Michael Wong is an Emeritus Board Member of the Harvard Business School Healthcare Alumni Association.

Michael Wong

For decades, how many of you have read resumes with people proudly mentioning how they are fortunate of being able to work “at the intersection of technology and life sciences/healthcare?” With 2023’s accelerating layoffs across Fortune 500s, including Verily Life Sciences’ (an arm of Google's parent company, Alphabet) recent 15% staff reduction, these are challenging times for our readership. To learn more about potential practical steps for your career sustainability, please see Jasmin Patel’s (Senior Partner at a-Connect) thoughts in this latest Harvard Business School Healthcare Alumni Association Q&A.

Michael Wong: Although we are only days into the New Year, massive layoff announcements—including Amazon’s 18,000 targeted reduction and Salesforce’s 10% restructuring—have created angst across Fortune 500 workforces given how these firms had successfully performed over recent years. With many of my bio-pharma colleagues still recalling their respective firms’ pipeline droughts and associated downsizings in the past decade, what do you see on the career landscape for them in the next 11 months?

: Firms have had a rough year—Roivant announcing laying off 12% of their employees and Novartis plans to lay off more than 7% of their global workforce, to name a few. Given my conversations with industry executives, candidly, 2023 will most likely be a challenging year with the spread of cost constraints and more headwinds across other pharma and biopharma. Of relevance to your US-based readers, global employers have become increasingly comfortable with shifting operations from North American and European locations to Asia Pacific (APAC) countries. As global workforces engaged remotely quite effectively during the COVID-19 pandemic, past C-suite assumptions around tapping into emerging economies for highly skilled workers at lower costs have changed.

With these factors in play, your friends should make sure that their 2023 efforts have a clear line of sight towards creating tangible value and impact via their upcoming projects/initiatives. While achieving timelines and crossing stage-gates are important, each initiative should also craft upfront an aspirational Amazon-style Future Press Release summary that includes the pain points, solutions, and benefits that the project team seeks to secure; once the initiative is completed such communications should be conveyed internally (eg., via Slack, Teams, company newsletter). Of equal importance is the ability to build personal connections in a workplace that continues to change. Per some of a-connect’s research, “…We have experienced, across the board, that the challenges of wherever, whenever and however seem to be easier to overcome than those of whoever, as building new relationships remains a key area of concern.”

Given your years working directly for Novartis, what three career advice recommendations would you share with co-workers of the past as well as clients of the present day?

First, always expect the unexpected. While the past months of massive reorgs occurring across several Fortune 500s including bio-pharmas, can be stressful, I would encourage the readership to view such changes as opportunities masquerading as challenges. For instance, not too long ago, if you were a hiring manager, you were likely stressed about attracting and retaining top talent during the Great Resignation. In 2023, the current upheaval represents a unique opportunity to hire top tech talent into your firms. Just as I never imagined some 20 years ago when I was studying at Wharton that I would one day commence a decade-long journey working abroad across Switzerland and Asia; your readership should adopt an agile mindset to embrace changes that they cannot visualize today.

Second, similar to the “ABC” adage of “Always Be Closing,” I would recommend that your readership “ABN,” that is “Always Be Networking.” Especially if you’re in the enviable position of being gainfully employed, invest ahead of the cycles to help others, including colleagues in your current network, as well as contacts of the past from schools and prior jobs. It’s not only the right thing to do, but is a good way to build and maintain relationships which in turn may create future opportunities.

Finally, recognize that careers are no longer the straight path that was the norm for the Baby Boomer generation when someone may have journeyed along a 35+ year playbook of roles at Merck or J&J. Crossing sectors, like I did, starting in strategy consulting, then to Big Pharma, followed by Private Equity and now back in consulting, not only provided terrific learning and personal development, it was also a lot of fun. And so, for those bio-pharma readers who work side by side with consultants and always wondered about this career path, do scan the materials that I had co-presented at the 2018 HBS Healthcare Alumni Association panel event which are still relevant.

