Join Andrew Tisser (Talk2MeDoc Podcast) with Marieke Jonkman as they discuss the significance of communication in the healthcare industry. She is a healthcare professional that disseminates medical and scientific information through relationship building. Marieke talks about the change in her day-to-day tasks given the COVID-19 crisis and her take on the current state of affairs of the pharmaceutical industry’s role given the pandemic. They also get into the issue of communication and burnout among people in the industry.

By the end of the episode, you will learn the value of communication between different pharmaceutical arms, be curious, and establish clarity on your goals. Enjoy the podcast!

Today’s Guest

James M. Dahle, MD, FACEP

Marieke Jonkman, PharmD

Dr. Marieke Jonkman, PharmD is a Board Certified Medical Affairs Specialist with 15+ years of experience in the pharmaceutical industry. After losing her best friend at a very young age, Marieke made it her life’s mission to improve patient outcomes. Specializing in precision medicine, Marieke has advocated for pathway-specific drug approvals through both basket and umbrella clinical trial designs before they became all the fashion. In 2015 Marieke transitioned to Medical Affairs as a Medical Science Liaison, and she was given the “North America MSL of the year 2020” award recently. In addition, Marieke is working on becoming a Certified Executive Coach through the ICF, specializing in coaching for the medical professional.

In her spare time, Marieke enjoys spending time with her two daughters on their small farm outside of Buffalo, NY. That is if she is not crocheting—current project: a fashionable cover to go over a face mask.

You can find Marieke Jonkman on…

LinkedIn: https://www.linkedin.com/in/mariekejonkman/
Twitter: https://twitter.com/MariekeJonkman

 

 

“Where’s this other person coming from? What is their story and how do they get to that story? And maybe, you know, maybe their rights and maybe by listening and asking questions, I can find out how they came to that story and we can find a middle ground and combine our stories, so to speak.”

 

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Disclaimer

All opinions expressed by the guest in this episode are solely the guest’s opinions and do not reflect the opinions of Andrew Tisser DO, Talk2MeDoc LLC, or any affiliates thereof. The guest’s opinions are based upon information he considers reliable, but Andrew Tisser DO, Talk2MeDoc LLC, nor any affiliates thereof warrant its completeness or accuracy. The guest, Andrew Tisser DO, Talk2MeDoc LLC, or any affiliates thereof are not under any obligation to update or correct any information provided in this episode. The guest’s statements and opinions are subject to change without notice.

Transcript

Andrew Tisser 0:43
Marieke Jonkman Welcome to the Talk2MeDoc podcast.

Marieke Jonkman 0:53
Thank you, Andrew. I’m glad to be here.

Andrew Tisser 0:57
Well, great. I’m glad to have you. So I’ve recorded a little bio for the listeners about who you are, but in your own words, if you can tell people who you are, what you do and what your role is in healthcare.

Marieke Jonkman 1:10
So my name is Marieke Jonkman. I’m a PharmD and I work in the pharmaceutical industry. And to be a little bit more specific, I work as a medical science liaison, which is a healthcare professional that’s disseminates or shares, medical and scientific information through relationship building. And medical science. liaisons are part of what’s called medical affairs, which is very distinct and separate from commercial we have a huge firewall between the two of us. Commercial or commercial counterparts can provide health care providers with on label information that can help with patient’s care decision making.

Whereas medical science liaisons are subject matter experts Experts and we are on top of all the current research both published and unpublished. And this means our knowledge and depth of information goes beyond what is described on the label and what the drug is approved for. So there’s one very important caveat though. MSL cannot let me repeat that can not go out proactively and talk with healthcare professionals about off label use of the drug that’s absolutely strictly prohibited. When an employer sells for active talking with you as a healthcare professional, we have to stay on label.

However, if a physician or another healthcare provider has a research or off label question, and MSL is able to answer those questions, whereas our commercial counterparts absolutely cannot do so. So I always recommend that any physician on a regular basis Keeps in contact with their medical science liaison. Because that way without having to go off without having to read all the literature or going to every conference, you can be apprised upon all the research that’s going on in your area, or you know, what’s not your prime area of expertise. So that’s basically what I do. I talk with physicians, nurse, nurses, health care providers, and I share information about what’s going on.

