Interview with Lode Dewulf
Lode Dewulf works as the Chief Patient Officer at the French pharmaceutical company Servier. We spoke to him about his longstanding career in pharma and about what it really means to be people centric.
You left the pharmaceutical industry a few years ago with the intention of not returning. What changed during your sabbatical that catalysed your motivation to return?
A growing awareness of a few things. Firstly, my conviction about pharma’s societal value contribution was revived and deepened as I attempted to apply and spread patient centricity in different settings: as a carer for several individual patients, as a clinician in general practice, as a co-ordinator and field worker for a medical NGO, and as a patient value consultant. All of these had a deep but – for me – too limited impact compared to pharma; more than ever, I believe that pharma is a very important and impactful stakeholder to help drive the big change needed in healthcare. Secondly, I realised that I still have something valuable to contribute to companies wanting to drive this change. The combination of understanding, vision, values, abilities, and track record which I have been fortunate to build up over the years is still a rare commodity in this field. Thirdly, I missed being part of a team. I want to be a part of the change, not only to advise on it. The biggest reason though, is that distance creates clarity: being away made it so obvious to me that the basis of patient centricity is employee centricity. I guess I rediscovered the golden rule: ‘Treat others how you want to be treated’. Only companies that treat their employees the right way can truly succeed in treating patients the right way. Now, that is something I wanted to help happen, again!
What about your experience and personal attributes made you the right person to take on the role of Chief Patient Officer at Servier?
Firstly, my track record of trust and performance, and also my experiences, vision, and broad and deep network. These give me the street credibility to help drive the deep changes we need to make in both culture and organisation. Secondly, my personal values are very much in line with Servier’s values: people (colleagues and patients alike) first and innovation. Values are very important at Servier and are really used to make decisions. The third reason is a very pragmatic one: mastery of French. In the same way as one cannot connect, listen, and work with patients without knowing their language, I would struggle to engage many of my new Servier colleagues, especially in HQ, if I could not speak French. I wouldn’t say you couldn’t do it without it, but it is certainly a huge bonus to have.
In an industry that hires thousands of employees, what are the foundations to building a people centric culture?
Culture is everything we do, say, and pass on, based on shared beliefs and values. Culture has several levels: what we have (level 0); what we’ve done (+1); what we can do, our skills (+2); our beliefs (+3); and our values (+4). No matter how different people are in what they have, do, or can do, if we climb high enough, we can connect people at the value level. If you try to align people at lower levels without aligning their values, it won’t work. At the value level, the worker in the factory can connect to the sales rep and to the top line manager, and vice versa. That is the power of value alignment. The golden rule reminds us that we all want to be treated in a similar way, and if your company is strongly centred around that value, it gives you unique leverage. Again, patient centricity starts with employee centricity, and this is a unique strength of Servier. This commitment and the example of living it must come from the top and go further than just words. When it does, then your employees do not have to waste time, energy, and other resources fighting for themselves and engaging in uphill, downhill, and lateral battles. Values unite, and they drive culture.
Why are some companies slower in adopting patient engagement and what are the steps needed to motivate this change?
Firstly, companies, like patients, are completely different in their needs, beliefs, and habits. We can’t just say: ‘This is the magic formula, copy and paste’. That would be as misplaced and outdated as the same approach to every individual patient.
Secondly, the adoption of anything ‘new’ follows a few well-known patterns, and understanding these can help. Innovators always go first because something is new; they are driven by the value of new. The rest then follow either because they copy as soon as the new thing looks okay, because they don’t want to seem old fashioned, or even because they have no choice. Adoption goes from leaders, to early adopters, early majority, late majority, and the laggards, in that order. Companies, like people, will fit into one category when it comes to adopting something new, and this can vary depending on the situation. Another adoption pattern is ACCA – Awareness, Comprehension, Commitment, and Action – being aware there is something new, comprehending what the added value is, committing to make that change, and then acting upon that. A third pattern follows maturity. Like children, immature organisations are driven by their own needs: it’s me first. As you grow, you start not wanting to be defined by your own needs and eventually you get to an age where you define who you are, often relying on role models. As adult you know who you are, but you also know what matters more is who you are to others: your contribution to your community. A lot of companies include the patient in their mission statement, but why and how is the patient there? To receive more (‘me first’), to be different (‘I am not you’), or to follow role models (‘I am like X’)? What matters is not only what you write in your mission statement because it’s not (only) about how you define yourself but how others define you based on your actual engagement with them in true partnership. The common value of all three adoption models is that they help you understand where you are, and thus also a little bit who you are, in the adoption process.
Thirdly, human resistance to change is naturally high because change means risk, and ever since we were hunted by tigers in the forest we like to avoid risk. Until today, pharma has done very well by focussing on financial performance and using the innovation-sales model. It takes guts for a leader to say: ‘Let’s try something new’, and this is a big hurdle to get over to achieve patient centricity at all levels of the organisation. My experience over about 30 years is quite consistent: our industry, in general, does not like real change, and we adapt mostly out of necessity, more than because of opportunity. Today, we really need to change.
Where do the biggest problems lie with the communication between pharma and patients? What measures have you executed to amend this?
As the saying goes: the road to hell is paved with good intentions; even with the best intent you can do a lot of harm. We need to create awareness that the patient may not always want what we think they do. We need to go from a push model, whereby I tell you what I think you need, to a pull model, where we sit down together, and I ask you what you want. True listening is the start and the base and means that you want to learn and understand. As we go from push to pull, we can also start moving from transaction to relationship engagements. In our classical transaction model, the patient is seen and treated only as a data or revenue source. To create a relationship, you use four basic principles. STAR: Shared objectives, what do we both want; Transparency, no hidden agendas, what you think is what you say, and vice versa; Accountability, you take responsibility for the quality and results of the relationship; and Respect, respect each other’s needs, speed, and habits. If you have STAR, then you will be a star: you will have trust and trust is the basis for engagement. It is not difficult; but it is very hard!
In a role where success isn’t measured by revenue, how do you best measure your ROI with regard to patient value?
Healthcare is moving from volume to value, from an economic system controlled by input (the more we put in, the more we hope to get out) where health is seen as a cost, to one controlled by output (where we start doing the maximum to reach the objective) and health becomes an asset. Patient value isn’t easy or quick to measure, but for the first time with technology and through standard measurements, we have started to get an idea of what the output is in regard to health. There are three outputs we can measure quantitatively and qualitatively. One: is there a different or better outcome with my intervention versus without? Two: if we can’t get a better outcome (and also if we can) can we give the person a better experience? From making the appointment through to seeing the doctor, there is a lot we can do to improve patient experience. Three: Access! Access to the right diagnosis quickly, to information, tools, support, to the best therapies available, and to love and a social network! Patient value, measured in these dimensions, is the only future metric and criterion for success, and it has the unique power to unite all stakeholders in healthcare, including patients, including pharma.
Finally, if you could go back 30 years, what is the advice you would give to your younger self?
Enjoy every moment even more. As you get older you realise how fast time flies. Don’t stay in things that aren’t good for you. You have to enjoy work because the ride is short. Also, it really is about the people. Even though I am a people’s person I would say focus on the people even more, first my family, then my colleagues. My last piece of advice is: pick your boss well; make it the first and only criterion for accepting a(nother) job. What you do and where you do it is less important than truly having a boss who grows you, who respects you, and who empowers you. And, obviously, then try to be(come) that boss yourself. Looking back on some of the best things I’ve done, they were, as a boss, being able to help certain people grow, and to help them discover and move forward on their path. That is value that stays, well beyond the working relationship.