am your host Dr. Ann Tsung. Today we have Dr. Nerissa Kreher. She is a PEDs endocrinologist and has since pivoted actually to become the chief medical officer of a biotech company. I just love talking to physicians who pivot and actually explore other spaces so that they can achieve the five freedoms, to think about outside of what’s possible other than working in the hospital and in the clinic. So that’s why I wanted Dr. Kreher to come on to the show. So thank you so much for coming on. Please tell us a little bit more about your journey, and why do you do what you do currently?

01:35 Dr. Nerissa Kreher Sure, Ann. Thanks so much for having me. So pediatric endocrinologist, as you said. I was very interested in clinical research during my fellowship training and got a master’s in clinical research with the goal of doing academic clinical research. That plan sort of fell apart when the hospital, Mass General, that I was planning to have a role actually had budget cuts. They offered me a job but doing clinical medicine. I think that it was the first time that I really said what do I truly want and was true to that and didn’t just take that role so that I had a job. I continued to look, and that’s ultimately when I transitioned to pharma and biotech. Via a networking opportunity, someone that I had worked with asked for my resume. And so just a year out of fellowship, I transitioned into, first, medical affairs. This is almost 20 years ago now. I’ve had the opportunity to work in a number of companies — both larger and small, both in medical affairs, as well as clinical development — and ultimately have progressed through the ranks to the level of chief medical officer.

02:55 Dr. Ann Tsung What exactly — just to kind of explore this a little bit more. Most people, sometimes they probably will not know what a chief medical officer for a biotech company does. Could you explain it a little bit more?

03:06 Dr. Nerissa Kreher Certainly. So the chief medical officer is part of what we call the C-suite. The C-suite, they are responsible for all aspects of the people underneath in the company. So, for example, I have responsibility for clinical development, for clinical operations, regulatory, patient advocacy. And so I have people reporting to me at the VP level, the director level, where I had been in the past and risen up through.

03:40 Dr. Ann Tsung How many physicians are typically working with you in this group?

03:46 Dr. Nerissa Kreher So the company is a relatively small company. I currently have three physicians working under me. You know, it can vary depending on the company size. Many big pharma companies though have hundreds of physicians working. Even at Pfizer, for example, it’s thousands of physicians.

04:07 Dr. Ann Tsung And why would a physician want to pivot into this space? If they didn’t know anything about it or they had an inkling about it, why would they give up clinical medicine? Or, do they have to give up completely clinical medicine to get into this space? What’s so attractive about the space?

04:24 Dr. Nerissa Kreher Sure. So I like to talk about three different roles, and they have different attractions. So clinical development, medical affairs, and pharmacovigilance or drugs safety. All of those offer people opportunities to continue to use their clinical skills but in a way that doesn’t require them to see patients. So there is a lot of flexibility in the pharma roles from the standpoint of there’s not a patient waiting for you in the office. And so your workload can be accomplished with more flexibility. That is a huge driver for people these days, where they’re looking for some work-life balance, for example, or maybe they’re just not satisfied with a day-to-day clinical medicine role. Certainly, it’s not appropriate for everyone. The physicians that are out there enjoying clinical medicine every day, they’re probably not looking at biotech and pharma. But for those who are looking for different ways to utilize their skills, it’s a great opportunity to consider.

05:32 Dr. Ann Tsung And is there a specific specialty that is more suited, or, really, it can be from different specialties depending on which type of company?

05:41 Dr. Nerissa Kreher Yes, so different specialties. I’m a huge proponent that we’re physicians. To your audience that’s listening, we’re physicians. We’ve done very, very hard things. And so working in pharma and biotech is available to all specialties. Now, there are specialties that are sought after more. There’s lots of oncology drug development, for example, and so oncologists are sought after. Rheumatologists, immunologists are others. But I’ve had the opportunity to work with general pediatricians who have landed in pharma, with internist, with family medicine physicians. So there really are opportunities for all specialties.

06:24 Dr. Ann Tsung And you’re talking about flexibility. So it can be remote, potentially 100% remote, and more flexible in terms of if you have children, that the hours can be flexible. Is that correct?

06:37 Dr. Nerissa Kreher That’s correct. COVID really changed the working environment. Many roles are now remote. Some have moved to what we call hybrid, where they want you to be in a headquarters office some number of days depending on the company, depending on the manager. But lots of opportunity for remote work from home in these pharma roles. From the standpoint of thinking about children, thinking about that work-life balance, it is a great example of maybe you can get your kids off to school more easily, right? Or, meet them at the school bus at three o’clock if there’s not a meeting scheduled that you need to be. Whereas, again, if you’re in clinic, that opportunity is perhaps lessened.

