Hey, guys. Welcome to the podcast. My guest today is Jennifer Mohawk, and she is senior director of medical affairs at Apogee Therapeutics. And we talk about MSL burnout and how to handle the stress of the job. So I think everybody is gonna get a lot out of this conversation. Jen was awesome. Don't forget to follow me on LinkedIn and join us for MSL talk live, which is typically the 1st Tuesday of every month at 1:30 PM EST, and those announcements will come out on LinkedIn.
As always, thank you guys for all of your support of this show, for subscribing, and for sharing. Welcome to MSL Talk with Tom Caravella, a podcast specifically designed for MSLs and all things field medical. Hey, Jen. Welcome to the podcast. Thanks for joining me. Thank you. Long time listener, first time caller here. I love it. I love it. Well, guys, you are in for a treat.
So Jen and I, just to give you guys some backstory, we had a conversation in San Diego at Mass West and came up with this idea to do this podcast together. And I love this topic, and I think Jen's gonna be awesome. But before we get into it, Jen, why don't you do an introduction? Tell everybody who you are and all that good stuff. Sure. Thanks. So I'm Jen Mohawk. I'm a senior medical director with Apogee Therapeutics, but I'm not here speaking on their behalf. My views are my own.
I did my PhD in circadian biology, actually, at the University of Michigan. Go blue. But after quite a stint in academic research, I decided it was time for a change. And when I pivoted, I went into dermatology and immunology and medical affairs. So that's what I've been doing ever since. Awesome. Well, thanks for joining us. So, guys, we're gonna talk about MSL burnout. And before we do, I just wanna say the MSL job is the best job in the world.
You know, we did an episode I did an episode recently with, with Kirsten Kurtowski on the dark side of MSL ing, and people loved it. It was, like, one of the most downloaded episodes in 2023. The only thing is some people were like, oh, it's kinda negative, and it's like, really wasn't I don't know why a couple people had to make comments that, like, I'm I think if you guys listen to this podcast enough, you'll know that it's, like, glass half full always.
But we do need to be real in order to help people. You're not gonna grow unless you know that there is there are things that you need to be aware of. So this this is not the same conversation. It's a little different. We're gonna talk about burnout. So before we get into that, Jen, can you give everyone a definition of what MSL burnout actually is? Yes. So I have a recipe for burnout, and it is stress plus emotional and or physical exhaustion plus negative self feelings, and that equals burnout.
And it's a condition. It's not a disease, but I do think it can be contagious and spread through teams for sure. Spreads through teams because one starts talking and then I think the conditions that lead to burnout in one individual might while they might not be experiencing the same things. And I also think that there are actions that individual takes then that make it more likely to spread as well as just, kind of the natural social interactions that lead to that that kind of contagion cycle.
You know, that makes sense. I didn't think that we're that there that this was contagious. I I didn't think it was a contagious thing, but it does make sense because misery loves company. It does. You know? And and it's lonely. And I was in the field for 10 years, and it's lonely in the field. So what happens is you keep in touch with your colleagues, you start start sharing stories, and you start commiserating.
And then all of a sudden, what what one person is feeling, all of a sudden, someone else is feeling. Well, yeah, I feel that too. Whether you did or you did it, I think. Am I right about that? Yeah. I think so. And, also, just the you know, when you're burned out, it it changes the way you approach everything.
And I think when even when you have and I'm not saying that you're a bad person then on the team or in the culture, but when you're bringing that negativity, negativity spreads really easily. Yeah. And still positivity. But Yeah. Yeah. Yeah. And it's natural. But, I think if if we can try to get ahead of it and realize that you're not helping yourself and you're not helping the other person, you're not helping you think you're helping each other, but you're really not.
You're just breaking each other down. So let's talk about you mentioned stress. It was one of the things you mentioned. Let's talk about that. So what are the stressors that you're seeing MSLs face these days? Yeah. MSLs face a lot of the same stressors that everybody else faces. Some that I think are very prevalent in the job are high job demands. It's a demanding job. It is. I think on certain teams and in certain environments, there can be a lack of control and autonomy and a lack of support.
