I used to think that being one of the few female cardiothoracic surgeons in the world was my most unique quality. Since the establishment of the American Board of Thoracic Surgery in 1948, approximately 200 women have achieved board certification in cardiothoracic surgery. In fact, it wasn’t until 1961 that the first woman was able to attain board certification in this very male-dominated field. The year I took my board exam, there were only 100 women in the field.
It is, however, even more unique for me to be a female practicing cardiothoracic surgeon with an MBA; I have yet to meet even one. I am confident they exist, especially in light of the fact that undergraduate schools are now offering dual MD-MBA degrees. In fact, my own alma mater, Union College in Schenectady, New York, offers a Leadership in Medicine program in which students can obtain a BS, MD, and MBA in an eight-year academic track. With hindsight being 20/20, I cannot imagine why a physician would not embark upon an academic path that ultimately leads to a degree in business.
Having said this, my very own path to an MBA was a bit circuitous, and yet there was a certain convergence between getting an MD and getting an MBA. In the most simplistic terms, my motivation to become a doctor was so that I could heal people and my motivation to get a degree in business was so that I could heal more people.
At the time I applied to the UCLA Anderson School of Management, I was the director of the Mechanical Assist Device Program at Cedars-Sinai Medical Center in Los Angeles, where I was enjoying my practice as a heart transplant surgeon. I had, in fact, founded and built the Mechanical Assist Device Program using little more than my clinical skill set from my fellowship in mechanical assist devices at the University of Pittsburgh Medical Center.
Finding a Missing Piece
While building this clinical program and working with various artificial heart manufacturing companies, it became apparent to me that something was missing in my life as a heart surgeon and program director. In fact, that “something” was a language barrier that I simply couldn’t cross: the language of business.
While I was fluent in the language of medicine — a complex language grounded in science, theory, and case study — I was completely ignorant of the language of business, a language also grounded in science, theory, and case study. While one language was used to save lives, the other was used to change lives, and I found them both extraordinary and necessary to my evolution as a physician and surgeon.
And that is how I found myself, at the age of 40, going back to school to take exams, write essays, and spend 40-plus hours per week “hitting the books.” Unlike medical school, which was rote memorization, business school was taught by the Socratic method, and you’d best come to class prepared to lead a discussion of the latest economic debacle or Harvard business case study or risk personal humiliation.
Business school was a great intellectual challenge for me. It was like a springboard for my mind. I was in a new territory of learning and exercising “muscles” in my brain that I never knew existed (and that, anatomically speaking, do not exist). I also found myself surrounded by some of the greatest minds I have ever met: my fellow executive MBA classmates. I learned as much from them as I did from my highly proficient professors and it was all very stimulating, especially coming from a field of medicine that revolved more around a technical skill set.
All of this hard work and study certainly paid off. I finished my MBA in 2006 with a new cadre of assets, the two greatest of which were:
The ability to build and leverage myself as a brand (and recognize the importance of doing this).
The network of UCLA staff and alumni with whom I can collaborate and look to for advice and support in any endeavor I choose.
Also, as a result of getting an MBA, I now address problems differently. I think differently. I act on my instincts differently. And most importantly, I am now constantly scanning my life for opportunities — especially opportunities that utilize both my business and clinical skills.
Building a Brand
In terms of building myself a brand, upon graduating from UCLA Anderson, I developed a marketing plan for myself as a physician and a platform that positioned me as a national expert in heart disease in women and women’s health. To this end, I wrote a memoir, Heart Matters, which was published by Random House. It received a 4-out-of-4-star review from People magazine and went on to be a New York Times Bestseller for both the print and eBook versions.
At its core, Heart Matters is a book that educates women about heart disease. Around that core of information, I added the stories of patients whom I have taken care of throughout my career. The stories are both poignant and tragic and send the message to women that heart disease is our No. 1 killer and is an epidemic among women.
Heart Matters is also a memoir of my life as a female heart surgeon who is juggling a career, two young children, and a husband who is a liver transplant and hepatobiliary surgeon. In other words, a story about a woman who is trying to find balance while trying to have it all and make a difference — isn’t that what we are all trying to do?
My book was optioned by Universal Studios and made into a scripted medical drama that NBC picked up as a series for the 2016 television season. In the TV show, Heartbeat (now streaming on NBC’s Peacock streaming service), Melissa George played me, and my husband was played by actor Dave Annabel. I served as a co-executive producer and worked on nearly every aspect of the show.
I found it truly fascinating to see how a television series is produced. Similar to an operating room, everyone on set has a specific job — from the writers, to the directors, to the camera operators, to the props manager, to the set designers and lighting staff. Each person must do their job to the highest standard for the whole production to come together in a unified way. Each person has a common goal: to make that episode and ultimately the entire show a success.
We function like that in the OR. Everyone, from the surgeons, to the nurses, to the anesthesiologists, to the perfusionists who run the heart-lung machine brings their A-game for the singular goal of a safe, successful operation.
I have also leveraged my brand to build an extensive list of speaking engagements, radio and TV appearances, and newspaper and magazine articles and interviews, and I have used my platform to educate women about heart disease. I have been on NBC, ABC, CBS, and FOX news, the Martha Stewart Show, The Doctors, The Doctor Oz Show, The John Oliver Show, and the Oprah Winfrey Network, and have been interviewed by Barbara Walters on 20/20. I’ve worked with wonderful celebrities like Queen Latifah and Joe Montana, who are dedicated to building awareness about heart disease.
