Finding Success as a Rare Diseases MSL - podcast episode cover

Finding Success as a Rare Diseases MSL

Jul 05, 202237 minEp. 111
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Episode description

In this episode, Giovanni Passiatore delves into the complexities of working in the rare diseases arena as an MSL. Giovanni shares his extensive background and provides insights into the unique challenges faced in this field, including strategies for effective territory coverage and engaging with key opinion leaders. He highlights the critical role of patient identification and the emerging importance of patient diagnosis liaisons. Giovanni offers essential advice for aspiring MSLs, emphasizing the significance of humility, relationship-building, and business acumen. The episode wraps up with a focus on the resilience required for success in the MSL role and appreciation for the audience's engagement.

Transcript

Hey, guys. Welcome to the podcast. My guest today is Giovanni Pasatore. He is head of MSLs for TSC Rare Diseases, and we talk about how to find success as a rare diseases MSL. Great conversation. Giovanni is great. Think you guys are really gonna like this. Don't forget to connect with me and follow on LinkedIn where I put all my announcements. Check us out on, Instagram.

Our videos are on YouTube, and we do MSL talk live on the 1st Tuesday of every month at 1:30 PM EST, and that's on LinkedIn live now. Look out for those announcements. I think the next one coming up is the Tuesday after 4th July, So it's not actually gonna be on the 1st of that month. So just be on the lookout for that and check it out, and thank you guys for all your support and for listening.

Welcome to MSL talk with Tom Caravella, a podcast specifically designed for MSLs and all things field medical. Hey, Giovanni. Welcome to the podcast. How are you doing today, buddy? Hey, Tom. How are you? Thank you for having me today. Yeah. I'm awesome. I'm excited. You know, for those of you guys listening, Gio and I know each other for a long time and ran into each other at a conference, came up with this idea, which I'm excited to talk about. And, and here we are.

So, before we get started, I'm gonna let Giovanni introduce himself, talk a little bit about his background and that sort of thing. So go for it. Well, I'm Giovanni Castillo. I'm born and raised in Italy. I've been in the US for, like, 16 years right now. So we're currently on the head of, MSL, US MSL diseases. And I have more than, 10 years of experience as a MSL, MSL manager, also MSL trainer, trainer from the the entire, medical affairs department. And and that that's my experience so far.

So and it's been a great ride. And last 3 years and a half, I've been a case of rare diseases, and I have a team of, 2 separate teams, and we focus specifically in the rheumatology and immunology and lysosomal storage disorders. Yeah. And you came up with this idea, which I think is an awesome idea, which is talk about how an MSL can be successful in the rare diseases space, which is very different.

And the reason I say this, we have some clients that are in the rare diseases space, and it's a totally different animal than maybe some, you know, some of your your more standard therapeutic areas. So let's start. If you can let me know what does the industry how does the industry categorize or designate a company as a rare diseases company? Does it based upon the number of patients that that product serves? What exactly categorizes our company as rare diseases?

Yeah. Well, that's a great question, and the definition can be a little bit different based on the country. So let's say in the US, like, you know, the, there is a rare disease act in 2020, 2002, or 2,002, defined that the rare disease as a number, like, prevalence of patients which should be lower than 200,000 patients Okay. For diabetes. However, sometimes also the definition can be based also the lack of treatments. That's why all the lack of, like, in the resources.

That's why, it was also that was so called orphan, orphan disease because there is not really anything that can help these patients. And there are also some definition, but in another country, I'd be the the threshold can be a little bit different. For instance, in Japan, it's, I think, it's around, like, 15,000 lower than 50,000 patients suffering with that disease. While the European, union defined a little bit differently, like, around, like, lower than, they're looking also out.

The treatments, they are life threatening. So sorry. The disease, they're life threatening and not just the, the prevalence of the disease. However, overall, we can look at here in the US. We are more looking at number of patients, and I can say that can be considered rare, but also you can go on to the ultra rare. If you're less than, let's say, 6,000 patients, for instance, in the US, that's what we'll consider ultra rare. Yep. Interesting. I and that's kinda what I thought.

