Working Life: Dr Todd Hobbs, Vice President and Chief Medical Officer, Novo Nordisk

Novo Nordisk's VP and CMO discusses his leap from family medicine into the pharma industry, his biggest achievements, and how having diabetes himself has shaped his outlook on treatment throughout his career.

You are a trained medical doctor; how did that shape your early career?

I knew I was going to be a doctor from a young age – I had several family members who are physicians. When I got into medical school and was trying to decide on a specialty, I think I realised right away that I liked a lot of variety and that I didn't want to be in a specialty that was not that different from day to day. The variety of seeing children and adults of all ages, male, female – that's what actually drove me to decide on family medicine in the US. I then did a residency and I began my own practice in family medicine. Based on my own personal history of having diabetes, it quickly became what I really enjoyed the most and where I felt I was helping the patients the most. I then decided after a few years that I was going to focus only on diabetes patients. It really did drive pretty quickly; it was very busy and I had several thousand patients at our clinic and in the hospital. It was very rewarding to do that.

So why the switch to the pharma industry?

The unfortunate part is that in the US, and particularly in a primary care type of practice, you're not given that much training on the business side of running a practice. It was just really challenging: basically, seven days a week, 365 days a year, I was coming into the office or hospital and seeing patients there, coming to the clinic and trying to see new patients that that I needed to see, as well as talking to my practice manager who was advising on how to manage the business side of running a busy diabetes practice. That was not something you prepare for in training.

Because of my unique background, as a family doctor in diabetes, I started doing talks for other doctors around the country, and there were several companies that I spoke about based on what I was using myself – insulin pump companies, and also Novo Nordisk from whom I was using NovoLog insulin. Out of that, Novo approached me for a field role that was similar to what we would now call a medical liaison. It was a not an easy decision and I really felt torn leaving my practice and the patients that I had cared for and their families, but I also saw that opportunity to hopefully help more patients, and to interact with some of the top thought leaders in diabetes that I had met or read about; now I was actually going to get to meet them and work with them. That was what kind of clinched the decision for me and I think most would agree it's been a pretty good decision.

You mentioned that you have diabetes yourself; do you think that has helped shape your chosen career path?

Oh absolutely. Certainly there are days where things are challenging and we're doing something that is maybe not the most enjoyable, but I really don't look at most days that I'm with Novo Nordisk as work. I have a son now that has type 1 diabetes along with all my 30 years of diabetes, and it really is enjoyable, and that's the odd thing, because when I was in med school, I didn't think I wanted to go into diabetes because it's a reminder that I have the condition, that I have to think about it every day. Actually, it's been sort of what has driven me: that things are changing, the innovation, some of the new things we're doing and the advances that are being made - it's exciting. And that has actually been the opposite of what I thought it would be. It's helped me to more or less understand what many different individuals are going through; I was a patient as a teenager, obviously; I have a son with diabetes so I kind of understand what parents would go through; I was a clinician for 10 years so I understand the challenges in the clinic. It has absolutely helped and influenced what I've done throughout my entire time with Novo and almost every day.

You've had quite a clear progression within Novo Nordisk; what do you think is the secret to your success?

When I first started residency, I had a really good mentor and they said: 'you're going to see doctors that come in here and think that they're smarter, better or know more than everybody in the clinic. What you need to remember is that the most important people are the nurses that are taking care of your patients, and you should treat everybody on the floor with the same respect.' I think I took that to heart. It does apply now: you see individuals that get into leadership positions, it's not about managing or directing as much as trying to lead a team. I think you have to treat everyone with respect and also appreciate their position. You see physicians that try to jump to industry, and the ones that aren't successful are the ones that still maintain 'I am the physician and I make good decisions, and I have to make the important decisions for this patient.' They're having a hard time fitting into a team or reporting to someone else.

I think there was certainly a time period in the beginning where there was an adjustment to that, but I think I had really good mentors and others that guided me. They taught me to know when to be confident about your skill, but also when you need to partner with others. A clear example is the constant push between medical and commercial; they don't have to be completely against each other, but you do also have to understand where the data that is generated around a product is going to be used, and where the commercial side of things are going to go, and where you can help with that where possible. You need a clear understanding that you have to be part of the team, everyone has a voice, and not being afraid to lead when you need to make decisions, but by example more so than leading by just position or power.

You've been with the company almost 15 years. What's kept things interesting through all that time?

In my practice, I wanted every door that I opened to have some new challenge. There's always change in the biopharmaceutical industry, and when you look at the roles that I've had at Novo, it's been a constant set of new challenges or new changes. I did not appreciate this until I got into my career with Novo Nordisk, but you have to keep learning every day. When you're at college and med school and you're thinking about being a doctor, you think that you're going to finally know everything, and when the patient comes to you, you're going to have all the answers and you're going to be able to help them. Now I kind of laugh because, no, you have to continue to learn, because what we know changes so quickly and we have new advances. I'd say that you have to really embrace change and you have to be ready for it, because it can be a good thing: you can learn new challenges, new skills, and you can offer your leadership in times when people might need it, when they're going through change. So that's been really nice of Novo to give me the opportunity to really learn and grow with the company.

What major challenges have you faced throughout your career, and what did you learn in overcoming them?

I was brought into the home office from the field to work specifically on Tresiba, or insulin degludec, at the time before it was approved. I was part of this bigger team; we all sat together and we trained over 4,000 individuals on the data, getting them ready to launch. Then we received a complete response letter from the FDA, I think literally a few days after I got back from this training, and it was quite unexpected. It was a gut punch; you're like: 'wow, this has changed everything, what are we going to do?' We turned around a trial design from the FDA to begin patient recruitment for a large cardiovascular outcomes trial literally within a matter of months, and got that executed. Two years or so later than we really wanted, we got the approval for Tresiba, and to see that through was quite rewarding. I look back and some of my most important lessons that I've learned in the past 15 years came through the challenges of that complete response letter. Now, hopefully, I can use that as we face challenges again, or I can advise other leaders in the company that are facing similar challenges. In hindsight, it was a tremendous learning experience.