Welcome to Farmer Talk Radio. This podcast is focused on building up a CMO team as your company evolves from the twenty twenty five Chief Medical Officer summ at three sixty. For more information on the CMO Summit, editorials, podcasts, or webcasts, please visit CMO three sixty dot org. Thank you and enjoy the podcast.
I you know, personally think that once you've assessed the portfolio and pipeline, that this is actually one of the more exciting tasks one has as especially an incoming CMO.
And so you know, amongst.
The colleagues that are seated with me, there are decades of experience in all different types of companies.
So I'm really looking forward to hearing what people have to say.
To get us started. We'll do introductions. Well, we'll start with introductions. So I'm Harold Bernstein. I'm the president of R and D and also act as the CMO at Maze Therapeutics, where a mostly small molecule precision medicine company using genetics to inform therapeutics.
Hi, Harold, my name is Jing Morn.
I'm the chief Medical Officer of Scalaroc, which is an unusual name. We are a late stage clinic late clinical stage company that really focused on TTF beta superfamily. We have been fortunate recently had a positive phase re readout.
We filed our BLA and MAA.
I've been in the industry for two and a half decades, just myself alone.
That's how all val am raw Lima. I'm EVP of clinops for Inception Group. I've been there about three years, although the relevant experience that I bring to the table today is prior to that about twenty years in various levels of clinical operations, and really the last fifteen years as v EP of clinical ops for very very small biotech in gene therapy and rare diseases.
Mostly I am Dan Bloomfield. I've been the CMO of Anthos Therapeutics, which last Thursday became Anthos and the Artist Company. I had a long background at Merk and they moved about to take about six years ago. Seven years ago, two years at Carduran, and now at Anthos. We've been developing a factor of eleven inhibitor and antibody four professional stroke and a treatment of DVTMP.
Good. Is it good evening or a good afternoon? I'm not sure In any case, you're still awake, So this is delightful. Matt Frankel, chief Medical Officer of Kimo MAAB. We are developing a chemic well a monoclone antibody to a chemic kine CCL twenty four, instrumental in both inflammation and fibrosis, and we recently concluded our phase two open label successfully in patients with primary scrossing coloningitis and preparing for our phase three at this time.
Great thank you so to get us started.
I'm a firm believer in not bearing the headline, so I thought we'd start off with the take home message and give everyone up here a chance to just provide one sort of key learning or take home that you've gleaned. And then, of course, I think what we recognized in our pre conversations is that there's so many different circumstances
that require different approaches, and we'll get into that. So I'll start off, and from my perspective, I think, especially when you're coming in as the CMO again, after you've seen the scope of the pipeline and what are the near term deliverables, it's really to assess who you have on your team and make some decisions in fairly short order about whether you have the right people that you're working with, and that if you don't have the right people or capabilities, how are you going to fill that
and have a plan for you know, whether that's going to take the strategy of hiring versus engaging with consultants.
Okay, so maybe we'll start with Matt at the other end.
All right, So I'm going to actually start off with a question, because this, you know, we've got to make this interactive. And the question is how many of you have hired someone too early?
Okay?
Very few? How many of you have hired people too late? All right? A few more people. So my answer is it depends. And I think the point that you have to realize, as you, as I've certainly realized, is that each of us are going to make decisions where we're either too early or too late. But each of us has to realize that there's something that drives us toward that of making the decision and we have to go
for it. So that's my point is at some point you're going to have to feel like you got to do it, and then you do it.
So I'll follow on that and say that I having just been through an experience where we're hired too late that I think there's a cost of hiring too early, but there's a much bigger cost of hiring too late.
And need to think about where you're going and what's go set you'll need as you move forward is critically important and for cmos, many cmos like myself who grew up in pharma, don't know what you don't know about getting things done because they're all done for you by the armies of people out there, and not knowing those things is really it really becomes problematic unless you have folks around you to help mentor you and help you see the light.