I I always had an idea that there was some threshold of number of patients that are affected, but it's interesting that you mentioned that there's rare diseases and then ultra rare diseases, which, you know, obviously, is a much smaller patient population. And by the way, it's it's kind of funny. For those of you guys that are listening to this, Giovanni are are both wearing a purple shirt. Didn't plan it. Just happened. It just happened by mistake.

My skin look blue, but I think it also look like it look like purple. Anyways, you gotta check it out on YouTube. It's kinda funny. We didn't plan it. Anyway, so let's talk about obviously, I I'm sure that poses challenges. So you're an MSL leader. You said you have 2 MSL teams reporting into you. So what types of challenges are you faced with as a leader, and how do you strategize in this rare diseases space?

So I guess the one of the challenges, the challenges that you find in every single organization, how to bring value, how to show value to senior leadership of their MSL. Like, you know, what they are doing. I think the bigger question, and I heard I listened to your podcast, previous podcast. That's topic has been discussed. How with this value that MSL are bringing to the organization.

And and some that depends also by culture, by your vision of your senior leadership, and also the therapeutic area that you're working on it or products. So those are really defined. So and I think those are challenge that you can find, everywhere. How we position the MSL to be successful. In my mind, that's, I think, is my primary work show job and challenge.

How can make the MSL into rare disease space in which it's already crowded, in which we are competing sometimes with our own colleague internally for for FaceTime. Mhmm. How we can make the MSL to be the center, people that are role within the organization. That's I think it's a a challenge, but also, it's an opportunity, I think, for all of us as a, medical affairs professional to look at that kind of way.

And, and I think if there is also another way to look in terms of rare diseases, We're we're looking at very limited numbers of physicians who treat these patients. And then you really have to you don't have, like, a pool in which you can make the MSL feel sometimes, like, you know, they have a a lot of opportunities to go out there and talk with people.

How you can how you can balance the having the MSL to be, let's say, busy without being too, to without the burden, and how to can make the accomplished without providing opportunity for them to grow, opportunity for them to progress, learn, and be engaged in the company. I think that there are it's different way to look at challenges. I think it's more for me. I felt more internal challenging.

Derma challenge are the one that I feel that I need to deal more on the daily basis more than external. Got you. Got you. And and I guess that that poses some differences in strategy, I would imagine. So if you have less k o l's that and and less patients, the strategy must be different. So you you've worked at other organizations that may not be in rare diseases. Now you're in this rare diseases company. So how is the strategy for field medical different in a rare diseases company?

Some of the strategy are kind of the same. Right? You know, you still have to work, along alongside with your commercial and marketing counterpart to have, like, a brand vision for what you want to do and then build, like, your your goals and your tactics. And I think that what differentiated the rare disease from other, company, everybody, special centric, on their vision, on their mission. Rare disease company, not just mine, all the rare disease company, they need to be patient centric.

It's a business need. It's not just a model. They need to be patients need to be at the center of everything that we do. And the reason is that it's so important that when we look at medical affairs strategy, we look at the real needs and met the need that these patients are facing every day. And this will start not just with the medical strategy, but the strategy, the company strategy. How the clinical the how the clinical, development has been, is being run is based on also patients' feedback.

Our medical strategy needs to take a take in consideration the patient's need, their feedback, what they need to do, what what they feel important for us to achieve, because it's so much connected, the disease with the patients. Here, we can name name of the patient. It's not just like it is not men. So I think that that's what in my mind differentiate the, like, you know, not the rare diseases with rare diseases company.

Rare diseases company need to, need to put the patients at center, everything, listen to them, listen to their feedback, their what they need to say, and also implemented that data strategy. Got you.

