Movers and Shakers in Medicine By Dr Manju Sheth
(In this edition of Movers and Shakers in Medicine we present Dr. Brian Pereira, an outstanding physician who has combined his medical knowledge with exceptional entrepreneurial skills to turn around corporations and organizations. A successful writer, editor and an inspiring leader, he is known to push people to realize their true potential.)
Brian J. G. Pereira, serves as Chairman of the Board of Biodel, Inc. (NASDAQ:BIOD) and Chairman of Board of the Harvard-MIT Biomedical Enterprise Program. He is Professor of Medicine at Tufts University School of Medicine, the Sackler School of Graduate Biomedical Sciences, and the Tufts Clinical and Translational Research Institute. He is also an honorary Professor at several universities worldwide. He has more than 200 publications to his credit, delivered more than 500 invited lectures, served on the Board of more than 12 scientific journals and has edited the widely read textbook “Chronic Kidney Disease, Dialysis and Transplantation”.
He has served as President and CEO of AMAG Pharmaceuticals, President & CEO of the physician corporation at Tufts Medical Center, and interim Chief Operating Officer at Tufts Medical Center. He was the Past President and member of the Board of the National Kidney Foundation. He serves on several boards including the Harvard-MIT Health Sciences & Technology (HST) Program, Board of Youth That Care, Inc and American India Foundation. He is a member of the Board of Directors of NephroPlus and has served on the Board of Directors of Satellite Healthcare Inc, Tengion Inc, Aksys Inc, SomRx Inc, Advanced Renal Care Systems Inc, and others.
He has an MBBS from St. Johns Medical College in Bangalore, MD in Internal Medicine and DM in Nephrology from the Post Graduate Institute in Chandigarh.
From his high school days it was very obvious that he excelled in every subject and thus choosing a career became difficult. “It was a tough to make a career choice when I finished grade 12. I loved math and physics, got the best score in Karnataka State and was admitted to all the medical and engineering schools, including IIT. Unfortunately, in those days, there were a large number of unemployed engineers and thus a medical career seemed safe bet,” says Pereira.
He came to the US and had very successful career as professor of medicine. He was already a full professor by the time he got to his late 30s. He became convinced in the late 1990s that it was important for physicians to take a greater leadership role in the business of medicine and decided to get an MBA from Kellogg’s School of Management. “An MBA was important because it provided structured way of acquiring knowledge in a short period of time and provided the credibility that was equally important. When I finished, Tufts Medical Center was in financial trouble like many other academic institutions in Boston and I was an MD with an MBA – that landed me in the interim Chief Operating Officer role at Tufts Medical Center. We turned things around, but there were 18 independent physician corporations at Tufts who were collectively loosing tens of millions of dollars. I was sent to merge them into a single Physician Organization and be the CEO and was able to lead this organization to profitability”.
He did not restrict himself to medical organizations and decided to use his managerial skills to turn around companies. “When two large investors of a struggling public biotech company (Advanced Magnetics) approached me about running the company, I could not resist the opportunity. Essentially, I have found myself at the right place at the right time, and jumped at the opportunity to fix a difficult situation. I just cannot resist a challenge!” says Pereira.
The metamorphosis of Advanced Magnetics, a struggling, early-stage, Biotech company into AMAG Pharmaceuticals, a fully integrated commercial Biotech company was my most exciting journey thus far. “On my first day in November 2005, I felt like I had walked into Miss Havisham’s home in the Dicken’s novel Great Expectations”. The facilities were run down, morale was poor and time had stood still for 25 years at this “family-run” publicly traded company. In two weeks, the sole Regulatory person and the sole R&D person left. The company had 19 employees, no human resources, IT, financial or clinical development infrastructure, had repeatedly bungled its drug development programs, disappointed investors, was running out of cash and had a market cap of a little over $50 million. In the next 12 weeks, we moved the offices to a new facility, renegotiated the clinical development program with the FDA, staffed all the key functions, opened dozens of new clinical trial sites, marketed to existing and new investors, spurred new analyst coverage and completed a secondary stock offering. I was convinced that we had a terrific drug in Feraheme; building a world-class team and clinical and commercial program to deliver on the promise was an achievable goal. By the end of 2006 (one year), we had successful results from our first trial and our market cap had risen to over $1 billion, making the company the best performing stock across all the US exchanges. Over the next three years, we recruited a world class team of senior executives and rebuilt every department of the company; completed the Phase III clinical program with outstanding safety and efficacy results, filed an NDA, got Feraheme approved, launched the drug commercially, and raised over $500 million in three secondary public offerings. This was a fun ride”
What drives him to take on complex turn around projects? “A strong belief that “I can make a difference” is the most important ingredient of any endeavor that I embark on. There are a large number of extraordinary individuals that can take a great organization to even greater heights or ensure that previous success is nurtured and maintained. This does not excite me. I enjoy taking on organization or situations that are in disrepair and are in need of good management and leadership. It is hard for me to identify facets of my personality that make me who I am, but I am obsessively organized (drives my family crazy), an early riser and am in the office by 7 AM, and I don’t go to bed until every email has been answered and my desk is clean” says Pereira.