07:25 Dr. Ann Tsung Yeah, and what is like the monetary compensation compared to being a physician, like a full-time physician?

07:31 Dr. Nerissa Kreher So this is very different. So it’s not based on your specialty, which is something for people to really wrap their head around. A going in rate is typically in the mid to higher two hundreds for most director-level roles. That’s where many physicians will be starting. So the compensation for a pediatric endocrinologist like myself, that’s really nice compensation, right? For an orthopedic surgeon, that’s going to be probably a pay cut. And so physicians have to think about that from the standpoint of, their specialty is no longer going to drive it.

08:13 On the flip side, there’s room for lots of acceleration in salary as well, which I think, again, is different than clinical medicine where as you increase in your title in pharma and biotech, your salary goes up. And so I’m talking into the three hundreds and even four hundreds. That’s base salary. There’s also a bonus structure included. Then you have to think about things like 401k matches, stock and equity opportunities. So you’re really considering the whole package and also considering, I think, the hourly rate that you’re getting paid, right? Because there’s not on call. There’s not weekend time. So there are trade offs to be considered there.

09:02 Dr. Ann Tsung Yeah, you’re not doing your notes at home essentially after clinic.

09:06 Dr. Nerissa Kreher That’s exactly right, yes.

09:08 Dr. Ann Tsung Yeah, because a lot of the clients or a lot of other physicians I’ve talked to, they go see the patients, peds or internal medicine and family medicine especially. But then they’re doing notes until nighttime. So their hourly rate, if you divide that out evenly, drops significantly. And with this pivot, it sounds like they can get location freedom. They can get time freedom. They can be on the path to financial freedom for investments or maybe get equity in the company, et cetera. So it sounds like it’s a path to at least three of the freedoms. Not the physical or the vitality, but at least three of them.

09:44 Dr. Nerissa Kreher Exactly. And even from the vitality one, I like people to know — and I’m not saying that this doesn’t happen in hospital settings and clinical settings. But there are a lot of perks. So companies are trying to be very attractive to recruit people, right? And so things like being able to get gym reimbursements, things that help your vitality from the standpoint of cultural activities, being exposed to other cultures through activities that the company is participating in. So it’s much more corporate than clinical medicine typically is. And so there are exposure opportunities that I think many people don’t see in clinical medicine as much.

10:36 Dr. Ann Tsung And do you think that physicians have an easier or harder transition into corporate, as we don’t get taught about business or becoming an entrepreneur? Things might move fast depending on the size of the company, or things might move very slow. So I’m curious if it’s like a more seamless transition because physicians can learn anything, or they have a tougher time depending on the person?

11:00 Dr. Nerissa Kreher Right. That’s a great question. It’s actually something when I’m talking to people about the transition that I make sure to raise to them. I think that physicians are highly capable of making the transition. One of the big things they have to consider is that they’re no longer sort of the only decision maker. And I recognize now, in clinical medicine, insurance has a role. Lots of other things have roles. But the physician is now working in a cross-functional team and will have to accommodate for other factors like budgets, for example. The slow and fast pace, I think, is something that people also need to be aware of. That might be, in a smaller biotech, things might move very quickly. Maybe not as many hard and fast rules. We’re sort of building things as we’re growing them. Whereas in a larger pharma company, maybe there are lots more processes and procedures that people have to understand. So it is a consideration for people to really understand as they’re making that transition.

12:08 Dr. Ann Tsung And is there a potential possibility for part-time work if people want to keep up their clinical skills? Can they do it part time? Is that common or not common?

12:16 Dr. Nerissa Kreher It’s not as common. I do get that question a lot. There are roles where people are able to keep maybe a half day, and I think a day clinic would be a big ask. There are also opportunities for mentoring a fellow’s clinic, for example, where you’re not necessarily having to deal with your day-to-day patient care, but you can still have that touch point. That’s a negotiation you have to make with the company and your hiring manager.

12:48 Dr. Ann Tsung Got it. I’m going to pivot a little bit to the how. If people are thinking about this and they are interested — I know you do coaching for physicians who want to pivot — what will be the top three steps for them to do if they want to get into this space?

13:06 Dr. Nerissa Kreher Sure. So first is understanding those three different roles that I mentioned, and there are lots of opportunities to learn about those. But that helps them to understand what are they really going after, and is it attractive to them? The next would be, you have to have a resume. So many of us only have an academic CV or curriculum vitae, but you really need a resume. And so that’s an important step. Then the other that I would focus on is increasing your networking skills, especially via LinkedIn.