Andrew Tisser 3:33
Fair enough. So, I mean, the purpose of the show is to talk about communication and you’re certainly communicating different issues about your drugs with the different physicians and nurses that you work with. So I think it’s quite appropriate. Now just to make the distinction even more clear, you are not involved in sales. You are not going pushing drugs to doctors offices, you are given the information, scientific information before Behind the drugs usage, correct?

Marieke Jonkman 4:02
Yes. And by title 21 of the Federal Code of Regulations, we have to provide a fair and balanced reports. So if if there’s negative information as sales or commercial person is not likely to highlight it, but a medical science liaison is obliged to tell you. So if if the drug I’m I’m representing has a very negative side effects. I have to mention that in every conversation that I have.

Andrew Tisser 4:38
Absolutely. Okay. Well, that that’s certainly not what you think of when you think of the pharmaceutical industry, right. I think people have some poor connotations when they think of drug reps coming in pushing their drugs, but this is a totally separate arm of the pharmaceutical industry, that I just want to make the distinction about early. So very good. Who Who would you consider your team?

Marieke Jonkman 5:06
I’m part of my team is first the patient. Because every, every morning when I wake up, and I suddenly had my computer or I go and travel to talk with healthcare professionals, the first person I think about is patience, you know, how can I do best for them to make their lives better? So while they’re not directly on my team, and I’m not communicating with them, they are the most important person to me. So outside of them, of course, it’s all healthcare professionals.

I’m talking with nurses, PhDs, physicians, research researchers, as those are my external as my external team. And internally, I have my other medical science news. Since we cover different parts of the company, we also work very closely together with medical information. So if physicians have questions that they send to the company, they will get a letter with all the information. And another part is clinical developments. So I work a lot with clinical trials making sure that we have patient enrollment.

And now now that we’re having COVID-19, what’s very important is that the patients who are on our clinical trials continue to receive treatments. That may mean now we have to send drugs directly to the patients, which means we have a different kind of informed consent. Patients all still also still need to have their scans of blood work done. And so I really have to care that the patients are being taken care of. So we work very closely with clinical developments as well.

Andrew Tisser 6:58
Fair enough, you You bring up the current pandemic, how is your day to day changed, given the COVID-19 concerns,

Marieke Jonkman 7:07
we changed a lot of our meetings, to virtual meetings, especially zoom meetings. And my meetings have significantly decreased because most of the providers I work with are now working on the forefront. They’re treating COVID patients, they’re, they’re helping their hospitals, their systems to function properly. So my meetings have had very much decreased and my attitude has always been, hey, I’m reactive. If you need me, I’m always there for you. And that has, you know, gone a little bit bigger. I’m not going, you know, to New York City or to Boston or to Philadelphia, you know, for the past couple of weeks, whereas normally I would be in either Boston, New York City or Philadelphia at least once a week.

Andrew Tisser 8:00
Yeah, that was my next question I had from my understanding MSL job usually requires a fair amount of travel. So that’s that’s got to take a backseat right now I presume.

Marieke Jonkman 8:10
So more office work but still supporting, you know, our key opinion leaders very important.

Andrew Tisser 8:18
Absolutely. So what what exactly defines a key opinion leader

Marieke Jonkman 8:25
you can have various, you know, they’re officially called tiers. You have the international key opinion leader. Those are physicians and researchers who will publish in the big name journals like Jama nature, etc. They will also present a very big conferences, for instance, ASCO, I work in oncology. So that’s our big conference or at ash. These international cables travel all over the world. Below that we have are below and we have our national kales, they still do extensive research and they’re very involved with clinical trials.

They’re very involved on a regional level. And so they, but they stay more, you know, closer to home, they may still, you know, write articles in very distinguished journals, but not as often or they don’t do as much research. And then we have our regional key opinion leaders who really have a strong research and community based connection. They work much more with the patients and they have very important what we think is empathy and consideration for the patient. So they are very, their opinions are very important to us because in the end, that’s what we’re all doing it for, for the patience.

Andrew Tisser 10:00
Sure, yeah, I think we’re all united under that same goal, no matter what our roles. So I think that’s, again, one of the key points to this show as well. given current state of affairs, what do you feel the pharmaceutical industry’s role is given the pandemic right now.

