So you wanna be a KOL: Careful what you wish for

The highlights of being a key opinion leader in ophthalmology must be weighed against the drawbacks.

Issue: November 25, 2017

ByDarrell E. White, MD

“We all just wanna be big rock stars and live in hilltop mansions driving 15 cars.”
– Nickleback

So, you have decided that you would like to be a key opinion leader, a KOL, and offer your brilliance to make the world a more peaceful and verdant place. What could be more fun, right? Fly all over the country and enlighten your ophthalmic brethren/sisthren about the latest innovations? Dine in fancy restaurants, dropping all kinds of bon mots before noshing on bonbons at dessert? And you get paid, too!

I mean, come on — what could be better?

In all honesty, there is a bit of truth to all of that, but in this case the good stuff is leavened by the realities that go along with the gig. As Heinlein put it in The Moon is a Harsh Mistress: There ain’t no such thing as a free lunch. The life of a KOL is filled with compromises, pretty much just like any other job. Before I share a bit of my own journey let me share with you the good, the bad and a bit of the ugly of the KOL experience.

Good, bad and ugly

We should start with something that is a bit better than the good, our own version of a unicorn. A KOL who seems to have not only been arguably the most influential ophthalmologist in North America for 3 decades but has also by all accounts had more fun doing it than the next 10 top KOLs combined. I am talking, of course, about Dick Lindstrom, the Chief Medical Editor of Ocular Surgery News. Dr. Lindstrom has provided more actionable advice to more of our industry partners than even he can remember. Along the way he has given presentations that changed how each one of us practices every day. In my essay “I want to be the next Dick Lindstrom,” I nominated myself to take his place when he retires.

Face it: Nobody will ever be the next Dick Lindstrom. Let us hope he never retires.

As for the rest of us, we should all hope that our KOL lives go like Karl Stonecipher. Karl was one of the earliest LASIK surgeons in the world, and he has had a hand in many of the innovations that have come along since those early “wild west” days of laser vision correction. More than one young ophthalmologist has asked Karl how to become a KOL. His response is almost poetic: become worthy of being a KOL. He has been able to spread the good news of refractive surgery all over the world (ask him to tell you the story of getting lost on the way back to his hotel from dinner in Peking, arriving just in time to take the podium). Karl will tell you that the best part of being a KOL is being in the company of other KOLs, dreaming up the next cool thing to KOL about. For sure, this is the “good” of the KOL scene.

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Cue the music from the classic Clint Eastwood movie as we move to the “bad.” Most of this revolves around the fact that we still have not come up with a way to fit more than 24 hours into a day or 7 days into a week. Every minute you spend on the road, at a podium or in a boardroom is a minute you are not tending to the needs of your patients. To be a KOL, you need to have an opinion, and in order to come up with your particular point of view, you still have to go to work.

The travel and time away are the Achilles’ heel of the life of the KOL. One night, long after the plates had been cleared from our business dinner, I sat around a table with some of the brightest young lights in the world of ophthalmology. As it happened, all women. Just me, a lone old dude among several young mothers, talking through how hard it is to be the best KOL you can be while at the same time taking care of the other important things in life. Neda Shamie talked about predawn mornings starting at 4:30 a.m. spent completing Halloween outfits before her girls awakened. Preeya Gupta shared the constant fear that she was going to miss something important while she was “quadruple tasking” (how cool and accurate is that expression?). Liz Yeu had her family stashed upstairs in her hotel room. This was maybe two or three away weekends in a row, and she was not going to miss being with them. She would just take them along. On and on they all went. Marjan Farid got a laugh from everyone when she worried out loud about being passed by her daughter in math already. Not even in junior high yet!

Which brings us to “ugly,” although nothing about my friend and fellow OSN columnist Uday Devgan could ever really be called ugly. Uday offers himself as a cautionary tale about what can happen if you become really good at being a KOL and really bad at saying “no.” You see, Uday is everything a KOL is supposed to be. He does what we all do, and he does it really well. From the foundation of his own practice, he has been able to share real-world insights with both his fellow ophthalmologists and multiple industry partners. Being good is fun, and being told how good you are is more fun. All of a sudden, Uday realized that he had been on the road every other weekend for many years. All of those trips from Thailand to Texas had pulled him away from his career and his family and the friends who provided his foundation, what made him so good at the KOL game. His response? Uday learned how to say “no” to 80% of the KOL opportunities, electing to work on just the projects about which he is most passionate. To quote him, time is your most precious asset so choose carefully where you spend it.

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He seems really happy.

Personal perspective

How about me? What is my story? Here is what I told all of my young female colleagues around the table in Chicago: Though chosen, being a KOL is still a choice. Once upon a time, around age 37, I was in a similar place. While it may not be the right decision for anyone else, what I chose to do was stop for about 10 years (the Inspire* alumni group calls it D. White’s sabbatical). I coached football and went to horse shows, did the laundry and went grocery shopping. And I went to work, taking care of lots and lots of patients so that if I had the chance to be a KOL again I would have something worth saying. Perhaps I was more fortunate than others, but when I was ready to return to the game, there was still a place for me.

You wanna be a KOL? Cool. Go to work and build a foundation that provides you a clear idea of what you want us to know. Remember, even if you get the invitation to contribute, you must still weigh the costs of playing. It really is a blast, even if you do not get to have Karl Stonecipher’s experience. You still need to look at what you leave behind. If chosen, you may still choose.

And if there ever is a next Dick Lindstrom, I already have “dibs.”

“Just an ordinary average guy.”
– Joe Walsh

*White was a consultant and a speaker for Inspire. He is still in mourning.

For more information:
Darrell E. White, MD, can be reached at SkyVision Centers, 2237 Crocker Road, Suite 100, Westlake, OH 44145; email: dwhite@healio.com.

Disclosure: White reports he is a consultant to Shire, Allergan, TearLab, Rendia, TearScience, Omeros and Sun, and is a speaker for Shire, Allergan, Omeros and Sun.