 You may very well decide that becoming an independent consultant is how you navigate through your next set of career moves!

https://a-connect.com/knowledge/looking-ahead-a-path-to-continued-professional-renewal/

https://a-connect.com/knowledge/bryn-mawr-panel-discussion-on-gig-economy/

Jasmin Patel is a Senior Partner at a-connect, the consultancy that pioneered the networked consulting model, engaging with 600+ independent consultants in the US and 2,400 across the world to advise and support a broad range of clients on some of their most pressing business challenges. Jasmin’s prior experience includes roles as Managing Director for Fidelity Growth Partners India, Chief Operating Officer of Novartis India, and Engagement Manager at McKinsey. Jasmin received a PhD from Duquesne University and an MBA from The Wharton School at the University of Pennsylvania.


Michael Wong is an emeritus board member of the Harvard Business School Healthcare Alumni Association.

Articles

Jasmin Patel of a-Connect provides insight on how to navigate the ebbs and flows of employment. 




Navigating One’s Bio-Pharma Career through 2023’s Turbulent Job Markets

Michael Wong: At the November 2022 HBS Healthcare Alumni Association’s annual conference,

 a spirited debate around the Inflation Reduction Act of 2022’s likely impact on prices and new medicine development took place; and although there were strong opposing views of a path forward, it was clear that change must occur within our healthcare ecosystem.

While long-term value might be the ultimate goal, short-term budgets have a finite set of dollars that need to be wisely allocated across a set of initiatives, be they in healthcare or other worthwhile but competing initiatives. As might be expected, emerging technologies are often seen as a panacea, but given your dual role as a practicing physician and business executive, what are pragmatic solutions for 2023?

Artificial intelligence (AI) is a frequently referenced panacea, so let’s start with some basics. AI is the simulation of human intelligence in machines programmed to think and work like humans. Other referenced elixirs like machine learning, deep learning, natural language processing, and big data are all branches of AI. As for the potential that AI might have as a useful tool in health care and the medical research space, some include:

AI algorithms are “taught” to identify and label data patterns, while NLP allows these algorithms to isolate relevant data. With deep learning, the data is analyzed and interpreted with the help of extended knowledge by computers.

Many aspects of healthcare include elements of prediction, including diagnosis, treatment, administration, and operations.

One value proposition, whether I’m wearing my physician hat or executive one, is time savings. AI has the potential to streamline the notetaking process and admin tasks so physicians can focus on patients instead of their computers. Also, with AI able to analyze large amounts of data stored by healthcare organizations in the form of images, clinical research trials, and medical claims, it can identify patterns and insights often undetectable by manual human skill sets of clinicians or business professionals. I would note that despite well-intended forays into this space by many well-known Fortune 500s, the healthcare ecosystem is extremely complex, and various exits have taken place.

The good news is that progress in this area has occurred, and a specific example that comes to mind is a collaboration between the VA and DeepMind Health.

Acute kidney injury (AKI) can be difficult to detect by clinicians but can cause patients to deteriorate extremely fast and become life-threatening. With an estimated 11% of hospital deaths following a failure to identify and treat patients, the early prediction and treatment of these cases can have a huge impact on reducing life-long treatment and the cost of kidney dialysis.

In 2019, the Department of Veterans Affairs (VA) and DeepMind Health created an ML tool that can predict AKI up to 48 hours in advance. The AI tool identified more than 90% of acute AKI cases 48 hours earlier than with traditional care methods.

The logical follow-up question is if this is something that might be expanded to other life-threatening illnesses. Moreover, how might bio-pharma firms collaborate with home healthcare providers to see if an offering might be made available at the patient’s bedside or even potentially monitor the patient continuously at home (e.g., through a smartwatch)? With some predicting recession headwinds in 2023, strategic bio-pharma and home healthcare providers might consider collaborating and pooling their expertise and limited budgets to create scalable AI offerings for 2023.

Given your engagement with leading academic and business entities, what are your 2023 predictions for AI bringing meaningful impact for patients and the organizations which serve them?

It’s commendable to see many organizations pointing to how their AI efforts are striving to accelerate the discovery and development of new medicines, but the decades-long challenge of having diversity in clinical trials continues. Introducing automation might help bring efficiency gains for these firms, but the pain point of increasing diverse patients in their trials continues.