Yeah. So when when you're when you're planning things and you look at a traditional organization, there's certain parameters that would decide the number of MSLs on a team, how large the territories are, and what the territory coverage might be, what's the ratio of MSLs to sales reps, and that sort of thing. So how different is that? Is that very different? Or is it just maybe maybe the territories are larger? Maybe there's less MSL that's more concentrated?

Or am I just assuming that and that's not accurate? No. No. It's actually correct. It's not, you know, that we have a less like, you know, the territory our territory are larger. And, again, I think that the way that we mapped, it's kind of the same. Like, you we map based on numbers of, key opinion leaders. However, sometimes here, the number of key opinion leaders are really based on number of patients. So it's kind of concentrated, like, you know, a cluster of places.

So and and what you're looking to take in consideration that you you might have these rare diseases. You might have these big centers, but not necessarily all these names that you can see that are really people who are key opinion leaders. So Right. If there's disease that you will find, there is kind of a different definition of key opinion leader HCPs. So sometimes in another rare area, you cannot find a key opinion leader who doesn't see patients because it's an academic, for instance.

Mhmm. In rare diseases, most likely, not necessary all the time, you will find that the treaters are most likely the opinion leader. And that's and that's because usually they have experience with the dead disease or any treatments that was there. So they can actually provide it insights. They can provide it their real life evidence, experience that maybe any other among us do do not. So I think that's kind of the.

And and, of course, in terms of territory, like, you know, mapping, we we I personally don't look too much on the numbers of, numbers of, like, you know, Salesforce, or reps in our in our territory. What we're trying to do, we're trying to build territory that are manageable, at the same time challenging. So my philosophy, I've been an I've been an MSL for 10 years. So it's MSLs are highly motivated, highly educated. They want to always be ambitious.

So I think that there should be a good balance to be, busy without be too busy sometimes. You know? Yeah. So and I guess that I usually I usually don't work look at trying to map, but I also look and see how much can be reasonable. Take in consideration that in an organization like ours, but a lot of rare diseases, we also have a whole lot of internal project, a lot of internal educations. And that's also will take time, and that time is also valuable time.

So that cannot be considered just external. I'm not taking consideration just the external point of view, the external, part of their job for the MSL, but also the internal, part of their job as MSL. So are the metrics very different for rare diseases MSLs? I personally am not a kind of a smooth metric person, like you per se. So I guess that, you know, like, when I was in MSLs, so as a now, I try to, keep as light as possible.

I I mean, we we look at the numbers of interaction, but that's mostly light because in my opinion and this is personal opinion. I'm not I know that there is a lot of conversation about metrics. I think we still need to provide some, new guidelines. We should tell them what is okay because, you know, also there is kind of sometimes stress, for people in the field to be sure that they are kind of doing their job, and sometimes you want to reassure people that they are okay.

So I think that it's some there is some minimal amount of, interactions that you will think that's reasonable. And what that will be, I think that's very subjective in some way, so we can discuss about that. So I'm I'm looking more like at the value they're bringing internally and externally. So, yeah, the number of interactions adjustment is a way to look at that there is some activity, but also the way that they are man they are moving the needle with each single KOLs.

Are they relationship is improving? We have access to that person to the go out. Are the quality what is the sentiment that that CareWell is having toward the, our company as a whole or our product, our clinical trials development? Are we able to engage in, advisory boards, speaker program? Are they MSL involved internal project or part of the core teams that we have? Are are presenting insight to the core team. So there are all these kind of aspect that I look at that as, as a metrics.

I mean, the conference are attending is also for me a way to look at because it it it tells also, like, how much they are out and and work with this position. But, again, it's a mix between quality and quantity. I mean, there must be a little bit of that, but I try to keep the quantity very limited and more focused on the quality. Right. Right. And would you say I don't know.

This is a very specific question, but would you say that rare diseases MSLs get better face time than just standard therapeutic MSLs? I don't I don't know, honestly, because, to be completely fair, we started also we're we're out of the pandemic, So the team worked for 1 year and a half. I think that what I tried to do, and I think that severe disease I think the MSL and rare disease tend to tend to wear a lot of ads.