That's something that can be avoided, right? There are teams with great cultures that where that won't be an issue. But if you're in a situation where you don't feel you have control over what you're doing, you don't feel you have autonomy, that leads to burnout really quickly. The travel, of course, can provide some stress depending on the context and and work life balance and and all of these things.
It's not necessarily in my mind, at least the stressor that is the problem, but it's you have a physiological response to that stressor and it's not adaptive. It's not it's not made to help you deal with that stressor. Right? Our stress systems evolved in a very different environment than the one we live in now. So it doesn't help us when our body responds to a negative comment from a colleague on a team call the same way it would to getting kicked out of our tribe. Right?
Responding to a flight delay is if we're being attacked by a bear is is not necessarily helpful. Yeah. So there's, like, normal there's just some normal stressors that come with the job, it sounds like. 1000000%. And do you think that some people are just better equipped at handling it than others? Yes. And I also think that the support environment of your team makes a difference, and and and the the the end product of dealing with those stressors. Is there a good payoff?
Is there a good why behind that that matters? Yeah. How widespread would you say this is? Is this common? Or is it just like, like, maybe one out of every 10 people? Or is this everybody gets this at some point? I think almost everyone has experienced burnout at some point, at some point in their lives. But I haven't seen data on MSL specifically, at least not a large survey. Aflac does a survey of the American workforce every year.
And the last few years, they found that about 60% of the American workforce says that they're suffering from at least moderate burnout, with 1 in 4 saying their burnout level is high or very high. So that's that's a lot of burnout. Yeah. But I think it's also, like, a lot of a lot of the MSLs I know and I talk to are overachievers. And a lot of the stress they put on themselves, they wanna do well. They're really smart and and well educated, and they they're out there to do a good job.
So I think that that's a part of it. I think some of it's self inflicted because we just all wanna do well. And it I think it goes for I mean, I listen. I I I feel like every single day I leave here, like, someone just beat me up. You know? Like, when you work hard and you work really hard and leave it all in the field, there's there is some level of almost daily burnout.
So I I I feel this, but then I also have ways of coping and getting through the through it so that the next day I wake up, I'm totally refreshed. It's like new day, no burnout. I'm good to go. How do you feel about that? Is that am I is that just me making this up? Yeah. I mean, I think the difference is, right, you're taking time to separate yourself from those daily stressors so it doesn't become real burnout. Right? That's end of the day exhaustion.
But I totally resonate with what you say too because the the the overachievers that tend to come into this field, I think that's where that negative self feelings part of the burnout recipe comes into play. So if you feel that you, you know, failure on any one point that makes you a bad person or makes you a bad MSL, then that's a problem. And failure is good. Right? We have to fail to achieve. We just wanna fail what? Yeah. Yeah. So I I think that part is a big contributor. Yeah. Totally.
No. I agree with that. There's that expression, fail fast and fail forward. So looking at where we are right now, do you think that COVID has played a role in MSL's facing more burnout post COVID? Has does that have anything to do with it? Because, obviously, things have changed since COVID. I think it can for some, but overall, I I wouldn't say so. You know, there are some issues. There were a lot of access issues during COVID. Right? Access to KOLs, access to institutions.
And some of those haven't loosened back up after COVID. So that is an issue. And then, of course, I mean, we're on Zoom now, right? The use of virtual meetings and virtual technology, it's great in some ways, but it's also changed the bar and the expected level of interactions, I think, in many cultures. I've you know, a lot of people are complaining kids don't get snow days anymore. They have to go to Zoom school.
So I think there is that kind of phenomenon, like, we're expected to be available all of the time now because Yeah. This is the norm. Yeah. No. It's a different time. That's why I I I kinda thought as we were, you know, preparing for this, if that was a thing. And, you know, I really expected travel to be a big factor. You mentioned it, and I expected that to be a big factor.
