Today’s episode is a conversation I had with Emily Kramer-Golinkoff, who spoke to Penn HealthX last semester about her experience as a patient with Cystic Fibrosis, and in founding Emily’s Entourage, a 501c3 that accelerates research for new treatments and a cure for CF. Since 2011, Emily’s Entourage has raised around $3 million, and has invested in research projects and start-up companies looking to develop drugs for rare missense mutations that cause CF.

Emily received her undergraduate degree and Masters in Bioethics from Penn, and since founing Emily’s Entourage has been named a White House Precision Medicine “Champion of Change”, and received the 2016 RARE Champion of Hope for Advocacy Award.

To learn more about Emily’s story and Emily’s Entourage, check out emilysentourage.org, or look for them on any social media platform.

Map

2:00 – What is Cystic Fibrosis? What is a nonsense mutation, and why does it matter?

7:20 – What was Emily’s do-or-die moment that led her and her family to found Emily’s Entourage? Where do you even start?

12:35 – Marketing, storytelling, and sharing personal information on social media

17:00 – When did Emily’s Entourage begin to mature, and how do you keep it going?

20:00 – Working with The Cystic Fibrosis Foundation

23:10 – Helping launch Talee Bio, a gene therapy company looking to cure CF, and venture philanthropy

30:00 – How can future physician leaders help empower patients to be champions for their disease?

32:30 – Meeting Cheryl Sandberg, and shaking President Obama’s hand at the White House

35:00 – Where to find more info/plugs

Links

Emily’s Entourage Website

https://www.emilysentourage.org/

Social Media

https://www.youtube.com/user/EmilysEntourage

https://www.facebook.com/EmilysEntourage/

Publicity

http://www.cnn.com/2016/04/08/health/cystic-fibrosis-emilys-entourage-turning-points/index.html

https://inspirationalwomenseries.org/2017/07/14/inspirational-woman-interview-emily-kramer-golinkoff/

Talee Bio

http://taleebio.com/

https://gallery.mailchimp.com/692ad2becf8753ce1c9c9a24e/files/53d6e425-a5b8-426d-9513-6626d0d1ab31/Philadelphia_startup_Talee_Bio_seeking_...brosis_Philadelphia_Business_Journal_copy.pdf

The Cystic Fibrosis Foundation

https://www.google.com/search?q=cystic+fibrosis+foundation&oq=cystic+fibrosis&aqs=chrome.1.69i57j0l5.2446j0j4&sourceid=chrome&ie=UTF-8

Vertex Pharmaceuticals

https://www.vrtx.com/

Today’s episode is a conversation I had with Dr. Jake Brenner, who is pulmonary and critical care physician at Penn who splits his time between clinical work, developing technologies in the lab, and founding companies to bring those technologies to market. He completed his MD/PhD at Stanford, and participated in their Stanford Biodesign Fellowship program. He was able to spin two separate companies out of his involvement with that program, and is currently working on another called RightAir.

In the episode, we hit on the Stanford Biodesign program, how to think like an entrepreneur, the companies he’s founded, advice for young medical entrepreneurs and engineers, and a bit on his future goals. This is an incredible episode for anyone interested in using their clinical knowledge to design, build, and commercialize medical technologies.

Map

2:30 – Dr. Brenner’s Background and why he chose medicine and the MD/PhD

9:05 – Stanford and moving away from strictly biomedical research

14:35 – What does it mean to be an engineer?

19:00 – The Stanford Biodesign Fellowship

28:00 – Getting the inspiration to found Pevalon to help treat fecal incontinence in women

37:00 – Narrowing down the list of ideas from 300 to 8 - what makes a good idea?