So to jump on that, I'm often one of those people who is really meant to make all of those things happen and make it seem like I'm ashe did it. And my driving piece of advice, especially for new cmos and very small companies, almost regardless where you are, if they're hiring a CMO, that means they're really close to getting to clinic. You should get yourself a lieutenant in
clinops effectively immediately right at least one person. You don't have to build a huge team, but get somebody who knows how to translate between the science and you and then the vendors that you're going to be hiring somebody who can handle the contracting and those negotiations, because the finer points of those details are incredibly, incredibly important, and your jobs are too big. You shouldn't be in that level of weeds. So find somebody who can do that
for you and get a good lieutenant. If I can get you to do one thing, it's that one.
I agree with my colleagues. I've hired a lot of people over the years. One of the things that I've
really come to appreciate, deeply value more is phenotype. I actually hire much more based on phenotype than resume, because the person with the right phenotype, who's a problem solver, who's got the critical thinking skills, is going to over the long term outrun the person with the right resume, with the impressive resume for that matter, but does not have the belly, fire in the belly or the right culture a fit.
Great.
So I think maybe first let's follow up on what seemed to be, you know, one of the recurring themes, and maybe we can dig in a little bit more on how do you know when it's time to actually hire in a capability versus using consultants, which which is another alternative. And we also just heard a big session on fractional capabilities.
So I think as you're growing what we have found
success with in the past. In the small companies I've been at, very often people are focused on roles, and which you really should be, whether it's phenotype or skill set, You've got to be thinking about sort of what is your vendor strategy and then what skills does my team already have and what are we going to need in the next six twelve eighteen months, right not the next three months, because a lot of what we do have twelve eighteen month runways, And so thinking of people less
as roles. Maybe if you think high level of regulatory or clinops or safety or something like, you know, those are buckets you can put people in. But in smaller companies you're gonna have to wear a lot of hats, and so really looking at those skill fits and then I do think phenotype and curiosity and that roll up your sleeveness is tantamount as paramount for very small companies.
And so I think if I come back, it's skill sets and fit are way way more important than resume and roll that that'd be my tagline.
Then if I could add to what you said, It's like when you're building a team, it's like a chess board in front of you. You start with the goals, like what are you trying to accomplish next year, next two years? And then you look at all the gaps you have. What do you have already? Hopefully it's not just you. It's really hard when you're just starting out
with end of one. So look at the gaps and then think about what gaps are near term gaps, what gaps are long term gaps, and then think about that sort of the priority of these gaps and time sensitiveness of those gaps. And then to Herold's point, which I think, you ask yourself the question can you hire someone to do you want to hire someone instead of outsourcing that? And there are pros and cons to each, and then
it's like when do you hire those people? And then you also take a step back and look at the It's a chessboard, so you don't just look at individuals. You look at how each individual interact with each other. Because it's so important to also look at it from a governance model point of view, and how information flows from one person to another, how decisions are made, and how each individuals interupt with one another. This way, you're actually looking at it from a higher level instead of
just hiring for that individual. So to the point that you made about capabilities, it's such an important concept.
So fte versus a contractor, Dan, do you have any thoughts.
We ran Anthos pretty lean. We were eight or ten people, kind of getting through phase two and had an awful lot of contractors and consultants working for us, and we were very fortunate that the folks who work for us stayed with us pretty much for the entire six years.
We had a very devoted group of people. But what we found was as as things get harder, the work becomes a higher risk, higher cost, you begin to realize that there are certain roles that you need to count on that are critical for the business, and it's really important to recognize those roles and then fill those with people who are part of your team as opposed to
people external. But I did find that we had a lot of support from companies like SSI and from Halleran over the years, which really were helpful because they first helped us see the gaps that were coming up, realized that we didn't build a certain capability we probably should have built. But then they're able to fill in in the short term as we kind of hired behind that. But I think it becomes you kind of recognize when
you're too far behind. You're not getting the oversight you want, Your roos aren't getting the kind of oversight you need them to have. You're relying haveing around people who could potentially say goodbye the next day. Luckily for us it didn't happen. But when you think about the risk that would cause. If you're head of safety, a consultant leaves, that's not a great place to be. If you're a
head of clops leaves, you're dead in the water. So you really have to have people who have skin in the game and are going to be with you throughout the development.