So I wanna revisit that to ask you what's your recommendations for handling travel and getting ahead of it, so that it doesn't become more of a stressor than it already is? Yeah. Travel I don't think it there are things about travel that are very stressful, but I don't think it inherently needs to be a stressor that causes burnout. A lot of us travel for fun as well. Right? Right. I think for MSLs in particular, the pace of the travel is important and whether or not the travel is meaningful.
And that's something that, as an MSL, you might not always have control over, and you might need to work with your leadership to make sure it's true. Right?
If you're traveling because they want a body somewhere, but there's no real purpose and there's no real value behind that, that's a lot that's the kind of travel that's more likely to lead to burnout, that if you're doing something that you find as meaningful and important to the job, important important for bringing value to patients, that's a different kind of travel. And I think the kind of support system you have at home when you leave is incredibly important.
And I think that's important, you know, whether you live by yourself or whether you have young children or parents that you're caring for. I mean, no matter what, there are things at home that aren't getting done if you're not there. And so having a system in place, someone that takes the garbage cans out and and not having to worry about that every time you leave. Having that support is is big. Yeah. I I travel, too, and it can be stressful.
And I think one of the things that's helped me is I've become really organized. Really organized, so that I can eliminate the potential stress of travel. Meaning, I leave earlier, I know exactly how I'm getting to the airport, how I'm getting back from the airport. I have all my travel, like, I have somebody, like, lined up, and I have the packing down.
I like, it's it's so foolproof now because I've spent so much time organizing myself ad nauseam to prevent any now look, there's issues that are gonna happen. If the fight gets delayed, it gets delayed. If it gets canceled, it gets canceled. It's totally out of our control. But the things that aren't our control, that's that's what I'm trying to influence. Yeah. So let's talk about metrics for a sec. We have to bring metrics up, obviously. It's we have to.
A metrics and KPIs always seem to come up. How much of this would be performance anxiety, would you say? I think any any good MSL is gonna be able to hit the numbers. Mhmm. But whether or not they're gonna feel good about it is the difference. Right? And that's where leadership needs to be thoughtful. And what is the strategy driving that number? What does the number mean? Teeing up teeing up those metrics. How how they're employed and how they're presented to the team.
I'm a big fan of Simon Sinek and and start with why. Right? If you start with the what, have 50 k o l interactions a month, and your why is so we can show our value to internal leadership, that's not very motivating for the MSL, and it implies that what they're doing isn't inherently valued.
If your why is you wanna become a medic medical affairs team that's really making changes and and driving behavior to get better outcomes for patients, And then that leads to these 50 interactions that have meaning behind them and purpose behind them, and you're able to bring back actionable insights into your organization. That's a much different structure and a much different way of of pitching it and and then showing the MSLs what difference that made. I think that's important.
Yeah. Closing that circle. I think leadership has a lot to do with it. I totally do. And I think that for any leaders listening, I think it's important to be aware that this is a thing. I'm sure they all are, but I think it's important to be aware. What do you let me ask you. As an MSL leader, what do you think? Like, should MSL managers be looking for warning signs of burnout? And should MSL be paying attention to such a thing? Yes. Totally yes.
Because both the the symptoms then become a problem. So when we were talking about contagion, things that can be a sign of burnout in MSLs, they can also be a sign of other problems. But they're good to watch for, and they're gonna create problems in your team. So underperformance from people that used to be performing well Mhmm. Is a real big sign of burnout. It can be a sign of other things also, but it's a sign of burnout, and it's obviously not something that's gonna be great for the team.
Right? Competition amongst team members, that can be a sign of burnout. It can be a sign of other things as well, but it can be a sign of burnout, and that's not great within your team. That's not gonna lead to your whole team doing better and succeeding. Yeah. And I I think that this is it this is a wound that if it doesn't get treated, it could really fester Mhmm. And just get worse. And that's where the contagion that's where the toxic culture sets in.