Marieke Jonkman 10:20
First, you know, we all have clinical trials going on. We have patients who, you know, enter, especially in oncology in the clinical trial as the last option. And some of them you know, most of them are seeing benefit from the investigational drugs that they’re getting. So we have to make sure that there’s continuing Shin of care. That’s, that’s one of, you know, one of the first things the pharmaceutical industry should do. The second is we need to work very closely with the FDA and other regulatory agencies in getting our drugs in patients were appropriates with the COVID-19. scenario.

And, and I really see the pharmaceutical industry coming together working together, the difference, you know, what you would normally maybe consider competitors are working together in order to develop drugs much faster. I’m seeing where normally a phase one would take about 18 months, I really see people pulling from all directions, and making sure it’s not going to take 18 months, but that we can do it in 18 weeks or 12 weeks or even eight weeks. And I find that very, very encouraging researches coming like for instance, when Abbott’s got approved in three days with their rapid test for COVID-19.

I mean, that literally was pulling all resources together and For something to be approved by the FDA within three days, I’m pretty sure that everybody who worked at the FDA was working on getting disapproved. It’s when I read that I was like, wow, okay, that’s, that’s really but that’s what we should be doing. We can do this for very rare diseases and very, you know, for diseases that have a huge impact. So we can do that here. We can put all the research all the antibodies work together, collaborate, and get it to the patient. Let’s get those vaccines out there. We don’t need to wait 18 months.

Janssen is already working on making their production line much bigger. They their vaccine is not yet you know, in the clinical stage, but they’re already expanding building laboratories and production. Production labs for vaccines and and Stoffel Dr. Stoffel has said, you know, hey, if it’s not us, then maybe another vaccine can be made there as long as it gets to two healthcare workers in the first place and everybody else as soon as possible. So we’re working together, and that’s good to see.

Andrew Tisser 13:20
It’s remarkable. We really when, when you’re under the fire, what can be done? I mean, looking at all the collaboration and cooperation across many different industries right now, especially, like you said, getting something through the FDA in three days, which is unheard of means that it is possible and that some of this excess regulatory action, maybe maybe can be relaxed and in times of crisis, but it is it is encouraging I agree

Marieke Jonkman 13:50
One of the things we have to be very careful about is because some of the rules and regulations are relaxing, is that not every time thing is going acids, you know, should a lot of the protections are in place, especially for the patients. You know, we have informed consent for a reason. And now with the clinical trials with patients, when they come into the ICU, they’re very, very sick. And there’s really nobody to ask, you know, if they can sign the informed consent for the patient to go on a clinical trial, it becomes the decision of the physician.

Now, we have under, you know, our the Declaration of Helsinki, every individual must, you know, on their own decision, you know, the patient must decide for themselves independently and without pressure, whether they want to participate in a clinical trial. Now, once a patient is so sick with COVID-19, and they cannot Sign the informed consent. What do we do? Does the patient not go on a clinical trial? Or is the physician going to decide it? Now we can under emergency decision making we can a physician can make the decision for the patient. But, you know, what, if it’s a clinical trial and one of the drugs where we’re investigating isn’t as good as standard of care, you know, is it then the responsibility of the physician?

So, we have these protections built in. And in the regular, non pandemic worlds, those protections are there for very, very good reasons. We’re now stretching those protections, and that’s why it’s very good. That’s especially physicians are now you know, they cannot be sued for whatever happens, even if it’s in a clinical trial. So yes, it’s good that we can be more relaxed. So we gets treatment to the patient, but this should not become the standard.

Andrew Tisser 16:04
Oh, absolutely not. Yeah, I agree with you completely there. It brings back to the point of of proper communication between all the different arms, right if the if the people conducting the trials are not communicating effectively with the physicians on the ground or the patients enrolled, and we’re going to see certainly more fallout from there. So on non COVID issues, do you do you feel that there is an issue with communication among team members in healthcare as a whole coming from a bit of a different arm of rather than direct patient care?

Marieke Jonkman 16:45
Yes, I think with any conversation, and then anytime you have a breakdown of communication, and you have you land in troubled waters, and as from the point where I’m coming from When there’s a breakdown in communication, it’s usually a safety issue. And I know that’s a little strange to work it like this. But when people don’t feel safe to communicate whatever their perspective on the story is, they either go silence, or they start to dominate the conversation.