I'm going to be slightly contradictory and highlight that whether someone is a full time employee or a consultant, they both can leave tomorrow, and so you have to recognize that. You may think that there's some contractual agreement, but there really isn't between either one. So don't get too heavily
weighed on that based on personal experience there. The one thing I would add is to be opportunistic associated with it because there will be certain instances where and I'll give you an example from my past is we had someone a former colleague who was very good at safety, and I knew that she could do the job, and it seemed like a perfect opportunity to bring that person in, build out that team, carve it out, and then felt very good about and knowledgeable and comfortable and confident that
we were going to do a great job in that regard, and that we had a good rapport initially, so that was going to keep going. So be cognizant that there may be situations where, based on your extensive background and your relationships, you can find those individuals and go, Wow, this person is out of a job. Let's see if we can scoop him or her up at that moment.
I can stay. One other thing, which is that it takes time to hire really good, talented people, and so when you think you need someone now, you're six months
behind for many roles. And that's where people come in as consultants or contracts going to help you bridge that but you really have to recognize where do our need to have someone full time role do I need and then back off from that and realize I'd be a going now and maybe you hire too early, but if you're hiring good quality of people and you know you're going to grow into that role, it's probably okay. But there is help in between helping your bridge that bridge that period.
So I want to go back to gingior comment on phenotype. Maybe I'm a geneticist, so it struck a chord, but I think you know, we've all encountered that. I think it'd be great to hear from people.
Like what is that phenotype? How do you define it?
And this is sort of more like, you know, not necessarily capability or skill specific, but who do you need in a company on a team, And maybe it's based on where the company.
Is should I start.
So I've over the years have had a lot of luck hiring people based on phenotype because you could have twenty five years of experience doing bad things.
That doesn't make you any better, right.
I think that I also don't hire based on knowledge because nowadays we'll live in the digital world. Everything is at your fingertips, So when I think about phenotype, even technical capabilities. I'm looking for that someone who actually is not just the person that at a meeting that spews out clever comments. There are plenty of those, and I can't execute on clever drops of brilliance. What I am looking for is someone who can actually string that all together.
That person doesn't necessarily is not necessarily someone who speaks first or speaks a lot. That person is maybe a really good listener that strings everything together. The ability to critically think about issue and that really synthesize the issue and turn that into a well distilled plan. That skill is so rare, it's what I really really prize.
So that's one.
That's the technical skill sets. The cultural side is someone who's like positive. You know how people you hire someone they can drain your energy, and then you can also hire someone you want to hang out with that person all the time because they are fun, they're positive, they lighten up your day. So because you spend a lot of time with these people. So those are two things I'm looking for.
Yeah, I come back to curiosity a lot. I will ask people weird questions during interviews, but or twists of the interview questions that you might be used. You know that that twenty years ago, everybody trained for it, right, what do you want to do in five years? But I won't ask it that way. I'll ask things like picture yourself in five years, and how does this role
going to help you? Or how do you want to be mentored to that have you thought about the difference the delta between who you want to be and what you are now? Because I want people to think of themselves. I want to I want to understand that they're being self reflective, that they're curious and they want to engage with what it is that we're doing, and that they want it, that they kind of see this as a
true opportunity and not just a job. And so I will ask questions like that because I am trying to dig at I will describe it consistently as curiosity. And then I will also ask always, I always ask every single person about mentors, like what kind of mentors did they have? Because I want to know who do they see as having shaped their life? And I will always then follow up that question with a question around failure and how do they engage with failure?
Because those are all.
Things that will be problematic in the clinical operations space, you will have mentors all around you, some of the smartest people in the world. You're going to see in biotech. Things are going to go wrong and you're going to need to solve them. And I want to understand people's ability to do those things all of that thread and not you know, crumble in the face of that. And so that's that's what I'm looking for, and that's how I dig at it.
But might have a similar set of questions I asked When I interview folks, I always ask them about about a really challenging problem that didn't go the way they wanted and what happened, how did it have happened, how'd you recover from it? I find that to be useful. People sometimes can't think of one, which is always a red flag. But people should be able to share something that they were challenged by, and you can hear how they approached it, how eager they were, how curious they
were why it went wrong. Maybe went wrong for a good reason. So I think that's an important question. And I also ask people, you know, for them, what's a great day for you and what's a bad day for you? And you learn a lot about what motivates people and what really is is a problem for them. So sometimes what they hate is what your job is going to offer them. And so it's good to know that ahead of time.