So, obviously, it's really important that managers are attuned to this so that they can stay ahead of it. Yes. What about what is your advice on how what ways can MSLs handle the stress? What ways can they avoid burnout? I can talk about this all day, Tom. You got the floor, girl. Let's go. So I think you alluded to some of them. So one of the big things for me is reducing decision fatigue. So when you talk about how you prep for travel, that's some of it. Right?
Having having habits and systems in place that make some of those stressors avoidable. Mhmm. That can be things like, you know, having your packing very well organized, knowing how you're gonna get to and from the airport, knowing who's gonna take the garbage out and water the plants while you're at home, not having to worry about that every time. These are habits and systems that are great.
You can also have a habit of, especially, you know, on days when you're working from home, creating some distance between work life and home life temporarily. As you said, at the end of the day, sometimes you're just exhausted. Taking even 3 or 5 minutes to just kind of sit quietly, recenter yourself. Maybe you do some planning for the next day so that you leave all that jumble of thoughts in your home office space versus taking it with you through the rest of your evening.
I think that's really helpful. Setting boundaries. It can be boundaries between people. It can mean putting the do not disturb on your phone. This might not be something you need to do every time you step out of the office. I think there are things that happen after hours that are unavoidable. But but knowing when you need that, creating that separation, compassion for me is a big part of it, compassion for your teammates.
I don't always mean empathy, which I think could be a whole another different conversation, but but compassion and self compassion and self care, which includes things like getting enough sleep, going to the dentist, taking care of those those basic needs for yourself and making sure your team is doing so. And then so many stressors are gonna be unavoidable. So finding ways to discharge the stress. For some people, that's meditation or mindfulness.
I think physical exercise, some sort of physical release is the best kind if, you know, you are a zebra running through the savanna. Right? You're getting chased by a lion. You're either dead or you're running as fast as your stripy little legs can carry you. Right? And maybe you outrun that lion, you get back to your herd, you're bragging about how fast you were, you smoked that lion, and then all of those stress hormones get released, your heart rate slowly comes back to normal.
It's just a really natural way to discharge that physiological stress response. So I I love physical exercise. Some people don't. Some people prefer I don't know if I'm allowed to say this, but maybe like partnered bedroom activities is a good way to discharge stress. Solo activities has been recommended. People that really hate exercise, progressive muscle relaxation can be a good way.
So you just tighten one muscle at a time, hold it for a few seconds, and then slowly release it, working your way all the way down your body. That's a great way to get rid of stress. Yeah. I think that that gets rid of the stress when you can't get rid of the stressor. Wow. That's an awesome list. First of all, I you like, I feel like you literally took the words right out of my mouth. If I had to answer that question, it's pretty much how I would answered it.
Habits are so important to put yourself into a state on purpose. The meditation thing is, I think, is a huge thing. And I'll share something with you guys. I I've developed a new accountability partner, and that is, I have an Oura ring. Some people have, like, the WHOOP strap or whatever.
But to to be able to have a system or, a device that gives you some diagnostics and actually tells you about yourself and how much sleep you're getting and how and you could shows you your stress level, believe it or not, is really helpful. And their app, the Orator app, actually has meditations in it. And I started doing those. And their 5 minute meditation makes a huge, huge difference. It's crazy. You wouldn't think it would. For me, if I don't work out, I work out every day.
Every single day. I don't take any days off, and I know it's crazy. People are like, you're crazy. Don't be out of your mind. But I I have to tell you, the reason I do that is not because I'm a total psycho, a little bit because of that. It's because of the way I feel when I don't work out. I don't want that feeling.
So I'm very calculated about how I do it, but I agree with you that there has to be a system, a pattern, and just habits that you adopt that are gonna help you cope with or prevent having this issue of total burnout, because you're just not capable of handling. But I wanna get back to something. You said exercise. So I see your videos. So, guys, if you don't follow Jen on LinkedIn, she has this thing, which is awesome. I love it. She does, these home workout videos.
