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From Hopeless to High-Performing: Transforming Pharma Teams with Rajesh Anandan and Nechama Katan · Lab to Lives

• 0:18
  Speaker 1: Welcome to another episode of Transformation in Trials.
• 0:21
  Speaker 1: I'm your host, Ivana Rosendahl.
• 0:23
  Speaker 1: In this podcast, we explore how clinical trials are currently transforming so we can identify trends that can be further accelerated.
• 0:30
  Speaker 1: We want to ensure that no patient has to wait for treatment and we get drugs to them as quickly as possible.
• 0:36
  Speaker 1: Welcome to another episode of Transformation in Trials.
• 0:40
  Speaker 1: Today we're going to focus on the topic of building high-performing teams in life sciences, and today I have two guests.
• 0:48
  Speaker 1: I have Rajesh Anandan and I have Nehama Katan.
• 0:52
  Speaker 1: Rajesh, will you start with introducing yourself?
• 0:57
  Speaker 2: Yes, ivana, thanks for having us.
• 0:59
  Speaker 2: And I was trying to think about what I could say to give me some semblance of credibility with your audience, because I'm an industry outsider and I come up with a few good ones.
• 1:14
  Speaker 2: I had totally forgotten but my graduate thesis, which is about decades ago, was actually called a systems dynamics investigation of sustainable growth in the biotechnology industry.
• 1:27
  Speaker 2: Very excited about that.
• 1:28
  Speaker 2: And then I had completely forgotten.
• 1:32
  Speaker 2: But so I studied computer science a long time ago and I started working at Microsoft and about a week in I realized that studying computer science was fun, writing code for a living not so much for me.
• 1:48
  Speaker 2: So I ran back to grad school and studied systems dynamics and, you know, got into like the complexity of biotech kind of life cycles and just the long cycle times and the complexity it introduced.
• 2:06
  Speaker 2: But after grad school, still not knowing what I wanted to do, I actually went into management consulting and worked at Bain for a few years and a couple of the early engagements we did was in life sciences, again still with more of the biotech side of things.
• 2:28
  Speaker 2: But I had a very long windy road.
• 2:30
  Speaker 2: I left the corporate world, went to work for nonprofits, went and worked in the UN and then found my way back to a middle ground, with a focus on businesses that had a mission and purpose beyond shareholder value creation.
• 2:51
  Speaker 2: And so, about 12 years ago, I started a company called Ultronauts with an old MIT roommate of mine, with a mission to demonstrate that neurodiversity, different brain types, can be an advantage in a business setting.
• 3:04
  Speaker 2: And our theory of change was simply step one build a commercially viable business that could show beyond any reasonable doubts that having different neurotypes on the same team was going to lead to better results.
• 3:17
  Speaker 2: And we knew that if we did that, to do so would force us to reimagine the workplace, redesign work systems, figure out different ways of working so that a much wider range of humans and neurotypes and ways of perceiving information and systems and collaborating and communicating could actually work together and get work done together could actually work together and get work done together.
• 3:48
  Speaker 2: And part two of the mission was to take everything we've learned and figure out how we can share that with other teams, particularly teams that operated under high-stress, high-fear contexts, which is going to sound familiar to this audience.
• 4:01
  Speaker 2: And we launched another business coming out of the original company that is called TeamX.
• 4:10
  Speaker 2: That is a collaborative intelligence system for teams any team really which then I had the pleasure of working with Nehama, who was brave enough to give it a try in the early days and bring it into her teams at Pfizer.
• 4:30
  Speaker 1: That may be a perfect segue to Nehama's introduction.
• 4:33
  Speaker 3: Hello.
• 4:34
  Speaker 3: So, vana, I'm Nehama Ketan.
• 4:36
  Speaker 3: I've been on your podcast a couple of times.
• 4:39
  Speaker 3: Today I'm here as a wicked problem wizard.
• 4:42
  Speaker 3: Wicked problems are problems that have social complexity, so everyone is looking at the problem from a different angle and a different viewpoint and the great definition that I love is the stakeholders can't agree on what the problem is.
• 4:56
  Speaker 3: And in the context of team building, I think that that's really so true.
• 5:01
  Speaker 3: We talk in the regulatory space and E8 about cultures of trust and the ability to speak up and the need to raise issues early.
• 5:10
  Speaker 3: Our management in the large pharma companies all talking about trust in the last few years because of E8R1 and E6R3.
• 5:20
  Speaker 3: But there's just been it's a really hard, nobody knows quite what that means six or three, but there's just been it's a really hard, nobody knows quite what that means.
• 5:28
  Speaker 3: And I worked with Rajesh in a prior life where I used TMAX on a team very, very successfully where we brought in a range of different people and frankly, yes, I'm non-neural typical.
• 5:42
  Speaker 3: I think almost everyone is, but to some degree or another it's a spectrum, so the number of normal people in the world is probably smaller than we think.
• 5:51
  Speaker 3: But that this worked for the team, it wasn't because it was a special team.
• 5:56
  Speaker 3: It worked for the team because we had people from all the way around the world who needed to work together in an environment that was challenging, and we did it very successfully.
• 6:08
  Speaker 3: So that's me.
• 6:11
  Speaker 1: Thank you, Nahua.
• 6:11
  Speaker 1: I think I will start with having both of you explain to me what is a high-performing team.
• 6:20
  Speaker 1: What does that look like?
• 6:28
  Speaker 3: performing teams.
• 6:28
  Speaker 3: What does that look like?
• 6:29
  Speaker 3: Can I start?