And the reason why like like I said, limited amount of, KOLs to be to engage with. So you tend to also do other things that are not necessarily purely MSL, the job description kind of activities. Like, you know, you tend to also working on a contracting. You tend to also do, lease between maybe clinical, r and d or clinical development or even the commercial sometimes. You tend to have a lot of, touch point.

So you might have I would see that you get a lot of more touch points because sometimes you are the face of the company. And since you are pretty much tend to engage with the same KOLs all the time for a lot of activities, then the sole tend to probably to be involved in many of those touch points. But I'm not going I'm not going to probably, I'm not going to make the assumption that every single touch point is a face time in which there is a scientific exchange in some way. Gotcha.

And what challenges would rare diseases MS cells face, would you say? And just what I said, I think I think overexposed it. Like, you know, we are, the overexposed into the KOL, the fact that they are competing with internally we're competing internally with our colleagues. That's now it's not nobody's fault. It just it's the it's the nature of the our business. We compete also with the other, with competitors. So I think that it's different.

And also, you know, in general, the the pandemic has created that, like, kind of, crazy situation which everybody has to adapt. And I think the the field have really adapted very well, and now we are back in the situation which we really want to reset to which one is a good practice. I think that rare diseases for my in my point of view, it's more like, you know, the, overreaching for with the same physician and trying to saturate it their their saturated. They're, like, you know, engagement.

And that's one thing that, sometimes can be a little bit, it's something that is a challenge in my mind. So daughter my point daughter's thinking rare diseases is very broad term. Right? So when you talk about rare disease, we'll talk about that just so today. Just go to actual email today that we usually say 7 5 to 7000 rare diseases. Actually, it's been updated to 10,000.

This morning, just I got an internal email which about an article on, Rare Acts, which is saying we have 10,000 rare diseases, which 80% of those, being have any kind of treatment or, sorry, 400 are the terrorists and 80% are genetics. So we talk about a very broad spectrum of diseases. In my mind, one challenge that my myself, for instance, was facing, and I was facing myself to, to deal with the different rare diseases, but then each single therapeutic area is so different.

It's so specific with different set of, complication, different set of specialties that you need to deal with, different science. So now you work in rare diseases, and you're supposed to be an expert, but now you need to work with, you your your brain can hold. You can look and be an expert of 7, 8 rare diseases, which is sometimes can be a challenge to be considered an expert of everything.

And that's that's why I think you might find in some company that are not necessarily working on 1 or 2 therapeutic area that you can find the MSL can be a little bit stretched thin, not on their outreach with the parallel or external work, but more of an internal educate personal education. So what would you say what, if any, responsibilities differ for rare diseases MSL versus maybe a traditional MSL?

Or so are there different things that a rare disease MSL is required to do that, you know, that maybe a therapeutic MSL is not required to do? Well, it depends also you know, it depends on what is the stage of the drug, right, of the product. Sorry. It's, I guess, that the in rare diseases, like I said, you can work as many at because it's you cannot like to work with a lot of patient advocacy group. It's pretty important. Like I say, patients are at the center of everything in rare diseases.

They need to be to be consideration, so you might work a lot of on patient advocacy side. Also collaborating with the patient advocacy team internally. They also in my in our case, we work with the research and development and over, as MSL's last year or CRA, CRO kind of role. They triage pretty much all the clinical trials or and sometimes they come out they work on the advisory board in our in our case.

So it's I think that it also depends on organization how, big and now, like, you know, how flat is. So and that would make also difference. But I will see that there is many ads in the way that there is much more interconnection with patients and, and also other department can lean on the MSL to be the face of a company when it comes to external communication. Yeah. Well and you mentioned the word patient a number of times.

And I know that one of the clients that I was dealing with on the Ultra Rare diseases side, there was an element of not really patient advocacy, but patient identification where there is a lot of people, a lot of patients out there that are walking around undiagnosed. So they have this condition. They don't even know it's a condition that has any type of treatment for it.