In the middle of the day, just, hey, everybody. You can do this. So I don't wanna give it away. Can you tell everybody what it is and how this whole thing came about? Yeah. So I started doing my midday movement. Now I do, mid Monday movement. Actually, much the same as you, exercise is the one thing that reliably helps me deal with stress. And I had actually just had knee surgery, and so I wasn't able to do what I normally did.
It was a stressful time for me because both recovering from surgery and having my stress relief taken away. And so I started doing them as a bit of an accountability thing for myself to get my PT in every day and get a little bit of movement where I could. And also, I just love sharing the exercise doesn't have to be painful because some people think it is. Right? Some people for some people, it's a chore. And I think there's something for everyone that will work.
You just have to find what that is. I've been teaching aerobics classes for 15 years, more than 15 years now. And I I love sharing that with other people and seeing them they don't always smile while they're doing push ups, but they smile afterwards. But here's the thing. Here's what I love about it. And I watch them and, in, you know, full transparency. I don't get up and then do everything.
But I will say, though, the one thing I have to give you tremendous credit for, you 100% hit the nail on the head. You make it so simple, and it's it's practical. It's like, I could do that. I could do that during the day and still get exercise. Like, it I think a lot of times people think exercise has to be this big. Well, I needed to get 30 minutes on the treadmill. I needed to do this. Like, it doesn't have to be a set program.
It can really be just a series of of movements or or or muscle flexes or you you're I mean, you're guys, you should really follow Jen and check this out because I think there's a lot to learn about just simple ways that you can add a quick workout into your day that might just like if you did a 5 minute meditation and that has an impact. This is the same kind of thing. So I'm hoping I didn't just bombard your inbox with LinkedIn people. But, Thanks for the plug.
And the point isn't to necessarily follow along and do it. It's more just a reminder for us all. Get off from our desk for a minute. It's better for our eyes. It's better for our brains. It's better for our bodies. I love it. No. I totally agree. So what advice let's let's get away from the burnout thing for, for a second. And what advice in general do you have for MSLs these days as we move into a relatively new year? What what advice do you have?
So one thing that's been lurking in the back of our whole conversation, I think, is culture and values and how mismatches of that for an individual can lead to burnout. And I I think everyone should know. There are great work cultures out there, and you shouldn't stay stuck in a place that doesn't match what you want your work culture to look like and what your values are. You know, finding a new position or a better environment might not be an overnight thing, but it's out there.
And so don't force yourself into that kind of hole. I think networking is also very important and not just professional network, but your community network, building that support structure around you, and embracing your your own strengths. People are generally enjoy doing what they're good at and good at doing things they enjoy. I mean, not always. I enjoy singing karaoke, and I'm absolutely horrible at it. But you know what your strengths are. Right? Yeah. Oh, that's too funny.
Yeah. Know your strengths, lean into them, and know that it's okay that your strengths are different from your teammates' strengths. You spoke about comparing, in your imposter syndrome podcast. And I think that that's a big one. Right? We don't all have to be good at the same things, and we can lean on our teammates. And that's great. That's the great part about diversity.
Yeah. Man, you get on so many things, and it's funny, but I did a I I did what what you just said, like, I did a podcast on core values. A lot of people don't really understand what that means and how important it is to align your core values with the core values and the culture of the organization. And you should know that if you don't. And the other thing is, I did a podcast called, lead with your strengths, develop your weaknesses. I also wrote an article about it.
So, I mean, I I knew there was a reason why I had to have you come on this podcast. But you were awesome. Thank you for for everything. Thank you for being here. You have to come back. I think this is a great conversation. Any final words final words of wisdom? Thanks for having me. And, you know, everybody go out there, exercise, or progressively muscle, relax, and discharge your stress. Awesome. I love it. Well, thank you, Jen, and thank you guys for listening. Thank you for sharing the show.
Thank you for your support. Don't forget to subscribe, and we'll see you next time. 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.