• 6:29
  Speaker 3: Because I heard this great definition of a high performing team from someone who did SEAL training and he said a high performing team is a team that still performs when everything around it has gone to hell in a handbasket.
• 6:38
  Speaker 3: So if you can perform when you don't have management support and you can perform when you don't have environmental support and you can perform when you don't have management support and you can perform when you don't have environmental support and you can perform when you don't have ideal circumstances and you still perform, that means you actually have a high performing team.
• 6:55
  Speaker 2: Or, jess, you can give the appropriate definition am actually thinking in much simpler terms where I grew up in Sri Lanka and I started playing rugby.
• 7:12
  Speaker 2: I'm not very big, so, like I've met now, I'm not your typical rugby player, but I started playing rugby as a kid and my school happened to be one of the sort of you know better schools when it came to rugby in the Sri Lankan context, which is not the same as playing with, you know, the New Zealand All Blacks or something like this, and under national tournament.
• 7:51
  Speaker 2: The first year that I played, our team was favored to win because we had a prop forward.
• 7:54
  Speaker 2: It's like this huge guy who, you know, some kids mature early and this person he was like weighted three times as much as anybody else, the other 13-year-olds and we just expected to win because nobody could stop him.
• 8:07
  Speaker 2: Except in the finals.
• 8:10
  Speaker 2: We ran into this team where they had planned for this and actually had been tackling the 15-year-olds in their school, and they stopped our prop and the rest of the team hadn't practiced enough in a way that played to our.
• 8:28
  Speaker 2: You know, we had actually a really strong team.
• 8:31
  Speaker 2: We just got over reliant on this one star and we just hadn't practiced to actually play to our strengths and it was just a very disconnected group that now had to adjust to a world that changed and we just failed.
• 8:49
  Speaker 2: The next year we lost the big guy.
• 8:52
  Speaker 2: But most of us came back and actually you know, we really there were no superstars and we'd learned the lesson the hard way of like each person has a role to play and if we can kind of figure this out the right way, we could play to our strengths and adapt to any team or any strategy and arrive at a sort of playbook or on the spot on the field Because we trusted each other, we knew what the other teammates could bring, we knew when to count on them.
• 9:31
  Speaker 2: We could count they were going to be right there behind you when you needed to pass, as you were getting tackled.
• 9:37
  Speaker 2: And we actually won the Nationals that second year when we weren't supposed to win.
• 9:41
  Speaker 2: And there's a long-winded way of saying you know, high-performing team to me is sort of doesn't necessarily need to be a team of stars to be a star team.
• 9:51
  Speaker 2: I know that's a cliche, but it's a team that actually understands the strengths of the individuals as enough trust to sort of lean on each other and enough humility to sort of take the failures and the successes together, without trying to, you know, point fingers or take credit.
• 10:13
  Speaker 1: That's a great analogy and that is just like a parable that should be told to people about how having a star on the team can actually make it more difficult for the team to perform together.
• 10:24
  Speaker 2: Yeah, it becomes a crutch, you know it's sort of, and it's going to burn out the stars, because we've all had these themes.
• 10:30
  Speaker 2: It's, you know, going to burn out the stars.
• 10:34
  Speaker 2: It's disempowering for everyone else and it hides all of the other kind of issues that are holding the team back.
• 10:42
  Speaker 1: That's awesome.
• 10:42
  Speaker 1: I would like to turn us back to the life sciences reality.
• 10:47
  Speaker 1: What are some of the circumstances that make it difficult to be a high-performing team in a life science company today?
• 10:58
  Speaker 3: So I'll take that.
• 10:59
  Speaker 3: I think there's a couple.
• 11:01
  Speaker 3: So the industry itself is going through a lot of trash right.
• 11:05
  Speaker 3: There are a large number of US-based companies that are hitting loss of inclusivity, and so there's some financial pressures.
• 11:15
  Speaker 3: There's timing pressures from post-COVID that says, hey, why does it take so long to do a clinical trial?
• 11:23
  Speaker 3: Right, cut that time down, do things faster.
• 11:26
  Speaker 3: There's a technology gap.
• 11:28
  Speaker 3: Clinical trials are still being run, not entirely, but largely on technology that in some cases is 30 years old, with the expectations that wait.
• 11:39
  Speaker 3: If I can go shopping on Amazon or okay, amazon isn't a controlled environment, but I can have all my bank accounts linked together, why can't I get my medical data linked Right?
• 11:50
  Speaker 3: You know relatively the same amount of of regulation involved in why does one environment work and the other one doesn't.
• 11:57
  Speaker 3: So there's and then the big companies all lane people off, or a lot of the big companies are lane people off.
• 12:06
  Speaker 3: Anyone who doesn't have a GLP-1 is lane people off, and that creates an environment of wait.
• 12:11
  Speaker 3: Am I going to get laid off?
• 12:12
  Speaker 3: Am I not going to get laid off?
• 12:14
  Speaker 3: Am I going to get fired?
• 12:15
  Speaker 3: Thing is more real, at least in some of the organizations I've been at.
• 12:20
  Speaker 3: It's an aging population which adds an interesting stress.
• 12:24
  Speaker 3: I've been at.
• 12:26
  Speaker 3: It's an aging population which adds an interesting stress.
• 12:28
  Speaker 3: There's some statistics in America about the Gen Xers, the 50-some-odd-year-olds, who are all getting laid off way sooner than they expect to.
• 12:34
  Speaker 3: So they expected to work until they're 60, 65.
• 12:37
  Speaker 3: They're getting laid off in their 50s and they're not then finding another job.
• 12:40
  Speaker 3: So now you're stuck with.
• 12:44
  Speaker 3: Wait, my career is over.