So there's an element of patient identification that went along with launching that drug to make sure that the message got out. How prevalent is that? Thank you, Tom. Actually, it was one of the point that I didn't mention to the medical strategy. So, yeah, exactly. Like, you know, the patient identification is big. The diagnosis screening out, it's very important. That's something that's completely different when you work.

Either you're working rare disease or you're working on a newly kind of, you know, disease. Like, in my previous life, I worked in another rare disease per se. I don't think it was considered a rare disease, but it was a newly deceased state that was kind of be almost identified, and that was also the patient's anchor identification. In rare diseases, you pretty much go through the patient advocacy first, almost to identify the care well. So it's going to see the other way around.

You find the patient. You know, when they say, you need to find patient first in order to find who are treating this patient. And even when you find this treater, you need to understand, is that really the treater or it's part of the bigger group of people? So in other words, the patients who dictated where they have been seen, who are the expert in the field, and, and what is the med need.

So for us, patient identification, we're working right now in couple of product that that actually, it's starting like a new, for a new, disease state in the US, then that's really a bigger component to really understand where are these patients, how to be how how they are screened, what diagnostic diagnostic test are out, and if we can do anything to improve, and bringing awareness. Think of the other biggest difference between rare and nor rare. It's disease awareness.

You do have disease awareness also in other diseases, but sometimes they're well established. While when you do disease awareness of rare diseases, you might find the physician who are absolutely knowledgeable about it. It just that it's not on top of their mind. Right? Just because they are never seen maybe that patient or the last time they heard about that particular disease was in the medical school 20 years ago, like, for a couple of hours. And they know the basis.

They know the the why it should be, but probably it's not something that they are looking on the every day. So this is awareness, patient identification, agnostic. Those are really component that they are very strong, highlighted in the the rare disease area. Yeah. And and so there's a title that's emerged called the patient diagnosis liaison, which I believe is that is exactly what you just kinda, described, I think.

And and the only reason I say that is we haven't really gotten dove that far into it, but I think it's an important role. I think that if there's people out there and I know that there are MSLs and aspiring MSLs that are out there that may be interested in, you know, what's my next career move? Keep that in mind.

You might wanna keep that title patient diagnosis liaison in mind and start to do job searches as you're out there looking for, you know, keyword searches to see if there's job descriptions or if there's jobs posted for those types of people because that might actually be a good job for you if you specialize in a certain rare disease. Right? You might be a good fit for that. So do you see that as as that being another thing that's gonna come up as this patient diagnosis liaison?

It it could be something. I think that that's one of, that's one of topic in which we it gives a little bit of conversation, like, you know, who is the best, like, you know, what is the best characteristic of MSL? And sometimes we were focusing a lot on the. Right? And in this case, it didn't I think, honestly, for rare diseases, I don't think that's that's we got lead flow.

I think that there are some other, some other, component that can can make us very successful, MSL or and I look use the word MSL.

But in this case, I think it can also water the position that you just said, the patient diagnostic liaison or it's something that goes just not on talking about disease and providing information, fair and balanced way to the physician, But it's talking really looking at the disease state holistically and and putting the again, the patients at the center and how the patients can be identified, can be given the treatment, the the care they deserve, and

how the the center can improve their standard of care. So and I think that makes a little bit different. So there are some particular professionals that can also be extremely useful even if they don't fit in the DSM cell kind of mold that we are used to here from a different, like, you know, definition. And so I think that's, that it I think some company already have that position. We don't currently.

But I think it's very valuable, and it's very important because it's not something that stop our launch of the drug or not. It's some it's continuous always, identification of the patient. It's something that each one of us needs to also be been doing constantly. Right. Well and I mentioned the word hiring. I can't help it. I'm a recruiter by trade, so it always comes back to that. So when you hire MSLs as a rare diseases MSL leader, what do you look for? What do you look for when you hire MSLs?