44:00 – Choosing to specialize in pulmonary medicine and critical care, coming to Penn, and balancing having a family with the risks of being an entrepreneur

50:00 – Penn Health Tech, founding RightAir, and future goals

Links

Dr. Brenner’s Bio

https://www.med.upenn.edu/apps/faculty/index.php/g353/p8561789

Br. Brenner’s LinkedIn

https://www.linkedin.com/in/jakebrennermdphd/

Penn Health Tech Website

https://healthtech.upenn.edu/

Stanford Biodesign

http://biodesign.stanford.edu/

Pevalon and Fecal Incontinence

http://eclipsesystem.com/

RightAir

https://entrepreneurship.wharton.upenn.edu/startup-challenge-semifinalist-rightair/

https://www.design.upenn.edu/news/post/2016-idesign-finalist-spotlight-rightair

https://soundcloud.com/user-414944777/thomas-uhler

Today’s episode is a conversation I had a few months ago with Justin Larkin, who is a fellow Penn Med student. Justin is one of the co-founders, and current CMO of WellSheet, which is a start-up that is using machine learning to identify, prioritize, and visualize patient health data across electronic health records. This company was launched out of the Penn HealthX Labs incubator completion, and remains one of the programs greatest success stories. Now that I’ve started my clinical rotations and have been working with EHR’s, it’s so clear why we need innovation in this space – EHR’s are a total mess.

Justin studied at Brigham Young University before attending Penn Med for his MD, and taking time off to get his MBA at Stanford. He also has experience as an intern at Verily, otherwise known as Google Life Sciences, and he was the co-chair of HealthX from 2013-2015.

In the episode, we discuss a bit about his background and how he ended up in medicine, founding Well-Sheet as a medical student, going to Stanford for his MBA and participating in the Stanford Biodesign program, and what his future plans are. A great episode for anyone who is still trying to find out how they want to best use their skills and interests in medicine, business, and innovation to improve the healthcare system.

Map

2:00 – Going to BYU, playing football, and studying Portuguese

4:35 – Doing mission work for The Church of Jesus Christ of Latter-day Saints in Brazil

8:30 – Research at BYU, developing interest in health systems, and deciding to pursue medicine

13:20 – Getting involved with Penn HealthX and growing the program

15:40 – Founding WellSheet to fix EHRs and improve physician workflow

20:30 – History of EHRs – where did we go wrong?

27:30 – The early days of WellSheet – defining the problem youa re working on

29:00 – Being recognized by The Office of the National Coordinator for Health Information Technology (ONC), and the next steps – figuring out WellSheet was the real deal

32:45 – Becoming the CMO and deciding how much to commit to the company

36:40 – Knowing when to get help from mentors, and partnering with the big EHR companies

42:20 – Getting an MBA at Stanford, and the difference between MBA programs

45:10 – Balancing family, school, and being CMO of WellSheet from across the country

46:45 – Stanford Biodesign – innovating in the med tech space

48:40 – Working at Verily (Google Life Sciences) and the role of tech companies in healthcare

53:55 – Where does Justin see his career going?

58:00 – Advice for those starting their medical education – branch out

Links

Justin’s LinkedIn

https://www.linkedin.com/in/justinlarkin

WellSheet Website

https://www.wellsheet.com/

The Office of the National Coordinator for Health Information Technology (ONC)

https://www.healthit.gov/newsroom/about-onc

Stanford Biodesign

http://biodesign.stanford.edu/

Verily (Google Life Sciences)

https://verily.com/

STAT Article on IBM Watson

https://www.statnews.com/2017/09/05/watson-ibm-cancer/

Today’s episode is a conversation that Logan recorded with Dr. Ali Behbahani when he was here for the Penn HealthX conference in December to lead a workshop on thinking like a Venture Capitalist. Ali’s story is especially interesting because he actually worked in the business and investment world before completing his MD/MBA dual degree at Penn, and then decided to go straight back into finance and investing when he graduated. This is obviously not common for someone who goes to medical school, and it’s interesting to hear what Ali thinks about the path he took, and how he thought through his decisions.

Map

2:00 – Ali’s Background and how he became interested in the business side of science/medicine

5:20 –Working in healthcare investment banking after graduating from Duke

9:35 – Going to medical school and completing a n MD/MBA degree

16:10 – Deciding to go back into the investment world after graduation

18:30 – Venture Capital and New Enteprise Associates (NEA)

32:15 – What does Ali wish he knew sooner in his career?