• 12:46
  Speaker 3: What do I do?
• 12:47
  Speaker 3: And that's often the people in leadership.
• 12:51
  Speaker 3: It might not be the people doing the job, but the people in leadership are really risk adverse.
• 12:55
  Speaker 3: They grew up in a risk adverse industry.
• 12:57
  Speaker 3: The industry hasn't become more risk prone.
• 13:01
  Speaker 3: It's a low trust industry.
• 13:02
  Speaker 3: No one trusts I'm talking the US here.
• 13:05
  Speaker 3: No one trusts the government.
• 13:06
  Speaker 3: The government doesn't trust pharma.
• 13:08
  Speaker 3: Absolutely no one trusts pharma.
• 13:10
  Speaker 3: Pharma doesn't trust pharma.
• 13:11
  Speaker 3: And so you've got this inbred.
• 13:14
  Speaker 3: You're laughing, but this inbred lack of trust.
• 13:16
  Speaker 3: And then you add the fear that your management layer is worried about losing their ability to work.
• 13:24
  Speaker 3: What do you do?
• 13:44
  Speaker 2: To build on what Nehama said.
• 13:46
  Speaker 2: So with T-Mix we've now been exposed to maybe half a dozen different teams inside pharma organizations across a few different functions but around clinical operations, and there's a couple interesting things that mirror other sort of risk-averse bureaucratic environments.
• 13:57
  Speaker 2: One is that there's a sense of hopelessness that tends to worsen the longer you've been there, to worsen the longer you've been there.
• 14:15
  Speaker 2: And so what we saw with some of the teams was that if you looked at because Team X is collecting a whole bunch of data points, trying to predict some dynamics, et cetera Well-run teams in well-run organizations you would expect to see ice safety within the team so that you can have progress.
• 14:39
  Speaker 2: You know you make mistakes, you take risks, you ask for help when you need it, et cetera, et cetera, and you align with the organizational priorities because you believe that the organization is heading in the right direction, that you know effort is going to be rewarded, et cetera.
• 14:53
  Speaker 2: What we saw in the pharma teams was that you had the same distribution of.
• 15:01
  Speaker 2: You know some teams are well-run and had.
• 15:03
  Speaker 2: You know, had and I shouldn't say well-run and high safety.
• 15:08
  Speaker 2: These are not actually the same thing Because, for example, we learned this at Ultronauts where, if we had a couple teammates on a project team that maybe had complex PTSD or workplace PTSD from prior bad experiences, bullying, et cetera independent of how supportive the team environment was, their base state of psychological safety was going to be low.
• 15:31
  Speaker 2: There was literally nothing you could do to shift that unless you had many years to work together with a stable set of relationships, and you know that's not the world of work we live in.
• 15:41
  Speaker 2: Teams shift, et cetera.
• 15:45
  Speaker 2: That said, you could see that in the sort of pharma organizations, just like in other organizations, there was a difference.
• 15:53
  Speaker 2: Some teams had high safety, some didn't.
• 15:55
  Speaker 2: What was different, though, is that, across the board, you had low organizational trust, which you know, and the AI system can only pick up certain things, and then we'll usually have a coaching session with the team so we can dig into like.
• 16:13
  Speaker 2: And then we'll usually have a coaching session with the team, so we can dig into like, why is that?
• 16:16
  Speaker 2: You know what's going on here, and really invariably, there was just a pervasive sense of you know nothing, I do matters, like I've raised stuff before, I've tried to change stuff before and nothing happens.
• 16:39
  Speaker 2: And over time, if your initiative isn't rewarded, and maybe in some cases and this is, you know, from the outside we don't see the negative consequences.
• 16:43
  Speaker 2: But maybe actually you try to change stuff is going to be met not just with passive resistance, active sort of penalty.
• 16:51
  Speaker 2: Then over time you just stop trying.
• 16:57
  Speaker 2: Over time the next corporate initiative around trust and safety, you're just going to roll your eyes and move on, and that's toxic, I mean.
• 17:08
  Speaker 2: I don't mean that toxic gets thrown around a lot, but it's actually a negative reinforcing cycle that is really hard to get out of, because once you're there, and if it's correlated with tenure because the longer you've been around the more jaded you are then it's really hard to shift out of that, to break out of that.
• 17:25
  Speaker 2: And so you know that's a tough context to operate in, on top of the sort of obsolete technologies, the job security fears and on and on and on which are present in other industries as well.
• 17:44
  Speaker 1: That is a very interesting finding that, because in our industry, we have had people who have been in the industry for a long time which is supposed to be an asset but who have experienced staleness and lack of change.
• 18:00
  Speaker 1: They kind of propagate the staleness and lack of change and hence we remain in the same place as before.
• 18:12
  Speaker 1: Which is basically why I started this podcast in the first place is well, how do we actually break out of the staleness and how do we transform how we operate?
• 18:17
  Speaker 1: I'm very curious how do we move on from this atmosphere where all initiative gets killed, but also, because we have experienced that all initiative gets killed, we kill all the initiatives.
• 18:33
  Speaker 1: How do we turn this around, and maybe both on a team level, but also on an industry level?
• 18:40
  Speaker 3: So I've spent a lot of time along with trying to understand this question of trust, trying to understand how do you drive change right?
• 18:50
  Speaker 3: And so one of the Nicole who works closely with Rajesh had pointed me towards Greg Stahl's book called Cascades, and what it says is that you only one, you're always changing organizations and you're always going to have resistance to change.
• 19:08
  Speaker 3: But there's this magical mathematical theory that meets social science, that says you only need 10 to 15 to 20 percent of the population to drive a revolution, and that, based off of that, I think that the only thing you can do while you're in that organ is those types of organizations is role model and show that you can.