And I’m sure when you look back at conversations you’ve had over the past, you know, couple of weeks, couple of months, there’s been conversations where either you know, you communicated something and the other person was completely silence. Or, you know, you saw somebody else dominates, you know, the conversation. And that’s really when people don’t really feel safe. And that can be dependent on both internal and external factors.

If you have, you know, internally, you come to certain conclusions you make your own story, you make your story about why the facts as you observed bits are there. And your story may be, you know, close to the truth or it may be very opposite to the truth we don’t know, but every person is, is crafting their own story. And just like that you also have the external, that the other person is crafting their own story. And then you can have two stories that either match and then, you know, you can have good communication, but when those stories don’t match, there’s usually a breakdown in in,

in the communication and that can have large effects on especially patience, you know, if we all know the story where, you know, something happens in in the operating room and one of the nurses doesn’t dare to say something and you know, it goes negatively for the for the patient. Other. In other instances, somebody has a view that is not beneficial to the patients in general and they keep on dominating the conversation and there’s no way to change So I always my approaches, you know, when I feel that the conversation is not going in the right direction is to be curious.

Because not to anchor down in my story, but to become really curious, like, you know, where’s this other person coming from? What is their story and how do they get to that story? And maybe, you know, maybe their rights and maybe by listening and asking questions, I can find out how they came to that story and we can find a middle ground and combine our stories, so to speak.

Andrew Tisser 19:38
Yeah, those are great points. I don’t think it’s really been been said that way before on this show. So I I like that a lot. The you know, I I’m an early career physician, myself and I talk with many of my friends and colleagues and there’s a lot of professional dissatisfaction and burnout even in the in the earth. courier docs, which is alarming. Do you think that communication plays a role in that dissatisfaction? Or is that just a systemic issue right now?

Marieke Jonkman 20:14
I think it’s a combination. Because when you’re overwhelmed, and and let’s face it,in our health care system, we have so many responsibilities. That itit’s almost natural for anybody to become overwhelmed. And once you don’t have the structure, internally or externally anymore, your stories become, you know, they really become your stories and it’s very difficult to get out of your story. And then, you know, you have a further breakdown of communications which you know, external And internally makes it makes it worse so that the overwhelm is really a spiral down.

Andrew Tisser 21:12
Yeah, I agree with that. That’s true. Do you see a lot of burnout in the pharmaceutical industry?

Marieke Jonkman 21:21
yes and no. And I also, you know, this is my little sidekick, work as an executive coach. And one of the main complaints from most people in medical affairs in the special E, you know, medical science liaisons is that the workload is too much. You know, we travel, you know, so much, you know, I often leave at the six o’clock flights to Boston, New York or Philadelphia and I don’t return until 910 o’clock at home. And, you know, the next day Same thing again. That’s very, very exhausting.

And so what I find when I’m coaching people and trying to coach myself is that Yeah, when there’s too much overwhelm,nobody’s happy. And when you’re not happy, you cannot perform well. And if you don’t have structure, you cannot perform well. And when I talk with my, my clients, we really work on, you know, how do we make a path forward? How do we focus we, instead of having, you know, this broad, you know, overwhelm, how can we focus on what’s really important and, you know, make things priorities and other things, lesser priorities, what can we delegate? You know, what can we let somebody else do that so how do we balance life and life and work

Andrew Tisser 23:07
Have you had, what are some strategies that you use to help to help with combat some of that?

Marieke Jonkman 23:17
Well, as a coach, it really has to come from, you know, the coachee. That said, they have to really carve their path. And when we talk about we talk, first I always ask about, you know, what are your goals? And, you know, you, you see goals that are very, you know, broads. And the first thing that I always asked them is, you know, when you’re, you know, 6570 years old, and you look back at your life in your career, what do you wish?

When you look back, what you had accomplished, what is the most important thing to you? And I often find that nobody really knows an answer. They really have to think about that for a very, very long time. And sometimes it’s not until the next session that they, they come back to me and say, Hey, this is really when I look back on my life what I want to see that I have accomplished. And then we look back and you know, how’s the 10 year goal? What’s the five year goal? What’s your three year goal?

