I am very pleased to welcome Dr. Jennifer Gentile to the podcast. Jennifer, thank you so much for joining us.
Thank you so much for inviting me.
Today, Jennifer is a senior vice president at Ieso Digital Health, working on its 8 billion minds program, which aims to remove barriers to mental health care for millions of people around the world by delivering efficacious and regulated digital therapeutics for prescription use.
Prior to this, as director of behavior health at American Well (AmWell), Jennifer was deeply involved in developing the first national telehealth therapy program with insurance reimbursement.
Throughout these roles, she's remained an attending psychologist and maintains appointments with Harvard Medical School and the Department of Psychiatry at Boston Children's Hospital.
After earning her undergrad degree in psychology from Wake Forest, Jennifer received her master's degree in healthcare administration management from Brandeis University before going on to William James College, where she completed her doctorate in clinical health, psychology, and a postdoctoral fellow in genetics and metabolic psychology from Harvard Medical School.
For transparency, we are personal friends who often discuss our professional lives and during one of these conversations, you raised the subject of pivoting from clinical to corporate and I wanted to share some of the things that you had shared with me so that brings us to this point.
But before we get into the nitty-gritty, let me ask you why a Ph.D. or someone with an advanced degree in science would want to leave a stable and rewarding academic or clinical career for one in a corporate environment?
I think there are any number of reasons why people might want to leave. It could be more flexibility, different work tasks, different pay, more complexity with the pay, such as bonuses or options or things like that. I can share my personal reason for shifting over.
And I should say that I still have one foot in academia. I am 0.2 FTE in academia, and I don't think I'll ever plan to leave that, but 0.8 in private industry. But I personally left because I was frustrated with the access challenges in mental health care. And while I was able to see a few dozen patients a week, I wasn't feeling like I was making a huge difference in people's lives and I wanted to make a greater difference at scale.
I personally left because I was frustrated with the access challenges in mental health care. And while I was able to see a few dozen patients a week, I wasn't feeling like I was making a huge difference in people's lives and I wanted to make a greater difference at scale.
And so I thought that shifting to private industry, working on more of an administrative level, and expanding mental health access would be a way I could make an impact at scale, better impact at scale.
That's fascinating and I like how you describe the percentage of your time, which is devoted to both tasks and clearly when you were seeking to make this move, you did so with this notion that you would continue to stay in and in the clinic as it were. But you, so you were clearly seeking an opportunity that would allow that to happen.
Yes, and honestly I've found private industry to be more flexible than the academic roles. I don't know if that's consistent.
I've only been with a few companies so far, but that's been my experience thus far.
It's encouraging nonetheless. Take us back to those moments before you made that pivot...where were you; and what were the circumstances that caused you to redirect your professional journey?
So I'm on staff at Boston Children's Hospital and Harvard Medical School. And I was there for several years as an attending psychologist. Absolutely loved the job and I will be completely honest. It was terrifying to leave. I loved my job at the time. I thought that I wouldn't be able to be satisfied in another position, honestly, because there was a variety of clinical work, the colleagues were incredible, the research opportunities and I also, you hear... I don't want to say it's a myth or lore, but the phrase that there are a hundred other people in line who want your job. So why would you ever think about leaving a full-time position, there? And so it was a lot of thinking, honestly, it was a couple of years of thinking, frankly just because I wasn't sure if I'd be able to get the clinical opportunities elsewhere.
But I thought there was another part of me that I could help satisfy that I wasn't doing through my work at the hospital. I had gotten, gosh, in 1999 now I got a master in healthcare management. So I had some program management experience in my twenties that I did, as well.
Honestly, it was very much a cold interview that I did and it's not something I'd recommend to anybody. I looked at the American Psychological Association webpage to see what jobs were being posted. So, I knew nobody. I did, like I said, exactly what you're not supposed to do. I went to interview for this position and it was to build the nation's first national mental tele mental health program.
I knew nobody. I did...exactly what you're not supposed to do.
And I think I went in there with certainly a good amount of naivete. And I remember speaking with the now current chief medical officer there and he is fantastic. And the faith he had in me, because why would I have anybody know how to do something like that? But I thought I understand clinical practice, can learn a bit about credentialing, and write state regulations and things like that.