• 19:32
  Speaker 3: You can be successful right.
• 19:35
  Speaker 3: If enough people see that success is possible, they will step up and join it, and that that's going to happen regardless of how much senior management is driving something or not.
• 19:49
  Speaker 3: So that's something you can actually do at a more junior level.
• 19:52
  Speaker 3: Now you're always working with changing organizations and it's not about individual people.
• 19:58
  Speaker 3: It's really about the institutions and the organizations, and you need people supporting you, but you don't need as many people supporting you as you think you need, and change always eventually happens, even in stale industries.
• 20:13
  Speaker 3: That's called disruption, yes, and sometimes the answer is to go find disruptive people and go work there instead of where you're at right.
• 20:23
  Speaker 3: But then you need to have.
• 20:26
  Speaker 3: Then all you can do is work with the people around you and teach them to trust their guts well enough to know when it's time to move on with the people around you, and teach them to trust their guts well enough to know when it's time to move on Right.
• 20:34
  Speaker 3: So I think, as a leader in an organization that's got um challenges, that that the that you have an obligation to to model what you can and and do what you can um as much as possible.
• 21:00
  Speaker 3: Helplessness is a learned trait when Josh and I met over special needs children discussing special needs issues, and helplessness is actually trained into people in the American special needs issues and helplessness is actually trained into people and the American special needs system.
• 21:17
  Speaker 3: So you can train people out of helplessness.
• 21:19
  Speaker 3: It takes time and not everyone's interested, right?
• 21:22
  Speaker 3: So pick your friends, pick the people who are interested.
• 21:24
  Speaker 3: You don't need everyone, you don't even need half of everyone.
• 21:26
  Speaker 3: You just need 15 to 20% to show that something can be done differently.
• 21:31
  Speaker 3: Yeah.
• 21:33
  Speaker 2: And I would say you know kind of I think of like jujitsu and religion.
• 21:41
  Speaker 2: So, like you know, the first is you have to use the sort of oppositional inertia or momentum in your favor.
• 21:52
  Speaker 2: So right now the industry is in crisis in most parts of the industry and there's a somewhat knee-jerk reaction to look for ways to increase velocity, reduce costs and when you look at, you know how you actually need to do that.
• 22:20
  Speaker 2: One of the simple ways, of course, is to reduce waste.
• 22:24
  Speaker 2: And when you look at where does waste come from?
• 22:27
  Speaker 2: On most of these clinical teams now I'm speaking from a very small, you know N of six to eight, right, but at least in some of those teams and this was before, actually, nehala, we started working with your teams there was so much hidden waste coming from teams who had no voice.
• 22:52
  Speaker 2: So you'd have like some three, four person executive committee meet and change direction and that would without any input from the people doing the work or the teams doing the work, and this change would come flow down to the teams with no ability to sort of question or shape what was going to happen, and they would have to just change directions, shift plans, throw out months of work and then it happens again.
• 23:24
  Speaker 2: And so the same underlying kind of driver of like you can't take initiative, you can't change anything, you have no voice, you feel disempowered, is actually at the root of waste.
• 23:42
  Speaker 2: And so there's no way an organization is going to be able to move faster, be more nimble, responsive to market conditions that are now changing much faster than the industry is used to, unless you get to the cultural root of waste.
• 24:04
  Speaker 3: Sorry go ahead.
• 24:06
  Speaker 3: Not to argue with you, but I think that part of the answer is to come up with ways to adjust faster.
• 24:13
  Speaker 3: So it's not that the teams had no voice, because clinical trials change Sometimes it's the FDA says you shall do something different, right it's.
• 24:22
  Speaker 3: Do you have so much manual work in your processes that are so embedded that when there is a change, you can't do anything about it to move quickly?
• 24:31
  Speaker 3: When there is a change, you can't do anything about it to move quickly?
• 24:35
  Speaker 3: And do the teams understand that?
• 24:36
  Speaker 3: Because a lot of what's happening and I've seen it in multiple organizations is that there's I call it, the Excel air gap, Excel gap, right.
• 24:46
  Speaker 3: So you have this really cool process and then you have another real cool process, and between the two processes is Excel and it's the best high security gap on the planet.
• 24:54
  Speaker 3: It's an Excel tracker, right.
• 24:56
  Speaker 3: And so if you allow team members to say, look, I've got these trackers, let me fix them right, that's that thing right.
• 25:05
  Speaker 3: Allow them to fix those trackers and remove them.
• 25:07
  Speaker 3: So now your processes do this.
• 25:08
  Speaker 3: Well, now you make a change.
• 25:10
  Speaker 3: Who cares Like you're not having?
• 25:13
  Speaker 3: The most of your work is in this hidden work, that's in an Excel tracker, because it's a gap in a process, but then you're still backward-jushing in the place where the teams can't explain why they're spending two or three times more time tracking the process than doing the process ending two or three times more time tracking the process than doing the process, and management doesn't understand why everything takes so long when each of the individual process steps are the.
• 25:38
  Speaker 3: I joke, it's a 10-minute train between Worcester and the South Bronx, and for people who don't live in New York, that's right.
• 25:47
  Speaker 3: An hour and a half out of Boston and into a really dangerous neighborhood in New York, People will take.
• 25:51
  Speaker 3: It's a 10-minute train though, so why not?
• 25:54
  Speaker 3: It's like no, I'd rather sit for five hours on a train that's slower, that's going to take me exactly where I want to go, to where I want to go, without having to deal with the last mile problems, so to speak.