Well, I'm kind of, been to interview. I'm very kind of quiet and very composed, but if you know me a little bit, I'm very, like, you know, high energy, like, you know, super loud. So I look into someone who's actually empathic first. Let's put it this way. We talk about it again. I've been safe. I don't know many times. I used to be patients, but it's needs to be an empathy. Understanding that this is not, it's different.

You might my face story of these patients on when you speak within some conference, and their conference sometimes they are together, patients and doctors. So empathy is the first thing that I'm looking at. I'm actually my personal thing, I will I could have someone who is a team player as empathy, understanding, like, you know, that we are there for the patients who have a super smart guy who will talk about science, but it's not doesn't like that empathic component.

So I don't think that in general, like, you know, I mean, we're busy to experience out. It depends of the the life cycle of the product. So, in some cases, you know, in some cases, we need. In some cases, not necessarily. People can learn. I did learn. I think that, you know, the MSL are the one of the MRLs that they are fast learning, so, we can learn. But don't think that you cannot teach to be in public. So in my mind, my when I hire people, I'm looking more fit culturally in our company.

I feel a fit in my team, with me as well. Understanding that and they're a respectful person. Like, you know, like to be people that are they're respected, they're collaborating. And, of course, like, you know, I'm I'm giving that almost like, an assumption that everybody everybody can be can learn any single disease. Of course, like, you know, in some cases, for business need, we need to be quicker.

So we have to go with someone who had already maybe that experience in some particular area, understand the needs because like we we discussed already, there might be some different, difference between working a different space and working particular rare disease. And you need to adapt, and you need to adapt quickly.

But other than that, I think it is for me my hiring process is more going through the personality, more understanding, like, you know, someone has a has a good fit, as a good person first, and then going through really, going through the the, you know, the science and the performance kind of aspect of the work. Got you. So you, so now you hire an MSL. MSL comes on to your team. So what recommendations do you have for that MSL to find success and be a top performer?

And anybody that's out there that's either an MSL or a rare diseases MSL, this question is for you. Because I always like to find out what, you know, what are the recommendations from an MSL leader to someone who wants to be a top performer? Yeah. Well, I I'm I'm going to use the same, I'm going to use the same suggestion that I that my mentor, when I was doing my post doc, gave it to me.

So when I was looking when I think it's someone who spoke with me and my team, also people who, you know, sometimes they talk ask me, like, how to break into industry. When I was doing my past talk, I I was actually working with a KOL, and he was the one most humble person and probably I never met in the even before industry. And I asked him, like, you know, what is to be how is the good MSL? Where in your mind? What is a good MSL?

Let me say, do you think I need to be educated on that the disease was multiple sclerosis at the time? And I said, of course not. Well, yeah, don't pretend to be to come here and try to educate me. That's why I have a huge problem to use the word. I'm a stellar educator. I know this can be controversial in this podcast, but, I don't think we are educate. I think we are, we are liaise information. We we move information between the company and to company.

So and that's I think that's our main job, and that's, I think, what we bring. Like, you know, we might look at it sometimes, but it's not and that's what also we are not, like, educator per se. It's not our definition. And that's for me makes the difference. So we're not for me, the I don't know if I was successful in myself. I just want to believe I was. But for me, like, in go into every meetings with their humbleness with that person as an expert.

And, and we are going there to to not to teach them anything, but to learn from them. So and then pretty much find your style. Everybody's own style, like, try and see other people and find your style of work. Everybody someone is more conversional. Like, you like to just someone is more like a slide and focus. Someone is more like a data focus. Someone is more like like, you know, more like a laid back in some of their their way to everybody has their own style, and everything is okay.

So, for me, the successful one is one who can manage to understand their strength and their person their personality and also the weakness in trying to manage and trying to also, find what works with the other people. And each is different, but, you know, each person has a different, like, you know, popularity.