You know, I'm going to highlight what Jing mentioned earlier, which is and I put it in the category of can do spirit And it's the idea that people are going to have different roles, but are they enthusiastic and are they willing to roll up their sleeves and have that positive perspective that they're doing something because they are culturally fitting with the organization and it's going to make sense. That's what really is sort of the secret sauce, if I can use that term.
Thanks well, I.
Agree with everything everyone's put out. And I guess the one other thing I might add is I try and assess or look for people who I mean, the scientific version is the system as biologists, but in this case someone who has the capability to be an enterprise level thinker. And what struck me in the previous discussion is the CEO who said, you know, you may not realize all of the things in front of the CEO and why decisions are made.
And I think.
Also as the cmo uh, you know individuals. You know, early in my career, I had someone say to me, Hey, I'm responsible for eight hundred people and all their wants and desires, So you're just going to have to live with my decision.
And I think, you know, you want to.
You want to have a sense of the maturity level and can can someone think like that? You want them to sort of advocate for a position and back it up with data, but you want to know that someone can walk away from the conversation and live with what the decision is.
And and maybe that's a little bit of.
A little bit of what Dan was saying, which is someone who talks about something that didn't go right but then can articulate, but I understand why the decision was made, this was why, And you know, maybe I learned from that.
So maybe one thing Elso entered to pick up. And I think we were leading into this before and that is so I've been I've worked in both the Boston and the San Francisco ecosystems where we joke around that there's the shiny penny mentality where you know, people have a very short view of how long they're going to be someplace And one thing that I think about sometimes is like, when is it the right time to think about to like put business continuity into your plan as
you're hiring, and how do you need to think about that? Because you finally settle on like your dream team if you can get there, and then someone decides they're leaving, So when do you start thinking about business continuity?
Maybe, Dan, do you want to start?
Yeah?
I think it becomes important as you hire more senior people. And one of the things we haven't talked about is what happens when you're company evolving and as a CMO, you're suddenly pulled out for externality facing things and you
now can't really keep an eye on your studies. And so that depends upon the people who are running your studies, the kind of each project leader, and those are the people that you want to make sure that they recognize the challenge that they'll be facing when you hire them, that they're excited about that and they're not looking for a bigger job. I've might try to have someone tell me that they want to run a portfolio, then run
a program, because I don't have a portfolio. I have a program for them, And so that's I think knowing that those people that the person you're going to hire sees growth ahead of them. I think it's critically important.
And it's also important to make sure you can find people who can help you mentors and people who've been cmos when things get crazy and all of a sudden you don't have the time to have oversight over the people you've hired, or if someone were to leave you suddenly, can't you hire someone in the next month, You're still going to have to fill in.
Maybe I'll add that going back to funer type. Uh, you know the ideas you need people who are hungry from the no matter what. That's that's what you at least that's you know, it's we're not saying they're an A type or a BB type or c. But they're hungry and they want to they want to get work done.
Uh.
And that means that if you have no work for them, that's a problem. So you have to constantly be pursuing that that the giving them opportunities to grow. So it's a slightly different address, but it's the fact that you need to be thinking about your team from the standpoint of how am I enabling him or her to constantly have an opportunity to be curious, to keep growing, so that they have that focus internally rather than the shiny penny outside.
If I could add a little bit more to the business continuity concept. As the team evolves, one of the things I think about is like how critical is like, what are the incredibly critical roles that we have in front of us? And then I think about the depths
of the bench because clinical operations. This is actually a really good example because you often times have you know, young people in the age of their lives there you know, sort of they're raising kids and so on, their life changes, and I had I have still this amazing leader, and then below her is just you know, like four levels below and variou junior people with the exception of one
director level person. So over time I recognize how critical it is to have the depths of the bench, just because when something happens, you could, you know, affecting two people and then I'm out, I don't have clinical operations is critical. And so therefore we really talked about how to quickly build up the bench depth in order to really hover to have the full coverage over time.
And that's just one example. Many many examples. Regulatory affairs is also such a critical function.