Links

Ali’s Bio

http://www.nea.com/team/ali-behbahani-md

Alistair Blake is a British-trained physician who went to Cambridge. He performed his residency in London, and has worked as health policy fellow for the NHS. He is currently an MBA-student at Wharton, and plans on working full time after graduation with the consulting firm, McKinsey. After speaking for a HealthX event on campus, he joined us to dive a bit deeper into his thoughts on the U.S vs. the U.K health systems, and what he has learned as a physician who wants to transition into the business world.

Map

2:00 – Ali’s background and Education – growing up in Bradford, England and choosing medicine

3:45 – Medical education in the U.K is way different than in the U.S

7:40 – Why is Ali interested in health policy?

11:00 – working as a policy fellow for Professor Steve Field, the “head of primary care”

15:15 – incentivizing great practice to boost morale

17:15 – There are very few clinical voices high up in government, and junior clinicians can play a huge role

21:00 – Why come to Wharton? Why come to the U.S? How has Ali been enjoying his time in B-School?

24:30 – Trying to buy insurance as a foreigner after going to the emergency room

26:30 – McKinsey and consulting with a medical background

31:45 – The U.K system (NHS) and a few of the challenges it faces in the coming years

37:00 – The junior physician strike in the U.K

40:00 – What are some myths about the NHS and U.K system?

48:30 – What are Ali’s thoughts on where the U.S system should go from here?

55:20 – What is Ali’s long-term plan?

Links

Ali's LinkedIn

https://www.linkedin.com/in/alastair-blake-md-9080413b/

Bradford - Where Ali Grew Up

https://en.wikipedia.org/wiki/Bradford

Fellowship Ali Had

https://www.fmlm.ac.uk/programme-services/individual-support/national-medical-directors-clinical-fellow-scheme

Care Quality Commission in the U.K

http://www.cqc.org.uk/

Professor Steve Field

http://www.cqc.org.uk/about-us/meet-our-team/professor-steve-field-cbe

Coverage of the Junior Physician Strike in the U.K - BBC

http://www.bbc.com/news/health-34775980

NICE

https://www.nice.org.uk/

Tony Benn video – “If you can find money to kill people you can find money to help people”

https://www.youtube.com/watch?v=9LnY-jy_cE0

For our last episode of 2017, I hosted Dr. Patrick Brennan, the current Chief Medical Officer (CMO) for the University of Pennsylvania Health System (UPHS). We touch on Dr. Brennan’s passion for infectious disease, how he began to take on leadership roles in medicine – including those with the Philadelphia Department of Public Health, and as an advisor to the CDC and Secretary of Health and Human Services – the role of a CMO at a large non-profit hospital, high-level coaching in healthcare, and advice for future healthcare leaders. It’s an episode packed with amazing takeaways and insights.

Map

2:30 – Dr. Brennan’s novelty baseballs in his office and growing up a Philly sports fan

6:10 – Memories and epiphanies from medical school and residency at Temple University

10:30 – What influenced Dr. Brennan to focus on infectious disease and infection control?

15:05 – How do you get involved with administrative roles, and what do you have to watch out for? “Busy people get asked to do more.”

19:20 – Advising the Center for Disease Control (CDC) and the Secretary of Health and Human Services (HHS)

25:15 – The role of the Chief Medical Officer (CMO) in a large hospital system

30:00 – Pulling back the curtain on the day-to-day role of a CMO – what do you have to give up?

35:15 – The roles of coaches on Dr. Brennan’s life and career, and the role they serve at Penn Medicine – the “360 evaluation”

41:15 – What did Dr. Brennan need to improve upon to be a more effective leader? - giving feedback

44:55 – What would surprise people about how hospitals function?

47:30 – How has the ACA been both good and bad for hospitals?

50:30 – What would Dr. Brennan fix about the U.S healthcare system?

52:05 – What would Dr. Brennan do if he were starting his medical career over in 2017?

53:20 – Last thoughts and advice for future healthcare leaders.

Links

Release when Dr. Brennan was named CMO in 2005 (Bio)

https://almanac.upenn.edu/archive/volumes/v52/n02/pb.html

Atul Gawande’s New Yorker Article on Coaching in Medicine

https://www.newyorker.com/magazine/2011/10/03/personal-best

360 Degree Feedback

https://www.custominsight.com/360-degree-feedback/what-is-360-degree-feedback.asp

In this episode, I had a once in a lifetime opportunity to sit down with one of the most successful and respected healthcare leaders out there, Dr. Arthur Rubenstein.