• 26:07
  Speaker 2: Yeah, and I agree with your disagreement, so to say.
• 26:13
  Speaker 2: The other side of this is kind of when I said religion, it's sort of the serenity prayer, right, like what can you actually change?
• 26:20
  Speaker 2: And really it's thinking about local maxima in the context of a team and the constraints on your performance or output.
• 26:30
  Speaker 2: On your performance or output and to the Excel air gap thing, like in teams not even knowing how much time they're wasting or why it's taking so long.
• 26:43
  Speaker 2: With one of the teams we worked with, the kind of system recommendation was track waste, like create a metric and just manually track it on your team, include it in your dashboard that you're reporting up just to start the conversation, so that you have a data point that you can actually trust to have the conversation about trade-offs with.
• 27:10
  Speaker 2: You know the sort of people who are removed from the impact of sloppy decision-making.
• 27:18
  Speaker 2: You know inconsistent behavior and, interestingly, you know, one of the comments from the team leads was like for the first time in years, our team has hope, not because they believe that this was going to suddenly dramatically change everything, but actually because they had a concrete thing they could do that was moving in the right direction, even if it didn't lead to the result they were hoping, which is, you know, sort of more predictable mode of operations that would allow them to better plan and have less waste.
• 27:55
  Speaker 2: Just taking a small step, but a really concrete step, actually is really uplifting, especially if years of not being able to do anything to change anything is it really a life sciences problem or would any large corporation like the finance industry or, I don't know, automotive industry have similar hopelessness?
• 28:24
  Speaker 2: I.
• 28:24
  Speaker 2: So I've worked.
• 28:27
  Speaker 2: When I was at Bain I worked across a bunch, probably a dozen different industries and then with Ultronauts and more at the business strategy level.
• 28:34
  Speaker 2: At Ultronauts, again, we've had exposure to well over a dozen industries, but more at the technology, the CIO or the chief data officer's groups are very specific.
• 28:50
  Speaker 2: I'd say this reminds me more of certain parts of intergovernmental work, where there's sort of regulatory considerations, which is different.
• 29:07
  Speaker 2: So financial services has that healthcare, you know providers, payers there's that dynamic which is completely out of your control but also is the driving force for most things that happen.
• 29:21
  Speaker 2: The other, though I think that's unique to life sciences, is just the long cycle times, so just the long range investments that need to be made are different, and that does create a different kind of cultural ethos and dynamic.
• 29:45
  Speaker 2: And until the magic AI systems can replace clinical trials or some parts of it in a simulated environment, you know, which I'm not holding my breath for, like that's a reality that isn't going to change.
• 30:04
  Speaker 2: And so then you have like compliance related bureaucracy, long range bets that you have to make and kind of follow through.
• 30:19
  Speaker 2: That makes you even less able to course correct quickly and react fast, and so I think those two compound to create a particularly unique environment that's tough to operate in.
• 30:34
  Speaker 3: So I've worked in a bunch of different industries also, and what I think pharma is doing is every industry, when it hits the oh my God, we're no longer crazily successful and profitable right, has to worry about okay, wait, now I've got to figure out how to be, to scale and to be efficient, okay.
• 30:57
  Speaker 3: So I was in semiconductors when it happened.
• 30:59
  Speaker 3: I've been in um, I was watching, I was at a printer business, right, like who uses printers anymore?
• 31:06
  Speaker 3: And so pharma's got this weird set of, I think finance just hit that way a long time ago, right.
• 31:17
  Speaker 3: So I don't see pharma as being unique per se.
• 31:20
  Speaker 3: It's just that the way they're hitting the highly regulated, they've lost profitability.
• 31:28
  Speaker 3: You hear the stories of the good old days when there's all this money like the tech startups.
• 31:32
  Speaker 3: So there's all this money being thrown around.
• 31:34
  Speaker 3: That's all gone, and the people who've made it to management have done things the same way for 30 years.
• 31:43
  Speaker 3: So it's that for the first time in 30, 40 years, something actually has to change and no one has the tools to do it.
• 31:49
  Speaker 3: That's what's so cool about TMAX is that it provides tools for doing things differently without having to go retrain or get people completely in a whole new environment, go send everyone for management training.
• 32:07
  Speaker 3: That doesn't work anyway.
• 32:08
  Speaker 3: There isn't any common language even.
• 32:13
  Speaker 3: And then the other thing that pharma has is that there's this deep-seated belief that you can only manage in pharma if you've always been there, right, that they're so different that you can't hire a senior person from another industry and have them be successful.
• 32:27
  Speaker 3: And I think I'm a case in point of a counter example to that.
• 32:33
  Speaker 3: And many people like me who've come in have been like well, what's going on here, like this is weird.
• 32:38
  Speaker 3: But that's created a situation where people kind of know what they know and all of their friends know what they know, and there hasn't been a lot of oh, let's kind of look at things differently.
• 32:54
  Speaker 3: It just keeps it, aggregates the problems.
• 33:01
  Speaker 1: And Rajesh, based on your experience of kind of throwing the rule book out for how things are supposed to be, what have you learned in the teams you've worked with in pharma?
• 33:11
  Speaker 1: What actually what works?
• 33:16
  Speaker 2: You know, it depends on the team.
• 33:17
  Speaker 2: I think there's more variance between teams than across industries Because, like on a technical team that usually highly collaborative, maybe 10% of your interactions are with your sort of manager or team lead, right, and so most of your work experience and the experience of work day-to-day is driven by the interactions you're having with your peers.
• 33:51
  Speaker 2: And so the default corporate approach or reaction to let's support our teams is let's send the manager for training, and so first, like OK, but teammates are spending more of their time interacting with each other.