And what’s your one year goal? That’s and then, you know, when you start getting that clarity, you can you know, where you want to go. And once you have the clarity, you have to determine your necessity, you know, why are you doing it? These are your goals, but why are these your goals? And why do you want to get to these schools, because once you have the clarity and you know, you’re in necessity, you, you have the motivation to work through something. And then when you have those three, you can start working on your, you know, productivity, and that’s, you know, how we go through a path and eventually you know, every coachee defines for themselves,

you know, this is my path forward, this is where I have to go, and this is how I’m going to deal with it. And there’s always going to be, you know, setbacks. That’s, that’s just it’s not a, you know, we always hope that life is one single straight line up. But we find that it’s actually you know, goes up and down and you know, you have peaks and then you have, you know, valleys and you know, it’s okay to come back and reflect like, hey, okay, this was my one year goal. Not going to make it. That’s what can I do to, you know, what adjustments Do I need to make and how can I adjust and be flexible with

Andrew Tisser 25:48
great points for for those who don’t know, just briefly what what is an executive coach.

Marieke Jonkman 25:56
An executive coach is is a person who helps you You organically. So the results of you know better performance, focus, you know, coaches on the sidelines, getting the best out of you by yourself by, you know, really, you have to dig into yourself. It’s hard work. A mentor, on the other hand is somebody who has been there, done that, and they can tell you like, hey, when I was doing this, I found that this was working. That’s a mentor is really somebody you know, who brings you along, gets you, you know, grabs you by the hands and brings you along. A consultant is somebody who, you know, analyzes the problem and gives you a roadmap on how to fix it. And a coach really is the person who it’s like the mirror, it’s, it’s a coach reflects back to you. So you find within yourself the strength and your path forwards

Andrew Tisser 27:00
Great, it’s very well put. Personally, I work with early career doc myself with a small client base and I couldn’t have said it better myself. So let’s shift the show a little bit just to get to know you as the guest a little more. Do you have any book recommendations for the listeners?

Marieke Jonkman 27:22
Yeah, I, for the past year, year and a half, I’ve been reading the book aware by Dr. Dan Siegel, MD. It’s really about the neurobiology and neuroscience of meditation and awareness. This man is absolutely brilliant. Every time I reread the book, I find something new when I hear something new. It’s like, hey, wait, what’s that? Did I read that before? And how he explains you know, neurologic neuroscience wave How we interconnect with each other? I find that absolutely fascinating. Yeah.

Andrew Tisser 28:07
Great. I haven’t read that one myself have to check it out. So when you have time, what do you like to do for fun?

Marieke Jonkman 28:16
I have two lovely girls and we live on a small farm between Buffalo and Rochester. So even now that we’re at home, we still have a lot of room, you know, to walk and I really enjoy spending time with with my girls. My family, you know, has always been in Europe. So we’re still connecting over video and that’s one of the things I like the most connecting with people and really knowing and learning about them and knowing and being present with them. Or, you know, hanging on the couch watching Netflix and crochet.I mean, I love crocheting.

Andrew Tisser 28:55
Hey, that sounds great.

Marieke Jonkman 28:59
It’s I also have Little granny group. You know, we have some young young people, but yeah, once a month, now we do it virtually as well. We come together and do little crochet projects.

Andrew Tisser 29:12
Yeah, I mean, now more than ever, it’s important to find the hobbies that bring you peace and happiness. So that’s, that’s wonderful. So, to conclude here, do you do you have just one single piece of advice you could give to clinicians right now in the area of communication?

Marieke Jonkman 29:33
Well, be curious. Be curious.Try to figure out, you know, what’s the other person’s story? That’s that. And then, now, once you figure that out, see how we can communicate together in improving patient outcomes.

Andrew Tisser 29:54
very powerful advice. So and if people want to reach out or learn more about you or Get in touch. How can they find you?

Marieke Jonkman 30:02
That’s I’m most active on LinkedIn. So if you always send me a connection requests on LinkedIn,

Andrew Tisser 30:30
Great. Well, that all that will be in the show notes for the listeners. murica. Thank you again for agreeing to do this. This has been a lovely chat.

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