His accolades are too extensive to list in detail, but in short, Dr. Rubenstein is internationally known for his research achievements in endocrinology and diabetes, as well as for his role as the Dean of Penn’s Med School and as Executive Vice President of the University of Pennsylvania Healthcare System (UPHS) in the early 2000’s.

We were able to touch on his upbringing and medical training in South Africa, how he found himself practicing in the U.S, being recruited to Penn Medicine to steer the system away from financial disaster, where he learned his leadership skills, and a bit about the roles that large academic medical centers play in their communities.

Map

3:00 – Growing up in South Africa – playing cricket, choosing medicine, and his parent’s influence

7:50 – The influence of Apartheid, and the decision to leave South Africa

12:40 – Life in London, getting involved with research, and coming to the United States

18:35 – Dr. Rubenstein’s world-renowned diabetes research - the discovery and clinical usefulness of C-peptide

24:15 – Transitioning to administrative roles as a clinician

29:35 – Where did Dr. Rubenstein learn his leadership skills?

34:45 – Being recruited to Penn, and the dire financial situation of UPHS in the early 2000’s

41:45 – Changing the culture of a large institution – “the distributive leadership model”

48:30 – Building an outpatient center and raising money – enter Raymond Perelman and the Perelman Center for Advanced Medicine

54:30 – a second donation from Raymond Perelman – renaming Penn’s medical school, and boosting morale

1:00:00 – recruiting Ralph Muller, the CEO of UPHS, and the importance of their working relationship

1:07:05 – settling disagreements between the leaders of hospitals – the most common issues

1:11:20 – the role of large health systems in their communities

1:18:00 – What would you change about the current healthcare system? - coverage for everyone

1:20:20 – If you could only read 3 things for the rest of your life? – Shakespeare, Churchill, and William Osler

1:22:20 – Book recommendations – The Undoing Project, Good to Great, The Four

1:24:40 – What would Dr. Rubenstein do if he were starting his medical career in 2017?

Links

Apartheid in South Africa

https://en.wikipedia.org/wiki/Apartheid

Summary of Dr. Rubenstein’s Research Accomplishments in Diabetes

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3484474/

Article that Discusses Penn’s Financial Issues in the Early 2000’s

http://impakter.com/adding-humanity-into-medicine/

Raymond Perelman

https://en.wikipedia.org/wiki/Raymond_G._Perelman

Ralph Muller, CEO of UPHS

https://www.pennmedicine.org/about/leadership-and-organization/meet-our-ceo

Judith Rodin’s (previous President of Penn) Book – The University and Urban Revival

http://www.upenn.edu/pennpress/book/14337.html

Kahneman and Tversky

https://www.newyorker.com/books/page-turner/the-two-friends-who-changed-how-we-think-about-how-we-think

The Undoing Project – Michael Lewis

https://www.amazon.com/Undoing-Project-Friendship-Changed-Minds/dp/0393254593

Good to Great – Jim Collins

https://www.amazon.com/Good-Great-Some-Companies-Others-ebook/dp/B0058DRUV6

The Four: The Hidden DNA of Apple, Amazon, Facebook, and Google – Scott Galloway

https://www.amazon.com/Four-Hidden-Amazon-Facebook-Google/dp/0735213658

Other Coverage of Dr. Rubenstein

https://www.bizjournals.com/philadelphia/blog/john-george/2011/06/rubenstein-reflects-penn-medical.html

https://www.eurekalert.org/pub_releases/2009-11/uops-pah110509.php

https://news.upenn.edu/news/arthur-h-rubenstein-mbbch-named-executive-vice-president-university-pennsylvania-health-system-

In this episode, Ryan sits down with Chris Molaro and Adam Pardes, the co-founders of the Philadelphia start-up NeuroFlow. NeuroFlow is a digital health software firm that uses advanced data analytics and machine learning algorithms on real-time biometric data to quantify stress, focus and relaxation for mental health.