Strategic bio-pharma organizations will figure out how to collaborate with other entities for creative new ways to recruit and enroll such patients. For instance, I serve as a board member with Walmart Mexico and Central America, where in the US, the retailer Walmart has a store that is within a 20-minute drive of 90% of the US population. With the launch of Walmart Healthcare Research Institute SM (WHRI), the company is planning to increase community and equitable access to 

. Together, the firms will need to determine an engagement model built upon trust so potential enrollees can make an educated choice.

Finally, at least in principle, new technologies like machine learning can provide unbiased predictions based only on the impartial analysis of the underlying data. However, the logic used to generate a medical result or recommendation needs to be shared instead of developed in a “black box.” These change management efforts are often dismissed for strategic initiatives, so one should consider how to ring-fence limited investment dollars accordingly.

https://www.hbshealthalumni.org/s/1738/cc/21/page.aspx?sid=1738&gid=11&pgid=77789&content_id=11020

Dr. Liz Kwo is the Chief Medical Officer of Everly Health. Before joining Everly Health, she served as Deputy Chief Clinical Officer for Anthem, VP and GM of Provider Networks at American Well, and Entrepreneur in Residence at Harvard Medical School's Office of Technology Development. Board Certified in Preventive Care and Occupational Medicine, Dr. Kwo remains active as a practicing physician at Cambridge Health Alliance, of Harvard Medical School. Dr. Kwo has an MD from Harvard Medical School, MBA from Harvard Business School, MPH from Harvard TH Chan School of Public Health, and a BA from Stanford University.

Michael Wong is an emeritus board member of the Harvard Business School Healthcare Alumni Association.

Dr. Liz Kwo of Everly Health outlines 2023 predictions for AI, including how it can be beneficial to patients

Creating Scalable Solutions in a Cost-conscious Healthcare Ecosystem 

Michael Wong: While a recent Fortune survey pointed to how executive compensation at 73% of S&P 500 companies is now tied to environmental, social, and governance (ESG) performance,

 what should their C-suites be doing to keep their teams focused on these initiatives when there are many internal competing projects? After all, with several economists predicting a recession in 2023

 many employees are rightfully concerned about their own jobs.

 Sustainability is fundamental, not only to the health of the planet, but to the health of our society and people. At AstraZeneca, we are harnessing the power of science and partnership to accelerate the delivery of sustainable healthcare.

Integrating sustainability into everything that we do now in fact future-proofs our business. For AstraZeneca, that means taking action across our three interconnected sustainability priorities: Access to healthcare, Environmental protection, and Ethics and transparency. Each of these is in turn underpinned by three focus areas, which are the ESG issues that matter most to AstraZeneca and our stakeholders, but also where we can have the most positive impact. To ensure we are making a difference, leaders need to drive awareness and understanding of these realities and encourage their teams not to be too short term in their thinking, helping them understand how the actions they take today ladder up to the long-term sustainability strategy.

While our sustainability ambitions stem from our shared Values, including “We do the right thing” and “We follow the science,” which serve as a compass to guide us in all that we do, we should not forget that sustainability also offers a competitive advantage. Sustainability is increasingly important from a business and broader economic perspective, with a sustainable business model expected by our investors and our employees and partners. At the same time, sustainability is increasingly demanded by future employees, especially Generation Z and Millennials. Research suggests that a strong sustainability proposition can create value through (1) facilitating top-line growth, (2) reducing costs, (3) minimizing regulatory and legal interventions, (4) increasing employee productivity, and (5) optimizing investment and capital expenditures.

Action on climate is becoming ever more important to our stakeholders, with the wider healthcare system beginning to look to deliver patient-centric, net-zero healthcare. AstraZeneca is part of the Scope 3 emissions of healthcare providers; we are part of their purchased goods and services footprint. Through our bold, science-based greenhouse gas emissions (GHG) reductions commitments and actions, we are well positioned to take advantage of the business opportunities presented by the increased demand for products and services with a lower GHG footprint. For example, the NHS

 has established targets to procure medicines only from suppliers with climate targets aligned with, or more ambitious than their own, and they have goals to reduce the footprint of respiratory products by 50% over the next seven years. AstraZeneca’s transition to next-generation propellants with a near-zero global warming potential within our Ambition Zero Carbon strategy is not only reducing our GHG footprint, it is also mitigating some of the transition risks we face in the market and will protect our revenue.