I would never have known how to navigate these marketing waters nor understood the power of brand-building and positioning had it not been for my business degree, and my hope is that this work has impacted people’s lives.
The Power of Collaboration
And yet, the most potentially rewarding project I am working on utilizes the second of the two greatest assets I received from my MBA: the ability to collaborate with and engage the UCLA Anderson community.
On the very first day of class, I met a fellow executive MBA student with a PhD in bioengineering who was in the earliest stages of developing a cardiac diagnostic medical device. From that day onward, we collaborated on the development of that device with what little time we had outside of the classroom and MBA workload. We utilized the expertise of other classmates and professors to help us with things such as patent application, design development, and funding opportunities.
Upon graduating from Anderson, we had built our business plan, patented the device, and built an initial working prototype.
We have since completed the third and final phase of the prototype, performed safety and efficacy testing in humans, and incorporated ourselves with the addition of a third C-suite member to our company who serves as president and COO.
We initially bootstrapped the financing of the company and then secured more than $500,000 in funding through U.S. government grants. We then created a C-corporation, Cordex Systems Inc., and funded the company with three oversubscribed rounds of angel-tiered investing and are currently raising a Series A round that specifically targets institutional investors.
Traditional blood pressure cuffs measure one metric: pressure in the blood vessels. However, this only scratches the surface of the critical cardiovascular information available. The device that we have developed, known as the SmartCuff, uses a proprietary mathematical algorithm that can take an ordinary blood pressure cuff and turn it into a sensor that can bio-hack a human pulse at 200 data points/second to yield information regarding vascular health.
Today, there are no non-invasive medical devices capable of monitoring changes to the vascular health of the endothelium (the protective lining of your blood vessels) in routine clinical practice. Yet all of the risk factors for cardiovascular disease — obesity, smoking, diabetes, high blood pressure, sedentary lifestyle, poor diet, elevated lipids — destroy that lining by causing inflammation in the endothelium. Quite strikingly, healthcare providers are not directly measuring vascular health despite the fact that they are deploying measures (medications and lifestyle modifications) to improve it.
To date we have tested nearly 700 patients with our clinical partners at Johns Hopkins Medical Center and are working toward FDA clearance of the device. We are also exploring applications of the SmartCuff in patients with long-haul COVID-19 as the coronavirus has been shown in both autopsy studies and clinical presentation to be attacking the endothelium as a key driver of disease manifestations.
Putting in the Hard Work
Building a company from product ideation to prototyping to performance and clinical testing to regulatory approval and commercialization is hard work. It’s like getting out of bed every morning and pushing a rock up a hill. It’s also very much like approaching a tough surgical case every day.
Most people think that surgeons enter an operating room thinking about how we’re going to succeed. We don’t. We enter an OR thinking about how we’re going to fail. And then we find a way to mitigate that failure. It’s failure that drives us, not success. Being the CEO of a startup means that I begin every day by thinking about how the company will fail today. And I do this while pushing that rock up the hill.
My COO and I both lost our dads recently. They died within a year of one another, but they left us each with a gift. They instilled in us the principles that have allowed us to persevere through some pretty difficult times. His dad, an extremely talented and compassionate surgeon, told him to always “play the ball where it lies.” This has been our mantra as we navigated the pandemic, which has been both a company stressor as well as a catalyst. I can’t help but feel sometimes, though, as if we are playing the ball in a COVID fairway bunker.
My dad, the kind of guy who did business on a handshake, told me that “if you work hard, you can achieve anything.” I can assure you that at our company, Cordex Systems Inc., we work hard every day. Whether the company thrives or fails, it won’t be for lack of working hard or playing the ball where it lies.
All of the things that I have accomplished through building and leveraging my brand and through founding Cordex Systems Inc., were made possible by networking with the UCLA community and beyond. I urge you, as prospective MBA students, to make the effort to really get to know your fellow classmates. Find out what they do for a living, what their passion is, and how they envision themselves in the future. You may be amazed by the synergy you have with them and by what a collaboration can yield.
Also, stay connected with your business school. The alumni network will be an endless resource, teeming with opportunity and only too happy to work with you. In other words, the bricks and mortar of your next company are likely sitting right beside you in class.
The Entrepreneurial Physician
From my vantage point, I see an MBA creating a new breed of what I call the “entrepreneurial physician” — a physician who either creates new enterprises or uses their newly honed business skills to improve and build upon their existing medical practice.
I fear, however, that doctors seek an MBA only to use it as a stepping stone to a position within health care/hospital administration and I think this could be potentially myopic. Once you get an MBA, change is in the wind, so keep your options open!
For me, the entrepreneurial route fit like a surgical glove. The high risk/reward ratio, the necessity of both speed and accuracy, and the ability to exact more rapid change are the very “surgical” qualities of entrepreneurship that drew me to this field of business. And yet, I continue to stay in the “trenches” of healthcare to keep my finger on the pulse of what is evolving in the field of medicine. In this way, I am able to leverage real-time data for our company and our investors.
And so, for me, I will continue to use my MD to save lives one patient at a time, one day at a time, and use my MBA to create technology that will change the lives of thousands. Either way, my hope is that I create a modicum of positive change in the world at large. Actor Melissa George said it best in one pivotal scene in Heartbeat: “It’s lives. High risk, high reward. And a chance to change the world.”
Excerpted from Lessons Learned: Stories from Women Physician Leaders by Deborah M. Shlian, MD, MBA.