Pereira is grateful to have been blessed with great mentors. Dr. Kirpal Singh Chugh, who is the father of Indian Nephrology, Andrew Levey (the Chief of Nephrology at Tufts) and Nicolaos Madias (the former interim Dean at Tufts) have been big influences in his life.
Pereira was born in Mangalore, a small town south of Goa. His parents were teachers in Bahrain (the Gulf). His grandparents raised him. He met his wife Sunita Ghai, who was a fellow resident at the Post Graduate Institute in Chandigarh. “She was a north Indian, hindu, khatri whose mother tongue was Punjabi and I was a South Indian, Catholic, Brahmin (Kamath) whose mother tongue was Konkani – a challenging match in the conservative India of the 1980s. The good news was that both sets of families were supportive and we had three weddings – a registered wedding to get the married doctors accommodations at PGI, whose allocation date happened to be a few months before our weddings, a Hindu wedding in Jabbalpur and a Catholic wedding in Mangalore.”
The Pereiras are proud parents of two very accomplished children. “Our daughter Natasha is a Stanford graduate, worked for Bain for three years and is a first year MBA student at Harvard Business School. Our son Nikhil is a Princeton graduate, spent two years at Morgan Stanley Investment Banking and moves to Boston in a couple of months to work at Berkshire Partners Private Equity. We are delighted that we will have both kids in town after 10 years”.
In addition to his professional career, he gives his time to support many charities. “I have served for over 20 years as a member of the Board of the National Kidney Foundation and two years as President. This was extremely rewarding as we developed landmark quality initiatives that are now the global standard. My wife, kids and neighbors started Youth That Care a tax exempt 501c3 charity from our home 15 years ago to send used medical equipment and educational material to developing countries. We opened many dialysis centers in India and furnished books at libraries. More recently, my wife and I have joined the Board of the American India Foundation and are honored to have co-chaired the gala for the past few years.”
On a personal note, his favorite movies are “Godfather I, II and III” (which he thinks is the best business movies ever made), Bobby and Lagaan. Meg Ryan is favorite movie star. “Mountain over Mountains” by Tracy Kidder who elegantly traces the life of Paul Farmer, the founder of Partners in Health, is his favorite book while “My Way” written by Paul Anka and popularized by Frank Sinatra is his favorite song. He loves Mangalorean and Punjabi food. His favorite international travel destination is Buenos Aires in Argentina, with side trips to the wine country in Mendoza. He loves to cook and treasures a stamp collection that spans three generations.
Is there anything at all that Pereira cannot do well? “Golf is in that list,” says Pereira. Is there anything he wishes to have done differently? “ I wish that I had taken more risks professionally much earlier in life “When asked about leaders he admires, his answer was nuanced. "I admire different qualities in so many leaders. I like the tenacity of Steve Jobs , oratorial skills of President Obama, managerial discipline of Jack Welsh, Gandhi’s ability to see through the clutter and look at the ultimate goal and the vision of Bill Gates” says Pereira.
For one who has accomplished so much, Pereira still has things he would like to take on. “There is so much more to do to make the world a better place. In medicine, the low hanging fruit have been picked and many of the newer drugs and devices that are coming to the market are largely me-too or marginal improvements over what exists. Regenerative medicine is the promise of the future, but the path to this promised land is fraught with technical and funding challenges. On the social front, there is a lot to do in terms of delivering healthcare, education, economic and social justice to the billions of people in the developing world. These are the two broad areas that I hope to spend my time in the years ahead. With due apologies to Charles Schulz, the creator of the cartoon Peanuts “God put me on earth to accomplish a limited number of goals. Right now, I am so far behind that I cannot die,” says Pereira.
Any special for our readers? “Dream of big ideas, pursue challenging goals and pick great mentors – while the destination is important, make sure that you enjoy the journey”