Our global scorecard plays an important role in rallying employees around our sustainability ambitions, goals, and purpose. This tool articulates strategic priorities for the upcoming year for the company as a whole and is designed to track our progress against these objectives. Sustainability and “being a great place to work” are built into our global scorecard and growth strategies. Executives are measured against specific elements of the strategy. The scorecard cascades down from the Senior Executive Team to markets and functions, where it is translated into local priorities. For example, in many countries, our front-line sales reps have moved to or are in the process of moving towards an entirely electric fleet. In the BeLux marketing company, during our recent national sales meeting, we made use of digital materials and tools only and dedicated a Townhall session to sustainability just a couple of months ago. The latter served to illustrate to employees how sustainability is part and parcel of their day-to-day activities, rather than an add-on.

To support our employees in delivering on our shared sustainability goals, we have also developed several internal communications tools. For example, in 2022 we launched a “Science Can” sustainability campaign,

 targeting both internal and external audiences. Through brainstorming sessions, the campaign aimed to spark conversations around what sustainability means for AstraZeneca, as well as increase understanding of how each of us can make a difference. The internal “We can” crowdsourcing activation enabled teams to identify actions they can take to help us deliver our sustainability agenda. Teams will subsequently implement these actions into plans and objectives for the coming year. We believe grassroots ideas, at an individual, team, site, or market level, have the power to change things— where even seemingly small actions can add up to make a real difference.

Our enterprise-wide “Pulse survey” is another tool that facilitates discussion on the topic of sustainability, and measures progress. A bi-annual employee survey, Pulse gauges employees’ understanding of their individual contributions to AstraZeneca’s sustainability priorities. The latest global results indicate that 87% of our employees have good insight into the role they can play in advancing our sustainability priorities.

With most S&P 500 C-suites and their direct reports representing a small percentage of the total employees employed, what three specific recommendations do you have to help convince the rank and file that ESG can be of value to their individual long-term career prospects?

Firstly, sustainability is a topic of increasing interest across stakeholder groups—from the patients, and customers we serve, to our employees, investors, payors, and policymakers. By adopting a strong sustainability mindset, employees are more likely to be successful in their roles and stakeholder engagements. With sustainability shifting from a ”nice to have” to a “must have,” an understanding of ESG is crucial for long-term career prospects.

Secondly, it is key to focus on inclusion and diversity (I&D), which in addition to creating a “sense of belonging” for employees, brings creativity, enables continuous learning, and supports the growth of both individuals and the company. An inclusive and diverse workforce, empowered to challenge conventional thinking, is key to unlocking breakthrough ideas and fostering innovation, which is so critical in the healthcare field. An analysis by McKinsey,

 for example, suggests that the most diverse companies are more likely to outperform less diverse peers on profitability. Similarly, a strong sustainability commitment contributes to a more engaged workforce.

The latter, in turn, is linked with better business performance and higher share prices.

Finally, prioritizing sustainability requires a broad skillset. For example, it relies on foresight and long-term planning, as well as cross-functional collaboration within and outside an organization. Being part of a sustainability-driven organization can help employees develop a skillset that is highly valued in an increasingly interconnected world, where building a healthy future for society, people, and planet, is of the utmost importance.