So we have a little over four minutes left and I thought maybe I would just hope pose one or open ended question. Then if anyone still has energy from lunch, they can get up and ask a question. But I'm assuming everyone's pretty depleted, and I think the question is just thinking about recent experiences. What was a challenge that sort of kept you up or destroyed your weekend and how did you actually how did you manage to deal with it?
How many weekends? I'm going to answer that question not from perspective of enrollment or safety or finanswer, but rather what me up with my team. And one of the things that I struggled with was having someone in a critical position running a program or trial who hadn't done this before. So great skills as a translational drug developer, but have never run a Phase TEE program. You know,
things may seem intuitive, but they're definitely not intuitive. In phase three, there's a lot of blind spots, and that to me led to two pieces. One is I had to find someone I didn't have time to mentor be wherever the person. But I also worried about retention when he was not getting the kind of responsibility he would have wanted, and I couldn't. I couldn't just let him go.
So that's a situation where when you can't really rely on it's not trust from the point of view of they're not being honest, it's you trust that they know enough to make the right decision when you can't be involved in all those decisions. That's something that I.
Struggled with, struggled with having to let us someone go because the company was retrenching and we had to do it, and I knew that, and we talked about the enterprise focus. But at the same time, this was a very capable individual who really was doing a great job. So it it sort of was counterintuitive to let someone go who's who can do spirit, capable doing a great job, and oh, by the way, we can't keep you.
So I think for me, it's very often blind spots, right, blind spots in what I am doing, what my team is doing, what the sites are doing, and now that I'm a vendor, what the sponsors are doing. And I used to sit in a role where I knew a decent amount in the sponsor leadership role. As a vendor,
I know a lot less. And the thing is, having spent twenty years in sponsors, I know that they know a lot more and that they're not telling and so what's often very hard on the sponsor side, and I'm saying this too many cmos who are here on that sponsor side, is I know that some things are proprietary, but telling your people why can really help people get on board with the what and finding ways to non confidentially or not give up the game, but really help
people get on board goes a long way. And I see this now on the other side of the fence, and if I ever end up on that side again, I think I will do. I have it more in my head to give the whys more than I probably have in the past.
Yeah. For me, it's how to elevate the team effectiveness. Oftentimes people spend a lot of time doing busy work, and so I think that the whole concept goes slow to go fast is really important to me, which means that you really take the time, don't rush into failure, don't hurry in the wrong direction. So take the necessary time to really think about the problem that you're trying to solve so that you're not solving the wrong problem in a hurry.
Okay, I'm going to pass on providing my answer to give one person a chance to get up and ask a question.
Get the work we do as cmos sometimes Avogadro's law, it expands to fill the volume in the space that we have. So and in a lot of situations, and in particular the current environment, the ability to be able to grow a team and build a team is.
Not an option.
So I'm just curious about your thoughts about building teams that remains small but are more fungible, asking people to do stuff they've never done before, and asking them to expand into this space that you have to fill when you can't fill it with people or resources, maybe.
I can't give it a shot.
What I find really really uniquely advantageous today is how much access we all collectively have the.
Information velocity is just immense.
Instantly Now I have access to these for gentlemen, and so I think that I'm shameless if I don't know something.
Just to reach out and most people are willing to help. Turns out, So I think that you.
Can have creative use of vendors, consultants, surround yourself with capabilities that you don't have, it really solves a lot of problems.
I'll just say that that person who just stood up Steve's a coffee as a guy who rescued me at a time when I was deep deep in the water. But I think the critical piece that I think he was alluding to is making sure you have somebody internally or externally who knows that job and who can mentor
keep an eye on advise that person. If not those people are available like Steve at places like SSR where you can have somebody can only be six hours a week, two hours a week, but there's someone paying attention to a person who's now expanding their responsibilities to a job they hadn't done before.
And I think it comes back to these overlapping skill sets, the types of people who you have in your organization, and really does come back to that we can feel. You'd be surprised what people can feel if you give them the chance and you give them a little encouragement, you give them a little why people might surprise you. And I think the more the more we do with less and the more we like lift up the people around us, the better off we all are.
Got the rid zero staring at us. Thank you.
We hope you enjoyed the podcast. For more information on the CMO Summit three sixty editorials, podcasts, or webcasts, please visit CMO three sixty dot org. Thanks for listening.