He took the risk and when I left that program, four years later, 80 million people had covered benefits. So it was a great experience. It was definitely a leap of faith. And when other psychologists asked me about my career, I tell them that taking risks, if you can, to consider taking risks, because there isn't just one path as a person in academia.
This sounds like you both took a risk. You were going into this great unknown. They were taking on someone who had not had a seat at the board but it sounds like it worked out.
I'm fascinated to know what you would do differently today. How would you have lined yourself up for success as opposed to what you experienced then?
Yes, and you wonder if seven or eight years ago maybe the standards were lower. I'm not sure. But I think it was a big risk. I'll be really frank with you, I think it's a big risk they took because their company recently IPO'd and is quite successful in many kinds of, best-of categories. It's been listed as the best tele mental health program. I knew clinical work, but I didn't know so many other things, policies, and procedures, and all these things. So, they definitely took a risk. In a lot of ways, I was lucky the group of folks who hired me - they definitely provided lots of mentorship.
Going in the initial interactions I was so green. I didn't know what LinkedIn was. Honestly, the idea of scheduling on an online calendar wasn't in my vernacular. Salary, for example, was more than I'd made at my hospital job. I didn't negotiate and my logic for not negotiating was that I've never done this before. And I don't know if I can do that; promised them I would do my best. So that was a curious thing.
Looking back, I would definitely negotiate it and appreciate the value of my training and value of my clinical experience as well as program management experience. I honestly didn't even think to negotiate stock options; I had no idea. Again, it wasn't in my vocabulary, having been in academia for so long. So thinking about somebody at the level I was hired at, I just assumed that wouldn't be something I thought, I don't know. I, maybe I assumed it was founders or something like that, or people who bought stock options.
So I would learn a lot about that.
I didn't even think to ask for a bonus...I didn't even think about non-competes...
I didn't even think to ask for a bonus. And likely it's somebody at that level would typically get a bonus. I didn't even think about non-competes cause I thought, Oh gosh, this is such a unique opportunity. I can't imagine I'm going to stay in this field forever. So I didn't even think about non-competes. In the end, the noncompete didn't end up being an issue when I changed jobs. But nonetheless, there are a number of things I just hadn't considered.
Now I did get a recommendation from a friend to speak with an employment attorney. And I have to say that was fantastic advice. There wasn't much that was changed, but for my next position, it was actually very helpful to meet with an attorney because I was savvier to better understand what questions to ask.
So I was very green and I have to tell you, Greg, I think, and I told you before that I kicked myself. I'll give you the example of the options piece; I didn't negotiate for options and the person who followed me did negotiate options. And she was able to get them and then the company IPO'd, and I honestly could kick myself for that. I was the very academic humble person to say gosh, I don't know if I can do it perfectly. So I'm certainly not going to advocate for myself. My work needs to speak for itself is the way I thought about it.
I'm picking my jaw up off the floor; I'm just stunned at the list of things that well, let's just say that I have had the occasion to speak with many people of science. And I do find that there is a common thread throughout where there is this humbleness, and I don't know what causes that, whether science is imperfect, there's more failure than success. And so people of science tend to have that humble nature at their core.
Do you have any views on that?
I think that's, that is accurate. It is my experience. I'm not by nature somebody who climbs kind of career-wise. So I think humility is part of that and honestly, it felt dishonest for me to fight for a number that I didn't know how I would build a national program.
It just could be completely honest at the time that's how I felt. Integrity is a big piece that I hope I can always practice with integrity. And I think when you're in academia, at times, you can turn your nose up at private industry and not appreciate that people in private industry are people too. And many folks in private industry are trying to make a difference.
And I think when you're in academia, at times, you can turn your nose up at private industry and not appreciate that people in private industry are people too. And many folks in private industry are trying to make a difference.
And so I think maybe part of it was trying to hold on to, I still, even though I'm going to the dark side, I'm still trying to hold onto my integrity. But, who knows? I've definitely grown from that experience. But that's an interesting question. I think the way people in academia can speak, you can speak in a different way.
Because I remember when I entered the business world, somebody would ask me a question, “what should we do about how to care for people with a certain condition?” And I would write this massive long email and I cite studies. And I think I was given feedback that no, we just want a one-liner opinion and you go in from academia. You didn't have to defend everything you say. You can't just say my opinion is you say my opinion is based on A, B, and C. It's a different world; different world.