Executive compensation at 73% of S&P 500 companies is now tied to ESG performance, survey finds

https://www.gzeromedia.com/gzero-world-clips/whats-the-chance-of-a-global-recession-in-2023

Technology Layoff spree in Silicon Valley spells end of an era for Big Tech

https://www.mckinsey.com/~/media/McKinsey/Business%20Functions/Strategy%20and%20Corporate%20Finance/Our%20Insights/Five%20ways%20that%20ESG%20creates%20value/Five-ways-that-ESG-creates-value.ashx

https://www.england.nhs.uk/greenernhs/a-net-zero-nhs/

https://www.astrazeneca.com/what-science-can-do/topics/sustainability/driving-sustainability-in-healthcare.html

https://endpts.com/astrazeneca-links-climate-change-and-human-health-in-new-corporate-science-can-campaign/

https://www.mckinsey.com/featured-insights/diversity-and-inclusion/diversity-wins-how-inclusion-matters

https://www.thecorporategovernanceinstitute.com/insights/guides/esg-can-help-companies-attract-and-retain-talented-people-esg-creates-a-happier-workforce/

https://www.wtwco.com/en-BE/Insights/2021/05/why-is-employee-engagement-important

Keira Driansky is Country President, Belgium & Luxembourg, for AstraZeneca. She is a graduate from the Harvard Business School, Yale University, and the University of Cambridge where she was a Marshall Scholar.

Michael Wong is an emeritus board member of the Harvard Business School Healthcare Alumni Association

A Q&A with AstraZeneca’s Country President for Belgium & Luxembourg, Keira Driansky

Driving ESG through 2023’s Economic Headwinds 

While firms have the best intentions to deploy emerging technologies into their workplaces to drive innovation, the probability of failure is high. With McKinsey’s 2020 research pointing to how CIOs reported that 10 to 20 percent of their technology budgets dedicated to new products is diverted to resolving issues related to tech debt; in this Harvard Business School Healthcare Alumni Association Q&A, Dr. Troy Sarich, shares his team’s strategies to overcome such odds.

Michael Wong: With your responsibility to lead Janssen’s global commercial capabilities across Data, Data Science, RWE, Precision Medicine, and Digital Health to grow the firm’s $50+ billion worldwide commercial pharmaceutical business, how does your team minimize this continued pain point that permeates across several Fortune 500s?

Investment in any digital capability is a major strategic consideration and requires a relentless focus on the problem to solve—so that technology efforts are strategically aligned. For us, it’s a balanced commitment to grow capabilities that inform and accelerate innovative health solutions—across our entire company.

As Jennifer Taubert, J&J’s Executive Vice President who leads our global pharmaceutical business, shared at your alumni group’s 2018 annual conference,

 our pharma franchise is focused on building strong enabling functions to utilize analytics for decision making, using integrated data and digital tools. My team at Janssen is the tip of the arrow when it comes to analyzing potential new technologies that could be commercially deployed to drive business value.

We prioritize which business pain points should be solved. In other words, we take a problem-first—versus a technology- or tools-first—approach to ensure we’re laser focused on the areas where digital- and data science-driven solutions can have the biggest impact.

We also take a broad collaborative approach across the J&J company; we work with J&J’s Technology group, Janssen R&D, our Janssen regional businesses and beyond, to identify potential new data science and digital health solutions that support our $50B+ pharmaceutical business. We plan, in partnership with our regional business leaders, for 12 to 24 months of capability building so that we are well positioned for production level deployment and success.

We scan internal and external landscapes to make sure every investment is tracking on target to deliver outcomes and, ultimately, impact for patients.

During my consulting days with bio-pharma firms, digital transformation was a common theme across

the C-suite agendas. Yet per my conversation with a leader of the MIT Center for Information Systems Research, she shared findings which revealed that some large companies are securing only 5% of their revenues from new digital value propositions.

 Based upon your team’s experience with supporting J&J’s pharma growth engine, what are the top recommendations for readers to consider as they strive to convert digital ideas into realized revenue?

We know that our success is dependent on bringing to market highly innovative pharmaceuticals that improve the lives of patients. We don’t view digital assets as a separate business—rather our approach to digital solution investments is an integrated one, linked directly to helping support and expand the impact of our pharmaceuticals. A key success criterion is to be able to scale such innovations across the marketplace where our pharmaceuticals exist.

Having a framework of key operating principles is essential so that your entire organization becomes familiar with the criteria that should be met prior to investing. Some key operating principles include thorough analysis of value creation and long-term ownership.