13:43 Dr. Ann Tsung I don’t know much about my LinkedIn. Because it was like once it’s setup, I haven’t logged in. And I haven’t responded to messages for, like, years.

13:51 Dr. Nerissa Kreher Yes, I hear that a lot. I work with clients on setting up LinkedIn profiles and really understanding how to utilize the platform to build their network.

14:04 Dr. Ann Tsung And regarding the three categories, could you expand on them a little bit? Where can they find out more? Is there a specific resource that is optimal?

14:14 Dr. Nerissa Kreher Sure. So I actually have a resource, a free download on my website that describes clinical development, medical affairs, and pharmacovigilance. It goes through what a day typically looks like. There is a very active Facebook group that people who are looking for roles and interested in not just pharma but other opportunities like utilization management and such. So that’s a great resource. Then, obviously, Google or ChatGPT, those are opportunities to get more information as well.

14:50 Dr. Ann Tsung And where do they find your resource?

14:52 Dr. Nerissa Kreher So my website is industryMDcoach.com. I also have a blog. So I publish a blog every week with lots of information there as well.

15:04 Dr. Ann Tsung Okay. Awesome. Then regarding the resume, can you explain what’s the difference between CV and resume and what actually needs to be eliminated and added?

15:13 Dr. Nerissa Kreher Certainly. So a curriculum vitae can be many, many pages long. It’s really just a list of what has occurred in a chronologic fashion, but it doesn’t actually describe what you did. And so when we translate it to a resume, we’re translating it to the use of active verbs. So, for example, if you, on your CV, maybe you have pediatric endocrinologist, associate professor, Indiana University, that doesn’t really describe anything, right? So in my resume, I’m going to say “led the fellowship clinic” and really describe what I did so people get a picture of what your skill set actually is.

16:08 Dr. Ann Tsung Is there a specific skill set that they’re looking for, a must-have, would you say?

16:14 Dr. Nerissa Kreher Right. So the clinical skill set is really the most important. When they’re looking for a physician, they’re looking for all that medical training we have and all that medical experience we have. So that’s the first. But there are softer skills that they’re looking for. They’re looking for leadership. So people who have been involved in — as physicians, we’re always leading, right? We’re leading teams. So if you’re rounding, you’ve got a team. You’ve got a nursing team. People don’t always translate that as well or give themselves credit for that as much. So leadership would be a really important one.

16:55 Another one is the ability to work cross-functionally. So you need to be able to translate our medical language. If you can only speak to another physician, and you can’t sort of explain things to patients well or explain things to people that don’t have a medical degree, that’s going to be difficult. Many physicians, of course, that’s not a problem for them. But we need to bring that forward and help people understand that skill that you bring as well.

17:25 Dr. Ann Tsung Yeah, I can definitely relate to that. Because at NASA, we got to be able to translate medical to engineers. Their discipline is very black and white, on the dot, with exact measurements. Everything is very precise. But, I mean, medicine, it’s like it could be this. It could be that. I don’t know. We’ll see how the patient responds. Then we’ll pivot and change our management.

17:47 Dr. Nerissa Kreher That’s so funny you say that. Because I also experienced that with, you know, we work closely with sales and marketing, regulatory. And when a physician says that, I think people think that it’s hard and fast. There’s a diagnosis or there isn’t. And, obviously, medicine is much more gray than that.

18:10 Dr. Ann Tsung Yeah, I agree. And what would you say would be your top skills or strategy that you employ to keep up your performance? Because as a CMO of a company and keeping up with your family, your personal life, we, in productivity MD, we’re always curious in the top strategies that people use to achieve that peak performance or productivity.

18:33 Dr. Nerissa Kreher Yeah, so the 80-20 rule, some people refer to as the Pareto principle, I think it’s just really important for overachievers like many physicians. So as I think back — you know, I’m 51 years old — early in my career as a young mom, especially, I wanted to do everything perfectly. If it was the bake sale at school, I wanted to bake something. I wanted to decorate it myself. That, I think, actually took a lot of time away from my kids. And instead of spending time with my kids, I was spending time to do something to make myself look a certain way. So being able to really be honest with yourself also about what do I really want to do. I really didn’t want to make those cupcakes and decorate them myself, but I did it out of this obligation.

19:33 And so it’s two things mixed there, right? It’s being honest with yourself about where you really want to spend your time and trying to push away some of that guilt and obligation. Then that 80-20 rule really applies to that as well. So maybe go buy the store-bought cupcakes, and take them to the bake sale. That allows you to really focus on what’s important. I think that, as I look back, now that I’m an empty nester, I don’t regret anything about how I raised my children. But I do wish that maybe I had been a little more honest with myself about how best to really spend my time.