Map

5:10 – The NeuroFlow Pitch – Chris

8:45 – Why Adam felt compelled to co-found NeuroFlow

10:05 – How did Chris and Adam meet? How did they come up with the idea for NeuroFlow?

14:45 – How did they have the courage to even start?

18:30 – How Chris and Adam complement each other as co-founders

20:45 – Creating “Values” for a company and ensuring everyone on the team follows through

24:55 – Thinking about the hiring process and how you can be “so good they can’t ignore you”

30:50 – FDA and the 510K exclusion – being classified as a “clinical support tool”

33:50 – Performing a clinical trial at Penn

36:00 – Starting a company vs. doing a research project

39:50 – Importance of marketing, and making sure you back up the hype

42:45 – Getting funding early on

47:10 – Getting feedback from investors

49:00 – The value of taking the “Medical Devices” course at Wharton – making connections and getting guidance from speakers

50:45 – The hardest decisions they’ve had to make

53:15 – The proudest moments they’ve had

55:40 – What will success look like for NeuroFlow?

Links

NeuroFlow Website

http://www.neuroflowsolution.com/

NeuroFlow Facebook

https://www.facebook.com/neuroflowlive/?ref=br_rs

Chris’s Huffington Post Article

https://www.huffingtonpost.com/entry/college-campuses-fail-to-fully-decode-mental-illness_us_5a0c6cece4b06d8966cf3417

Article on NeuroFlow Seed Money

https://technical.ly/philly/2017/10/18/neuroflow-1-25-million-seed-round-mental-health/

So Good They Can’t Ignore You – Cal Newport (Book)

https://www.amazon.com/Good-They-Cant-Ignore-You/dp/1455509124

FDA – 510K

https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DeviceApprovalsandClearances/510kClearances/

More Press

http://philadelphia.cbslocal.com/2017/11/19/philly-startup-creates-tech-to-measure-mental-health/

https://www.cnbc.com/2017/11/11/new-ptsd-treatment-options-for-military-veterans-focus-on-technology.html

Another Interview with Chris Molaro – Wharton Business Radio

https://soundcloud.com/user-414944777/christopher-molaro

In this episode, I was able to sit down with Dr. Neha Vapiwala who is one of my mentors, and overall one of my absolute favorite people at Penn Med. She just began work as the new Assistant Dean of Student Affairs for the Perelman School of Medicine.

We touch on her time at Johns Hopkins where she studied biology and Hispanic studies, and even worked with Dr. Ben Carson! We then discussed her time at Penn Med, the decision to pursue radiation oncology, how she began to take on leadership roles in medicine, and her goals as the new Assistant Dean of Student Affairs.

I really appreciated hearing Dr. Vapiwala share a bit about the areas she had to personally work on in order to be an effective leader. It was also great to hear her talk in depth about what makes her so passionate about oncology and more specifically the field of radiation oncology.

Map

1:50 – Restaurants in Philly that Dr. Vapiwala recommends

4:20 – Coming to the U.S as a child, Ellis Island, and growing up in Jersey

7:40 – Studying Biology and Hispanic Studies at Johns Hopkins – “why do a minor when you can do a major?”

11:20 – Why medicine?

13:40 – Doing research with, and being mentored by Dr. Ben Carson

15:45 – Thoughts on being a woman in medicine – What else did she have to consider? Did she have female mentors in medicine?

21:00 – Choosing radiation oncology – do you have to love physics?

29:50 – What are the current technologies in radiation oncology? Proton Therapy

37:00 – What does the future of radiation oncology look like? What will future researchers and innovators have to solve?

45:00 – When did Dr. Vapiwala begin to take on leadership roles in medicine?

51:30 – How did she learn to be a leader?

55:15 – What is one thing she needed to work on to be a better leader?

57:45 – Her new role as Assistant Dean of Student Affairs at Penn Med - how is she balancing this role with her clinical duties?

1:03:00 – What are some of Dr. Vapiwala’s goals for the next year?