: What value does the tool create—such as medical benefits for patients like earlier disease diagnosis or helping patients stay on their therapy longer? What value might be derived from healthcare data captured that can provide key patient insights at the same time it protects privacy? Is there a patient-facing tech solution that enables us to understand their behaviors and change our future go-to-market strategies/engagement plans?

 Who will own the longer-term technical support and quality assurance of the tool? What would be the ultimate value proposition for leaders to maintain a project’s long-term operational support? While failing fast might be a popular mantra in today’s agile world, to ensure long-term impact, it’s critical to focus on ring-fencing future funding to ensure the success of the winning ideas.

https://www.hbshealthalumni.org/s/1738/cc/21/page.aspx?sid=1738&gid=11&pgid=61679

https://www.pharmexec.com/view/planning-ahead-dr-jeanne-ross

Dr. Troy Sarich is Chief Commercial Data Science Officer, The Janssen Pharmaceutical Companies of Johnson & Johnson. He received his PhD from the University of British Columbia and attended J&J’s Strategic Leadership Program at the Harvard Business School.

Dr. Troy Sarich of Janssen reveals the company's approach to tackling financial challenges as they pertain to tech

Investing in Success

 a spirited debate around this year’s Inflation Reduction Act of 2022’s likely impact on prices and new medicine development took place; and although you were not even at the panel,

 your company was brought up during the concluding comments. Why do you think your recent 2022 efforts have garnered so much attention when there have been so many other ideas proposed to solve this long-standing challenge of safe and affordable medicines for communities?

You don’t need a degree from Harvard to understand the simple and transparent business model that my start-up has deployed. As a public-benefit corporation (PBC), our social mission of improving public health is just as important as the bottom line. We've built a vertically integrated supply chain to transparently charge a standard markup on every drug we sell. For instance, we charge $47 a month for Imatinib (Gleevec®), a common leukemia medication which typically retails for more than $9,600 a month or, with a drug voucher, would cost roughly $120 a month.

Our medications are available directly to patients or through our 

. To date we have nearly 1,000 of the most highly utilized and/or most high-cost generic medications in our pharmacy and so it is not surprising that over 1.2 million people have created accounts with us.

As for why I think there has been so much attention; it is the huge potential impact and value that our company can potentially create. For instance 3rd party researchers have shared their objective viewpoints; such as the Annals of Internal Medicine which suggested that Medicare could have saved 

 a year had it purchased generic drugs from Cost Plus.

Well, biopharma firms seem to be under constant scrutiny, but how about the value that they provide, like they did with the fast response to creating products to combat COVID-19?

I am not challenging the value that new innovative medicines can bring to solve ailments. However, disruption is needed when there are clear inefficiencies in the market. For instance, one report shared how the CBO estimates that the drug pricing provisions in the Inflation Reduction Act law could reduce the federal deficit by 

Still, as the provisions show how some of the price changes don’t take place until 2026 and thereafter, my company provides value now, in 2022. Last month, we announced that Capital Blue Cross will be the first health plan to partner with us. To secure a better understanding of our business model, check out 

 interview and hopefully your readers will enjoy it as much as they like seeing me on Shark Tank!

All kidding aside, the current state of the overall healthcare ecosystem needs to be disrupted in America. According to a 2021 Cost of Care Survey by Genworth, a private room in a nursing home costs $297 per day, or $9,034 per month. So just imagine what this could mean for your sandwich generation alums who not only might have tuition payments for kids in college and private school but also six-figure payments for a parent per year if their parent(s) do not have such insurance. These are big numbers that even many of your alums might not be able to handle if disruption doesn’t happen soon.