• 34:12
  Speaker 2: So how is you know, how are you going to use the 10 percent of interactions to actually have a meaningful impact?
• 34:18
  Speaker 2: That's number one.
• 34:20
  Speaker 2: Number two is there's plenty of doubt about do the way technical trainings on technical skills, you know the way those trainings are delivered, et cetera.
• 34:30
  Speaker 2: Do they actually work?
• 34:31
  Speaker 2: Because there's no feedback loops, it's not applied in context, you know, et cetera.
• 34:35
  Speaker 2: Naive to think that someone's going to sit through a four-hour workshop on, like, creating psychological safety or building an effective team or what have you, and then magically change their behavior in a way that's tailored and informed by the needs of the team they're working with, Because this kind of best practices approach doesn't work with humans.
• 35:12
  Speaker 2: Humans are different and that's something we learned the hard way at alternates, because we couldn't ignore it because the variances were so extreme.
• 35:18
  Speaker 2: It's just.
• 35:19
  Speaker 2: This is actually true on every team.
• 35:20
  Speaker 2: It's like you can't.
• 35:22
  Speaker 2: You know, even, um, like in the us, um, there's a commonly repeated practice on giving good, constructive feedback which is called the shit sandwich.
• 35:39
  Speaker 2: I don't know if I'm allowed to say that on this podcast, but essentially the yeah, the advice is you know, whenever you're giving constructive feedback is you know, whenever you're giving constructive feedback, always give it in the moment, so it's fresh in a live conversation, so there's less room for misunderstanding and, sandwiched between positive comments, so it's easier to hear.
• 36:01
  Speaker 2: And at Ultronauts and I'd learned this, by the way, I learned it at Microsoft, I learned it at Bain, I heard it at the UN, Like it's everywhere.
• 36:11
  Speaker 2: And so when we started having more formal kind of performance reviews, all this stuff at astronauts, we started training, you know, having these workshops on how to give good feedback, and I've sat through these things at other places as well you know resources, little tip sheets, all this stuff, and it was immediately obvious that this is like confusing to half the team who got out of a quote coaching conversation and they were 90 of.
• 36:40
  Speaker 2: It was compliments and there was some couple things that were mentioned that they don't even remember because they got all these compliments like all right, I'm doing great.
• 36:47
  Speaker 2: It was offensive to the other half of the team who thought that the person you know attempting to give feedback was just being a coward and beating about the bush and like trying to be shifty and not actually getting to the truth.
• 37:01
  Speaker 2: And then it really freaked out some number of teammates who got a calendar invite from their manager right after a group interaction with no context and just a hey, can we chat?
• 37:14
  Speaker 2: And the manager was just following the the advice of always give feedback in the moment.
• 37:20
  Speaker 2: Um, except the teammate.
• 37:22
  Speaker 2: You know, the last time this happened the teammate got fired and so now they this ruined their week pretty much.
• 37:28
  Speaker 2: So all this to say there are all these fallacies that are the foundation of quote, good management that if you start looking for evidence of like, where does like this shit sandwich thing, where does it come?
• 37:47
  Speaker 2: So, of course, when we saw this fail so miserably, we're like okay, where does this come from?
• 37:52
  Speaker 2: We couldn't trace it to any evidence-based study or anything Like really right and and the.
• 38:00
  Speaker 2: The real answer was well, you know it's.
• 38:03
  Speaker 2: There is no one approach.
• 38:05
  Speaker 3: Consultants like you.
• 38:07
  Speaker 2: Yeah, well, no kidding, I'm sure.
• 38:09
  Speaker 2: Yeah, you need a playbook.
• 38:12
  Speaker 2: You know that you can reuse.
• 38:16
  Speaker 2: There is no one answer.
• 38:20
  Speaker 2: And really, the other part of it is that most of us also aren't that self-aware, aren't that self-aware?
• 38:25
  Speaker 2: So, on the one hand, there is no one good approach to give critical feedback.
• 38:31
  Speaker 2: On the other hand, if I just ask you that question, you haven't thought about it before and so you know it's hard to answer.
• 38:39
  Speaker 2: But if you break it down into small bits that are simple, like so I'm going to give you some constructive feedback.
• 38:46
  Speaker 2: Do you usually want to know right away, or can it wait till the next check-in?
• 38:47
  Speaker 2: Right, you probably have an answer.
• 38:48
  Speaker 2: Do you usually want to know right away, or can it wait till the next check-in?
• 38:48
  Speaker 2: Right, you probably have an answer.
• 38:48
  Speaker 2: Usually like would you recommend me to jot down some notes so you can digest it or talk through it?
• 38:54
  Speaker 2: You know.
• 38:57
  Speaker 2: And do you want me to get straight to the point?
• 38:58
  Speaker 2: Do you want me to start by recognizing the good work you're doing, et cetera, et cetera, like.
• 39:02
  Speaker 2: These are easy questions to answer.
• 39:03
  Speaker 2: So, coming back to your question, you know what works depends on who's on your team, what they need to do their best work, what's holding them back, some of which they may not be aware of, because most of our reactions in the workplace are simply reactions based on years of experience good and bad, that have nothing to do with the current moment.
• 39:34
  Speaker 2: And so, you know, peopling is hard, like managing people is hard.
• 39:36
  Speaker 2: You know the AI systems will do a lot more, increasingly more of the project management, task management, organizational stuff, but the people management will continue to be hard and annoying and complicated because the needs are not always expressed or even known.
• 39:54
  Speaker 2: And so, in that context, what's unique about what works is take a tailored approach, actually figure out what different people need and what that means for the team as a whole.
