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Balancing clinical practice and corporate leadership presents challenges and rewards
Two physicians describe a symbiotic relationship between daily practice and research and development activities.
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Many practicing ophthalmologists work as consultants to industry, helping to steer research and development efforts. Some have more substantial and demanding leadership positions, particularly in small companies that focus on specific ophthalmic subspecialties.
Although balancing clinical practice and corporate leadership brings various challenges, doing so results in better products and improved patient care, according to two practitioner-executives.
“It’s a bit of a balancing act,” Richard A. Lewis, MD, chief medical officer of Aerie Pharmaceuticals, said. “I love the challenges of it. We have enough challenges in clinical practice, but I think that continuing to advance the field is a worthy cause.”
Lewis is also a full-time practitioner and serves as an OSN Glaucoma Board Member.
“I think the most important thing is that you really have to balance the time in terms of your free time outside the clinic. So, you’re doing this on your free time, which makes it a lot harder because now you really don’t have free time. That’s the issue,” Peter K. Kaiser, MD, a consultant for Ohr Pharmaceutical, said.
Kaiser is a retina specialist at the Cole Eye Institute, Cleveland Clinic, and an OSN Retina/Vitreous Board Member.
Aerie’s product pipeline includes Roclatan, a fixed-dose combination of Rhopressa and latanoprost for IOP reduction in glaucoma patients.
Ohr’s pipeline includes squalamine for wet age-related macular degeneration, retinal vein occlusion, proliferative diabetic retinopathy and diabetic macular edema, and several sustained-release products for glaucoma, allergy and retinal diseases currently in development.
Functions as corporate leaders
Kaiser described his duties at Ohr and as a consultant to several other companies.
“My activities at Ohr are involved in study design, analysis of data, product development, etc. I also do a lot for other companies in terms of business development and help a lot of smaller biotech companies bring their products up through the very difficult regulatory system and hopefully, eventually, to approval,” he said.
Lewis previously served Aerie as a medical monitor in clinical trials.
“In a medical monitor role, I oversaw the clinical trials, reviewed all of the adverse events and interacted with the company in terms of protocol development and any kind of regulatory issues with the FDA,” he said.
When Lewis assumed the position of chief medical officer in September 2015, company leaders agreed with his desire to continue practicing ophthalmology.
“I didn’t want to give up clinical practice. I really enjoy treating patients and felt that I could contribute to a greater extent by still keeping my hand in clinical practice. They agreed with that,” Lewis said.
Clinical practice benefits research
Practicing clinicians bring useful experience and insight to their roles in industry as consultants or corporate officers, according to Kaiser.
“It’s very important because you have a clinical practice that allows you to know what is required and what we need in practice,” Kaiser said. “A lot of chief medical officers may be physicians from other fields who may have been in the industry for a very long time, but now they’re joining ophthalmology for the first time. They don’t understand any of the nuances of clinical practice. They don’t understand what we’re up against on a daily basis. They don’t know what we need from a pharmaceutical company.”
Some non-ophthalmologists who serve as corporate officers mistakenly believe that they know best what a company and its customers need, Kaiser said.
“In contrast, as ophthalmologists who are in high-level positions in industry, we understand what we need. We understand the psyche,” he said. “We’ve done it, and as a practicing doctor, we’re still doing it. So, these are all very important areas that differentiate us from the average officer, whether it be chief scientific officer, chief medical officer or CEO.”
Research informs patient care
Lewis said experience in research can be used to help patients.
“I think that having a focus on taking care of patients really helps in the design of the clinical trial and some of the things that the drug will gain. It gives me a practical experience that being a full-time physician wouldn’t allow me to get,” Lewis said. “I can take the research side and tell patients what’s coming and get them involved in some of these trials. Whether we’re doing the trial or someone else is doing the trial, I can direct them. Glaucoma is ultimately a blinding disease. Everybody in glaucoma really wants to have the latest and best therapy. I think it’s a benefit for the patients when I can tell them, ‘Look, this is what’s coming down the pike. If you can hang in for 6 months or a year, this new device or new drug will be available.’ I think it’s a big advantage.”
Lewis said it is important to maintain one’s credibility as a practicing ophthalmologist while serving as an executive in industry.
“I don’t want to be perceived as a company guy only. I want to be perceived as adding value to what we do,” he said. “I think that if I gave up clinical practice and went full time with industry, I think that perception would definitely change because I would be forced to only support the company line. It is a balancing act, and I recognize it, and I hope I bring value on both sides. I hope I’m not biased on any one side.” – by Matt Hasson
- For more information:
- Peter K. Kaiser, MD, can be reached at Cole Eye Institute of the Cleveland Clinic Foundation Medical and Surgical Retina Unit, 9500 Euclid Ave., Cleveland, OH 44195; email: pkkaiser@gmail.com.
- Richard A. Lewis, MD, can be reached at Sacramento Eye Consultants, 1515 River Park Drive, Sacramento, CA 95815; email: rlewiseyemd@yahoo.com.
Disclosures: Kaiser is a consultant to and owns stock in Ohr Pharmaceutical. Lewis is chief medical officer of Aerie Pharmaceuticals and a consultant to AqueSys, Glaukos and Ivantis.