Mark Cuban is an entrepreneur, television personality, and media proprietor. Besides being the owner of the Dallas Mavericks of the National Basketball Association (NBA) and one of the main investors on Shark Tank, Mark recently launched his “Mark Cuban Cost Plus Drug Company” to disrupt the pharmaceutical industry and provide complete price transparency from manufacturing to prescription delivery.

https://www.hbshealthalumni.org/s/1738/cc/21/page.aspx?sid=1738&gid=11&pgid=77789&content_id=110204

2. file:///C:/Users/michael.wong/Downloads/Agenda-Boston-Conference%20November%208%202022%20(2).pdf

Medicare could’ve saved $3.6 billion by buying drugs at same prices as Mark Cuban’s online pharmacy, according to a new study

https://www.kff.org/medicare/issue-brief/explaining-the-prescription-drug-provisions-in-the-inflation-reduction-act/#bullet02

https://www.markcubancostplusdrugcompany.com/

A Harvard Business School Healthcare Alumni Association C-suite Q&A with Mark Cuban, Cost Plus Drugs co-founder



Disrupting the Pharmaceutical Industry

While 6% of Harvard Business School’s Class of 2021 joined the healthcare sector, their peers continued to flock to professional services, with 23% going into consulting.

 In this, Michael Wong’s latest Harvard Business School Healthcare (HBS) Alumni Association Q&A, Professor Laura Empson, senior research fellow at the Harvard Law School, pulls back the curtain on insecure overachieving professionals and explains how they can come to accept damaging patterns of overwork as inevitable and even desirable. With her research findings, Professor Empson provides important insights for the various stakeholders—those who are and those who hire these high-achieving professionals.

Michael Wong: When I asked an HBS alum who had

often seen as the Holy Grail for elite business school students, what the difference was between working for a consulting firm versus a premier Fortune 500, she explained, “Expecting someone to work 16-18 hour days, for weeks on end, to deliver a desired result is not going to be as readily accepted in a corporation as it may be at some professional service firms, since that is frankly not what they signed up for.”

 Professionals who join consulting, investment banking, private equity, or other professional services firms know what they are signing up for, so what is the problem? After all, like the Class of 2017, nearly a quarter (23%) of last year’s HBS graduating class pursued consulting.

 From my research, I have identified how the inclination to overwork and burn out is framed by a complex combination of factors involving our profession, our organization, and ourselves. At the heart of it is insecurity—both personal and professional. Exacerbating this problem, some elite professional organizations deliberately set out to identify and recruit “insecure overachievers”— exceptionally capable and fiercely ambitious individuals, who are driven by a profound sense of their own inadequacy. In the past, firms such as McKinsey and Goldman Sachs have been explicit about their policy of recruiting and promoting insecure overachievers—though given the new societal emphasis on work-life balance, the rhetoric of elite professional firms has become more circumspect.

 Firms want to hire these kinds of people because, in the short term, insecure overachievers respond by delivering exceptional performance. The problems start when these elite firms reinforce this sense of insecurity through their tournament model of promotion and their mechanisms of social control. Paradoxically, such professionals still believe they have autonomy and are therefore consciously choosing to overwork. They do not blame their firms for driving them too hard but blame themselves for being inadequate in needing to work such long hours to get their job done. Subsequently, by the time insecure overachievers become leaders of their organizations, they unconsciously replicate the systems of social control and overwork that have enabled them to rise to the top.

Elite professional organizations offer insecure overachievers the security of exceptional psychic as well as financial rewards: i.e., they can enjoy the comforts of being associated with an elite organization and are able to incorporate this elite status into their own identity to counteract their sense of insecurity. Their actions demonstrate how the ‘comforting’ social control mechanisms embodied in strong cultures can translate into cult-like conformity among senior professionals. The outcomes are often the dark side of social control and its most typical manifestation—overwork.

Employees are, therefore, willing to routinely work 70+ hours and in some cases 100+ during protract “crunch” periods, in exchange for highly compensated and coveted roles. But they may not be aware of the talent management strategies that underpin this? One Director of HR of a world-leading professional firms explained to me her firm’s policy of deliberately seeking graduate recruits who fit the profile of insecure overachievers. She explained for insecure overachievers, a job offer from her firm provided them with the comfort of knowing “you are special because we want you to be one of us.” Once they had absorbed the status of the firm into their own identity, they would be willing to “do anything” to remain part of the firm.