• 40:07
  Speaker 2: Like what does that mean?
• 40:08
  Speaker 2: Like, if you have a bunch of teammates who are sensory avoiding, you know, need blocks of protected time to do deep work?
• 40:15
  Speaker 2: Probably a lot of the curmudgeon, data scientists and statisticians how am I laughing?
• 40:23
  Speaker 3: Yes, Making them come back to the office for 10 hours a day of personal interaction is probably not going to be effective for them.
• 40:33
  Speaker 2: That's going to kill productivity.
• 40:34
  Speaker 2: But on the same team, regardless of where you're working, you also might have teammates who are sensory seeking or lean more towards collaborative work and a lot of interaction and all that stuff.
• 40:47
  Speaker 2: It's not so much this introvert, extrovert kind of labels, which are not concrete I don't know what to do with that but sensory avoiding and sensory seeking that's more real, it's more sort of specific, and so you need to understand these things because you have to find the right balance.
• 41:05
  Speaker 2: You know you have to, for example, make sure your team habits allow for uninterrupted time for deep work, because everybody needs it Some people more than others, but everybody needs it as well as shared collaboration time, because everybody needs that too, and so finding the right balance just depends, depends on the team and what you're trying to do together and who's on the team.
• 41:33
  Speaker 2: So, in that sense, like, what works is actually just taking a more tailored approach, and you know there's tools that help you do this, so that especially managers, kind of middle managers, can be just stretched thin, like, if you have 30, 40 people in your group, like, how are you gonna remember all this stuff?
• 41:56
  Speaker 2: The other thing that works, though, is having alignment within a group within a team of what they want to change.
• 42:06
  Speaker 2: As a manager, a team lead can't make you change, can't force a change in group behavior.
• 42:13
  Speaker 2: Even changing individual behavior when we want to is hard, you know.
• 42:18
  Speaker 2: Otherwise we'd all be in great physical shape and eating healthy.
• 42:22
  Speaker 2: But group behavior is near impossible unless there's full buy-in, or at least you know buy-in from most of the group that, yeah, we actually need to change this thing for our own benefit.
• 42:36
  Speaker 1: And Rajesh, I think you touch upon an important point here, and that is the individual's maturity to be able to change and ability to do so for the better of the team.
• 42:47
  Speaker 1: How do we build on that?
• 42:53
  Speaker 2: I'll start.
• 42:54
  Speaker 2: One is you can't change people, so you know all this.
• 42:57
  Speaker 2: A lot of the default, the knee-jerk reaction is let's train something into someone or out of them, right Like, let's train bias out of humans.
• 43:05
  Speaker 2: Like I'd love to see that let's make Nahama, nice or I don't know, fake know, fake like.
• 43:13
  Speaker 2: Is that the same right like?
• 43:14
  Speaker 2: Feature above?
• 43:14
  Speaker 2: But but, um, what you want to try to do is not try to change people and their defaults.
• 43:21
  Speaker 2: You can't.
• 43:21
  Speaker 2: You don't have that kind of time.
• 43:22
  Speaker 2: You're not a therapist, you're a manager.
• 43:24
  Speaker 2: Right, you got work to do.
• 43:25
  Speaker 2: Um, you got to figure out what sort of shard wire the shifts in practice behavior into the team's norms in just concrete ways, so that it repeats.
• 43:37
  Speaker 2: So, for example, one of the you know that's kind of challenges around.
• 43:43
  Speaker 2: Speak up.
• 43:43
  Speaker 2: Culture is not unique to life sciences, to life sciences, and it's equally important if you're running a technical team where people not raising issues causes tech debt, and you know launches get delayed and billions of dollars are on the line, so that dynamic exists in other places.
• 44:02
  Speaker 2: Trying to like talk to people about trust and safety, and you know all of that.
• 44:08
  Speaker 2: So it doesn't work to stop, it's a waste of time and it starts to actually be seen as disingenuous if the underlying cultural drivers that create a low safety environment aren't addressed.
• 44:21
  Speaker 2: What you can do, though, again, if the locus of control is the team, you know you can adopt habits that repeat.
• 44:31
  Speaker 2: So every team meeting there's a standing agenda item to raise emerging issues.
• 44:38
  Speaker 2: That's a thing you can do it.
• 44:41
  Speaker 2: It normalizes raising issues.
• 44:43
  Speaker 2: It doesn't make people feel any safer but it actually reinforces the behavior you want and it becomes a habit over time.
• 44:53
  Speaker 2: So I think it's.
• 44:54
  Speaker 2: You know you have to focus on what behavior designers call crispy behaviors, like it's got to be super concrete and tangible and hardwire it into your ceremonies, the repeating kind of rituals on your team.
• 45:14
  Speaker 1: Yeah, that makes sense.
• 45:14
  Speaker 1: I'm also curious this trend that we see with just general jadedness in life sciences.
• 45:25
  Speaker 1: Is this a US phenomenon or is this a life science phenomenon?
• 45:31
  Speaker 2: Or is it People are jaded, sorry.
• 45:34
  Speaker 1: Yes, that's.
• 45:35
  Speaker 1: People in life sciences, especially who have been here for many years, are just exhausted and have lost hope.
• 45:44
  Speaker 3: Yeah, I don't know.
• 45:45
  Speaker 3: I don't have enough exposure outside of the US.
• 45:48
  Speaker 3: My gut feel says it's not just a US problem.
• 45:53
  Speaker 3: I don't think that our cultures are that different across the world and I don't see a big difference when I work with teammates outside of the US.
• 46:00
  Speaker 3: I think it's more an organizational problem and that has to do with what kind of teams you're on.