So going back to the things you would have done differently, and your comment about LinkedIn is it's surprising to someone in my world, but that doesn't necessarily mean that's not a very common experience for people in your position. So I, but I would guess though, that a takeaway from this, for anyone who might be listening, is that a broad approach to professional networking, which might include LinkedIn, for people who might consider this at some point, might be a good way to start.
Yes. Networking in academia was not in my vocabulary by any stretch of the imagination. I had maybe phone contacts with people I'd met at conferences, but that was the extent of my network and research contacts for folks around the country. Maybe I did different conferences with or projects, but it just wasn't part of it.
So I should say during my first private industry job that I was there for four years, it wasn't until that last year that I got myself, a LinkedIn profile that I signed up for. And so it took me a while. Honestly, I think now networking and also a web presence is believe it or not important.
And it's not always comfortable. And if you think about LinkedIn, a lot of it is sharing what you do and that's not always second nature for folks. With my current company, it's easy, because it's super exciting and it's going to make mental health care better. But it can, at times it can feel like bragging or marketing or selling. And that's not, I've never been in that type of role before.
But I think networking is important and I can tell you I've dozens and dozens of folks I've met with, you can learn so many new things you can learn about other ways of doing things, whether it's clinical practice or programs or artificial intelligence it's helpful from a competitive perspective. It's helpful from trying to get a new job perspective.
I haven't personally, I haven't met anyone through LinkedIn from a new job, but it's interesting, if you are seeking a new job, just being out there, people can understand what your skill set is. Things you're interested in, things that excite you.I think it's important.
And I'm telling you this, Greg and I only have a LinkedIn profile. I don't have Twitter. I don't have Instagram and that I can absolutely acknowledge it's on my list, but I'm not there yet. Maybe someday.
You said that word marketing, which is the dark side of the dark side and it's the world I live in and I've tried to practice it with integrity, but I understand full well that perceptions are reality and when people look at marketing they conjure up images, which are not necessarily positive ones.
But I want to move to something else you said; you talked about citing studies and supporting a response to a question in an email. And it causes me to ask you to discuss the different expectations in a professional performance between a clinician and someone in the corporate world.
And thank you for asking that actually ties exactly to what I'm saying.
In private industry, I've found that when you do performance evaluations, a lot of them are numbers-based budget increases or clinical improvements or supervise this many people got this many projects done. So I find that a lot more data needs to be gathered. So in that way, it. I don't want to say it's proving yourself, but oversights in academic settings tend to be more if you're a clinician, for example, tend to be more clinically focused.
So that is definitely something new that you would prepare a whole page and the recommendation is to just to keep a running list of your accomplishments throughout the year. And again that's opposite to academia. You don't necessarily keep a running list of your accomplishments, you just keep plotting along, trying to move, toward your goals to see patients or work on projects.
So in that way, it's a, it's definitely different. I think that as well to say some of those are tied to bonuses that could be tied to pay increases. Again, going back to academia, there's just not as much flexibility generally, or at least in the mental health field. Particularly if you have grant funding.
It's very interesting.
I asked you earlier if you would take me back to that moment that you decided to make this switch and I'm thinking you walked into the office of your supervisor or someone whom you would have reported to, and you said to them something along the lines of, I've got some good news and I've got some bad news. The bad news is I'm leaving. The good news is I'm staying.
And it, again, I think that you've really threaded an interesting needle here, and I'm sure there's great advice that you can provide to people who want to make the same conscious decision to stay involved in the clinical world while moving to the corporate world.
What advice would you give to others who may want to do the same?
I think the big thing is to maintain relationships is very important. Understand who helps to make the departmental decisions. So the part-time position I have now, it actually took a few years to create that position and to have the funding so it was a good amount of patience, as well. So I would say patience and relationships are important and to be able to speak with both private industry, as well as academia as to why it benefits each of the stakeholders, why you have your feet in each category. Because it truly has benefited, thinking about my academic position when we shifted over to telehealth, I was able to contribute. I was able to help draft that initial emergency policy for clinicians who didn't typically do telehealth.
be able to speak with both private industry, as well as academia as to why it benefits each of the stakeholders, why you have your feet in each category. Because it truly has benefited, thinking about my academic position when we shifted over to telehealth, I was able to contribute.