I have warned some of the recent college graduates with whom I have worked over the years, who were interested in pursuing an MBA and then a career in professional services, that the 50 to 60+ hours/week they were clocking in at a Fortune 500 still provided some work-life balance. Once you hit 80 hours,

your weekends are shot and while the compensation might be great, you likely will not have time to enjoy it. Can and will professional services’ ecosystems ever be changed so that firms and employees have a challenging but healthy workplace model?

To begin with, not all professional services operate in this manner and others have recognized that it is unsustainable and are struggling to change. But, to undo this unhealthy relationship between the professionals and their organizations, change needs to happen at multiple levels.

For professionals, especially those who can admit that they are insecure overachievers, the most important aspect is to understand the effect that your own behavior and your employer’s attitude is having on your physical and mental states. The perpetual anxiety, which is a common theme expressed by my interviewees, displays itself in terms of how people struggle with the sense of never being good enough. Rather than simply feeling inadequate in their role (i.e., imposter syndrome), they try to make this feeling go away by working ever harder, to ensure that they “deserve” their success. But instead, their success may simply amplify their feelings of insecurity, as I explored with the professionals I interviewed for my BBC documentary on insecure overachievers.

 As one very senior lawyer said to me, when talking about him and his fellow partners, “We all feel scared, all of the time.” And, as they became overly attached to their elitist organizations, they succumb to the peer pressure from their colleagues and their culture. The irony is that very wealthy and successful people, whom you might expect to have relatively high autonomy and control over their lives, may end up feeling that they have no choice.

Second, for senior executives of professional services firms who have survived and thrived in this environment and risen to the leadership positions, the pandemic and Great Resignation have provided a unique window of time to reflect on their organizations’ cultural controls and operating models. While an 80+ work week may still be a norm at many of these firms, the pandemic has prompted many professionals to question some ”legacy” assumptions and enabled them to experiment with alternative ways of working. When I was a strategy consultant, on occasion I worked 72 hours without sleeping in order to respond to the partner’s requests ahead of a client presentation. Was I really doing my best work? Of course not. Could the partner have managed me and the client better? Of course, he could. While there are no simple solutions to the changing and conflicting sets of expectations of clients, leaders, and their professionals, smarter leaders understand the potential value of rethinking the work that their firms perform and how their employees do it.

Finally, buyers of professional services should reflect upon their behaviors and what the potential ramifications might be. As part of their increased awareness of ESG issues, many are reflecting upon the consequences of the purchasing patterns. They may examine their supply chain carefully to ensure they are not conspiring in the bad working practices in “sweat shops” in developing countries. Yet, just because they pay the professionals in their home markets very well, they ignore the more negative consequences of their expectations.

 last year, the pandemic represents a liminal phase in our economic and organizational development. We have been tested to our limits.

 Still, these experiences have offered opportunities to challenge not only historical norms within our professional organizations but also to create new and more sustainable ways of working.

Professor Laura Empson is a Senior Research Fellow at the Harvard Law School and Professor in the Management of Professional Service Firms at Bayes Business School, London. Professor Empson received her PhD and MBA from the London Business School.

https://www.hbs.edu/recruiting/employment-data/Pages/default.aspx

 (Private Equity was 14%, Venture Capital was 7% and Investment Banking was 4%).

2. Interview with HBS alum Katherine Bach Kalin, 

https://www.hbshealthalumni.org/s/1738/cc/21/page.aspx?sid=1738&gid=11&pgid=252&cid=123957&ecid=123957&crid=0&calpgid=2677&calcid=78391

What happened to Goldman Sachs? An insider’s story of organizational drift and its unintended consequences

http://www.ft.com/cms/s/2/0d506e0e-1583-11e1-b9b8-00144feabdc0.html 

eading Insecure Overachievers: The Comforts of Social Control,” In Empson, Laura, 

Leading Professionals: Power, Politics and Prima Donnas,

5. 12 hours/weekday and 10 hours each weekend day.

https://www.lauraempson.com/insights/insecure-overachievers-on-the-record

7. Empson, Laura and Howard-Grenville, Jennifer, “How Has the Past Year Changed You and Your Organization?” 

Professor Laura Empson pulls back the curtain on insecure overachieving professionals and explains how they can come to accept damaging patterns of overwork as inevitable and even desirable