• 46:10
  Speaker 2: And that has to do with what kind of teams you're on.
• 46:12
  Speaker 2: I think the yeah, I don't have enough exposure within life sciences to kind of teams outside the from the sort of job insecurity in the US because there isn't a safety net, right, so you lose your job, you lose your health, your family loses their health insurance.
• 46:40
  Speaker 2: That's a different world to live in.
• 46:44
  Speaker 2: That's a different pressure that does then seep into kind of risk aversion, right, and not wanting to rock the boat and somehow increase the chances that you're on the list for the next round of layoffs.
• 47:01
  Speaker 2: That might be more US specific, but I think there's job insecurity in other, you know, everywhere now.
• 47:12
  Speaker 1: That makes sense.
• 47:12
  Speaker 1: Well, nehama and Rajesh, I wish we had hours for this conversation, but I will start rounding off now.
• 47:21
  Speaker 1: And I always ask my guests the same question towards the end of the episode, and that is, if I gave each of you the transformation trials magic wand that can change one thing in the life sciences industry, what would you wish to change?
• 47:36
  Speaker 3: I'll go with Josh.
• 47:41
  Speaker 2: This is really hard.
• 47:42
  Speaker 2: I should have read the questions in the brief.
• 47:48
  Speaker 3: Okay, I'll go then and you can edit that out or not.
• 47:51
  Speaker 3: I think that this actually don't edit it out, because I think that the desire to say hey, the ability to say I've made a mistake, right, can we get to where failure is really talked about in a positive way.
• 48:09
  Speaker 3: On my teams, we did a party each release on the first bug.
• 48:13
  Speaker 3: Cool, we found a bug, we fixed it like that's a great idea, right, it was so great.
• 48:19
  Speaker 3: It was like for everyone on the team.
• 48:21
  Speaker 3: The first time I did it was like oh my, you guys, you didn't argue me about the specs, you didn't try to hide it, we found it and we fixed it.
• 48:30
  Speaker 3: We're done Like any other team has spent weeks masking it, right.
• 48:35
  Speaker 3: So there's that.
• 48:36
  Speaker 3: I mean, I think that what we need is language and tools like TeamX to be able to understand how do we have conversations around teams.
• 48:45
  Speaker 3: This is something that can be data-driven, it can be worked through, it can be discussed explicitly, and we need to get out of this generalized.
• 48:56
  Speaker 3: Oh, we think we can talk about teams, but we don't know what it means and it's like discussing love.
• 49:02
  Speaker 3: It's not.
• 49:03
  Speaker 3: It's a science.
• 49:04
  Speaker 3: Let's just figure out how to do it and have open conversations and do it in an open way, and an opportunity where every leader feels that they can say hey, what's going on.
• 49:21
  Speaker 2: My long, windy sort of path.
• 49:28
  Speaker 2: I spent a bunch of years at UNICEF and there's some really interesting research I came across that was titled Altruism, or being in a position to help others would have in helping children who had been through traumatic experiences either from natural disasters or wars or conflicts move past their trauma, where being in a position where they're the ones helping other kids actually was really healing.
• 50:07
  Speaker 2: It's really empowering.
• 50:12
  Speaker 2: And the thing is, you know, children need to feel like they matter, they need to feel a sense of importance and being able to do something like take an action that they can take Cause with children like there's, there's all these things they can't do, they can't drive, they can't do that but if there's something they can actually do that matters, it's incredibly empowering.
• 50:40
  Speaker 2: It's sort of life-changing and I think it's easy to forget, you know, given this whole conversation like why did people come to life sciences in the first place?
• 50:52
  Speaker 2: right, like intrinsically, most people in the industry wanted to make a difference yeah and over the years, that gets beaten out of you, just like, over the years, this sort of wish to help others gets trained out of the grownups, even though it's such a natural instinct that children have.
• 51:16
  Speaker 2: I think it's sort of similar where you come to this industry with this because of your need and wish to do something that matters and then you're in an environment where you can't do anything.
• 51:31
  Speaker 2: You can't change anything, and so I think, the more you can create the context where there are little actions you can take like that team that started to track waste, it's like, yeah, you could start to unwind some of the kind of conditioning that's led you to believe that nothing you do matters, that nothing's going to change.
• 51:57
  Speaker 2: And maybe you're right.
• 52:00
  Speaker 2: Right, Maybe nothing is going to change, but it might, and I do believe that the crisis the industry is in right now is a forcing function, and this is as good a time as any to try to shift things and shift the way things work, and starting with just really concrete actions that your team can take is within your control can be the place to begin.
• 52:26
  Speaker 1: Yeah Well, thank you both, Nehama.
• 52:31
  Speaker 1: Where can people find you if they have follow-up questions?
• 52:36
  Speaker 3: LinkedIn Nehama Ketan or at wickedproblemwizardscom.
• 52:41
  Speaker 1: Rajesh, how about you?
• 52:43
  Speaker 2: Same LinkedIn, rajesh Anandin or it's team-xai Awesome.
• 52:51
  Speaker 1: Thank you both for this conversation.
• 52:52
  Speaker 1: I think we might have to do a follow-up.
• 52:55
  Speaker 3: Okay, yes, sounds great Well.
• 52:59
  Speaker 3: Thanks for having us.
• 53:00
  Speaker 2: Yeah.
• 53:06
  Speaker 1: You're listening to Transformation in Trials.
• 53:09
  Speaker 1: If you have a suggestion for a guest for our show, reach out to Sam Parnell or Ivana Rosendahl on LinkedIn.
• 53:16
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• 53:22
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