So but every but at the end of the day for me, it's like beyond bullying approach, like, you know, consider every single person who has been working for 20 years in one disease to be the expert. And I know sometimes in myself, we think we are the expert. And, again, it's controversial. I know. But I think I I feel that, you know, we need to have a, like, a, a fair evaluation of our, of our job. No. I think that's great.

I think it's so important to focus on the relationship first, cater to the needs of your k o l, and then you can educate and provide information and, you know, liaise, all the things that that you just mentioned. But I think that if you really try to understand and identify what the true needs are of the k o l and how you can be a problem solver or you can be an advocate for them or you can, you know, be an information source for them, that's different than just going in and saying, hey.

Let me tell you what I know about this because you need to know it, and let me educate you because I think that that's the wrong approach. That's what I'm hearing, and I I think that, yeah, I in in some ways, it might seem, you know, controversial just because it's the MSL's job to educate, but I think we're talking about the approach and what the outcome should be and what that relationship should be.

It's a little controversial because they hear a lot of, like, especially for the I mean, I've been, like, for, more than 10 years now, and I but then and I know that there are a lot we met also even before, actually, I was an MSL video song. But I hear a lot of, like, especially now there's a lot of resources for the MSL, and I hear a lot like I like to educate people. Like, I'm a MSL as an educator. Then I feel always feel a little bit odd and because I remember what my my mentor told me.

It just, like, you know, stuck in my mind. So I can and I'm think and also because I feel that there is a component that we need to be also respectful for the people education, people background. There is and even if they don't know that this particular disease it for rare diseases, actually, it's I can see that there is more education component, actually. Because, like I said, you might have to maybe you heard about that disease, but you haven't really seen it for 20 years.

So and there is a component that you need to educate it. But I think it's the approach that might be different. So, I think that, for me, the very successful Amazon want to understand the needs of the the company also. It's not we it's another controversial point. Is the Amazon is also someone who needs to understand the business. I think we do. We are the just conversation last week when we were in the office.

Like, we need to understand the business because that's why that's why we can also ask questions that are more, related. So in this case, I don't think there'd be a rare MSL. Really, it's so different to be a regular MSL. I think at the end of the day, it's, they come out with the same streamlining. It's a task for me to have the same characteristic, to be also resilient, and that is also one of probably the big the biggest, I don't know, strength of MSL. Be resilient.

Again, you get one yes and 25 no. I think that's normal. So you need to keep going. And sometimes you, don't have a good good result, and you need to keep going. So, I think the resilience is but also understanding that, you know, what is the value for each single person that you're bringing? And sometimes it can be truly science discussion, and sometimes it can be just be a a a point of contact with some other physician. And they will be as valuable as just talk about 30 minutes about data.

Yeah. No. I love that. Let's leave it at that. Keep going. That's the probably the one of the greatest things that that I heard you say all day is is when in doubt, keep going. But this was awesome. You you were a wealth of information. I think people are gonna get a lot out of this, and I wanna thank you for coming on, my friend. This did not disappoint. And for everybody that listened, thank you, and thank you for sharing this.

I do appreciate every time you guys recommend this this podcast to your friends and to other people in industry, or anyone, it it's, it just makes such an impact on people. And, my favorite thing is when I get a message from somebody and they say, hey. I just landed a new job, and your podcast really helped me. So, again, share it, and comment. Let me know how you guys are, liking the podcast if you have any recommendations. And, yeah. And, Giovani, you have to come back, man. That was awesome.

I really appreciate you, and, best of luck for the rest of the year. Thank you, Tom. Thank you for thank you for having me. That was a lot of fun, and thank you for doing this, this podcast. It's, I am listening a lot when I'm on the gym in the morning, and, and it's good for our lower voice and the medical care. Thank you. Good stuff, man. Alright. Take care, guys. Thank you so much for listening to the show.

And if you enjoyed it, please subscribe so that you don't miss an episode in the future and feel free to leave a rating or a review or a comment. Thanks again, and we look forward to seeing you soon.

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