20:17 Dr. Ann Tsung Yeah, essentially, it sounds like just do what you want to do instead of doing it for other people, instead of doing it so that you get approval, like external approval from other people. I think as we get older, we stop caring more and more.

20:35 Dr. Nerissa Kreher It’s so true. But, you know, when I’m mentoring younger, not always just physicians but younger employees, it’s something that I share with them. Because I do think that if you hear it enough from someone, then maybe you can start to apply it earlier in life and not wait until you’ve gotten older and feel free to do those things.

21:00 Dr. Ann Tsung Yeah, I agree. Anything else that you found had been useful or helpful, like anything, like your own coaching or any other strategies that you’ve enacted that’s really helped you along your journey to be at your top performance?

21:16 Dr. Nerissa Kreher Absolutely. I’m a huge fan of coaching. I mean, I’m a coach, but I utilized coaches throughout my life. So executive coaches, I still use executive coaches from a professional standpoint, coaches related to entrepreneurship and how I’m thinking about my coaching business. Then life coaching to help with everything else, right? Relationships, kids, et cetera. So just a huge fan of really getting your thoughts out and being able to explore what they mean and how you’re managing your mind.

21:57 Dr. Ann Tsung Yeah, we always want somebody who is more objective to tell us, or really somebody to challenge us to think bigger actually or focus more. Because we tend to want to do a lot of things, have a lot of ventures or ideas. So when you can be focused, that’s when you can make the progress, actually.

22:19 Dr. Nerissa Kreher Absolutely. And, you know, we really — again, as overachievers, we sometimes feel like we have to do it all or understand how to do it all. And a coach can help you get to your goal so much faster if they already have that experience. So being able to lean on people, be mentored, you really can achieve much, much more that way.

22:44 Dr. Ann Tsung Yeah, I totally agree. So then I guess I want to share where people can find you for the people who are listening to this. Because if you contact Nerissa, she will help you get there way faster than if you’re just exploring this on your own, of course. I often say that you’re paying for the same results. The difference is that you’re paying either with your time or money. Essentially, you’re buying time back. So where can people find you, either on the website, social media, et cetera?

23:16 Dr. Nerissa Kreher Absolutely. So the website again is industryMDcoach.com. Lots of information. That’s the best place to find me. I’m also on Instagram, as well as Facebook. Instagram is The Pharma IndustryMDCoach, and Facebook is Industry MD Coach.

23:34 Dr. Ann Tsung Got it. And what would you say will be one major action for the audience listening to this?

23:41 Dr. Nerissa Kreher I would say if you’re interested in making a transition to pharma, getting comfortable with networking is a critical step that most people cringe about. So, really, putting yourself out there, starting to make connections, and networking will be critical.

24:00 Dr. Ann Tsung Is there a one event they should go to?

24:03 Dr. Nerissa Kreher You know, there’s not a great pharma event. Maybe that’s something I should do. But I think, really, LinkedIn is the place that they need to go. I’m doing air quotes around that. LinkedIn is where I would go for that type of networking. No specific event.

24:27 Dr. Ann Tsung Okay. I guess, yeah, they will have to first determine which of the category they’re interested in. Go to LinkedIn. Search for those categories, and just reach out to those people who are in that specific category, or the physicians in that category, or just reach out to you and see what the next four steps are. Right?

24:44 Dr. Nerissa Kreher Absolutely. And, you know, from a networking perspective, it’s thinking about: who are your colleagues from residency and fellowship who are now working in pharma? You’d be surprised. If you actually search, there’s some percent that are. Who are the medical science liaisons or pharmaceutical sales representatives that they know? So, really, sitting down and making that list is how they start to build out that network. And, obviously, I’m a huge proponent and happy to help people network as well.

25:17 Dr. Ann Tsung Awesome. Thank you so much for the tips. I didn’t know much about this. This is all new to me. I learned quite a lot, and I know the audience did as well. And just so that everybody knows, of course, everything that we discussed, it’s going to be on Productivity MD shownotes. So you can just go to productivitymd.com. And, Nerissa, thank you again so much for your time and your presence. I know there are some physicians who are just stuck on the golden handcuffs and are doing notes till midnight that they’re going to find this very helpful.

25:54 Dr. Nerissa Kreher Wonderful. Thank you again for what you do with your podcast and for having me as a guest.

25:59 Dr. Ann Tsung Alright. Thank you. And for everyone listening, just remember that everything we need is within us now. Thank you.

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