1:05:00 – Advice she would give to her first year Penn Med self

Links

Dr. Vapiwala’s Profile

https://www.pennmedicine.org/providers/profile/neha-vapiwala

Radiation Oncology

https://en.wikipedia.org/wiki/Radiation_oncologist

OncoLink – Dr. Vapiwala’s Scholarly Project while at Penn Med

https://www.oncolink.org/

Proton Therapy

https://en.wikipedia.org/wiki/Proton_therapy

Aaron Bhole is a first year med student at the Thomas Jefferson University Sidney Kimmel Medical College in Philadelphia. He is involved with a group at Jefferson called Physician Executive Leadership – or PEL – which is a HealthX like organization that focuses on developing future physician leaders.

We were able to hit on Aaron’s interest in the intersection of business and medicine, PEL, drug pricing, orphan drugs, and many other topics.

Register for the Penn HealthX conference happening THIS SUNDAY, December 2nd here:

http://pennhealthx.com/events/conference#Registration

Map

3:15 – Aaron’s time at Cornell, the 3+2 Program to get an MBA, and field ecology/cancer research

6:20 – getting interested in the “macro” of healthcare and the value of having an MBA before starting med school

9:30 – Physician Executive Leadership (PEL) at Jefferson Med

11:00 – Why should people care about rising drug prices?

15:40 – Generic Drugs, The Hatch Waxman Act

22:10 – Patent Life (~20 years) vs. Exclusivity (5-7 years, indication specific)

25:00 – How do companies decide how to price a drug?

30:15 – Negotiating drug prices? Would it work in the U.S? Spoiler – probably not

36:00 – Ryan’s thoughts on the patent system in the U.S

39:09 – Aaron’s response – improving how we incentivize “actual innovation” as opposed to marginal innovation

42:10 – Are current price transparency laws any good? (recent California law)

47:40 – Orphan Drugs – what are they? ; The Orphan Drug Act of 1983 – incentivizing the development of orphan drugs (small patient populations)

51:00 – Orphan drugs are expensive and the laws are being taken advantage of – “salami slicing”

56:45 – What is FDA (and Scott Gottlieb) doing now?

61:00 – Last few questions/wrap up

Links

GOP Tax plan may get rid of Orphan Drug R+D tax credit

https://www.npr.org/sections/health-shots/2017/11/03/561805484/house-republicans-aim-to-eliminate-tax-credits-for-orphan-drugs?sc=tw


Airspeed of a Swallow

https://www.youtube.com/watch?v=liIlW-ovx0Y

Physician Executive Leadership (PEL)

http://www.physicianexecutiveleadership.com/

Healthcare Spending Pie Chart (bit outdated)

http://bit.ly/2AEkSrz

Hatch-Waxman Act

https://en.wikipedia.org/wiki/Drug_Price_Competition_and_Patent_Term_Restoration_Act

A Primer of Acronyms and Different Drug Price “Types”

http://www.hivforum.org/storage/documents/2014/Geeneric_ARVs/cross_fchrgenerics_31mar14.pdf

Graphs showing How Much Brand Drug Price decreases with increasing Generic Competition

http://bit.ly/2Aezddo

Articles on How Gilead Chose to Price it’s HepC Drugs

http://bit.ly/2i0uguc

http://bit.ly/2BuHlnN

National Institute for Health and Care Excellence (NICE) – U.K

https://en.wikipedia.org/wiki/National_Institute_for_Health_and_Care_Excellence

ICER (Institute for Clinical and Economic Review) – U.S

https://icer-review.org/

Having Medicare Negotiate Drug Prices Probably Won’t Help (Articles)

http://www.latimes.com/business/hiltzik/la-fi-hiltzik-medicaire-negotiate-20170111-story.html

https://www.statnews.com/2017/06/13/drug-prices-government-negotiation/

Is California’s Drug Price Transparency Law any good? These articles say no

https://www.healthaffairs.org/do/10.1377/hblog20171002.062240/full/

http://www.drugchannels.net/2017/10/thanks-california-sb17-will-trigger.html

Orphan Drug Act of 1983

https://en.wikipedia.org/wiki/Orphan_Drug_Act_of_1983

https://en.wikipedia.org/wiki/Orphan_drug

Orphan Drugs are Big Business

http://wapo.st/2iYgf0H

http://n.pr/2Ak2Esb

FDA Attempting to Get Rid of “Salami Slicing”

http://n.pr/2Bla0v0