There is a level of credibility if I've been a clinician for 16 years I can speak about what real-life clinical work is not when I was a clinician 20 years ago. And so I think it adds credibility. So both kinds of sides... understanding how each benefits and then also being super transparent to make sure everybody knows what you're doing. That's really important.
I think some folks will do some kind of work on the side and to me, that's just a risk I'm not willing to take. If you want to take that risk, get a good attorney to inform you of what you can and cannot do. That's really important to make sure you're not violating any non-competes or anything else and just, to be transparent in your disclosures.
That's great advice. Now I'd like to shift the conversation to the present day, your current role in mental health.
In our previous discussions, you explained the situation as deteriorating from a crisis pre-pandemic to a full-blown mental health pandemic, during the pandemic. I wrote that down and was trying to unpack that and I really couldn't.
What is going on that people need to know about; what in your current role are you trying to do to create solutions, here?
And thank you for giving me this platform.
So, pre-pandemic, about a fourth of adults experience a mental health problem. About 80% of those problems go undiagnosed and untreated. And again, pre-pandemic about 120 million Americans were living in federally designated mental health provider shortage areas. For those who are able to access care, there are high dropout rates, a little over a third, depending on which study you look at, people drop out of care.
And for those who are able to finish a course of treatment, they're about 50% likely to recover.
So imagine that Greg, if you went to your doctor with a broken leg and the doctor said you have about a 50% chance of recovering. It's not okay. It's unacceptable. And since then, depression rates, anxiety rates have skyrocketed, and frankly, when the pandemic ends, there's still going to be lasting societal effects on this from a mental health perspective.
So I work with Ieso Digital Health and we're working on insight-driven mental health care, and that's both to improve access to mental health care as well as improve quality outcomes.
So bring that 50% up and they are if I said on average 50%, so their recovery rates are about 67%. And basically using technology to help inform care. So things like machine learning, natural language processing other AI insights, and data-informed care.
You referred earlier to your entry into the corporate world you worked for American Well at that time and telehealth now it's Ieso (Digital Health), which is also digitally driven. You've become a tech nerd.
See, this is the thing. If you take risks, you never know.
Greg, we have trouble hooking up our printer at our house. And I always said at American Well, now AmWell, I said, I'm the perfect person to be leading this, right? Because I'm not this amazing tech-savvy person. This is opposite to my skill set. So it shows that really anybody can do this.
I'm not this amazing tech-savvy person. This is opposite to my skill set. So it shows that really anybody can do this.
So I think it's incredible.
The idea that I've, I spoke as a keynote speaker at the health informatics program at Tufts school of medicine in January. That is such an incredible honor. And why would I know how to do this? But if you're open to learning, open to taking risks it's a lot of, off-the-job learning. I had no idea about AI prior to starting with Ieso but I think the world is open. It's not just if you're thinking academic bench researcher, it doesn't just have to be bench research.
There are so many potential opportunities in digital health, which is my field or other private industry work or government work, but just to, for people to be open to considering there are many ways in which you can contribute and still satisfy your goals of making the world a better place or whatever your goals are, financial goals, or what have you.
At the core it's curiosity, as long as you remain curious, anything is possible.
I have a final question. I always like to ask whether I'm recording or not. It always gives me encouragement to know what makes people optimistic. We've been through a very difficult year in so many ways. What keeps you optimistic?
I am so optimistic because I can remember five or six years ago sitting in front of major academic medical centers here in the Boston area, talking about telehealth and student mental health centers, for example. And they could not imagine, believe, conceive that telehealth was a responsible and ethical way to provide care. By no means is it the right care for everybody but a good chunk of folks can benefit and it absolutely can improve access cause we'd have a major access problem.
And so the idea that fast forward to spring 2020, that really everyone and not by choice was shifted to telehealth. And I think that is helpful. And it's telehealth, it's really more of the mainstream now, fortunately, and we're now in the conversation of digital health, so other ways to improve care.
And so thinking about how can we take that next step from access to improve quality. And the idea that these conversations are happening, the idea of tremendous funding going into digital health. The idea that the average person would consider using an app to - I don't know - track their mood or improve their sleep is exciting to me because so many people suffered in silence because they didn't think there was help, help that was palatable to them they could afford it, that would really speak to them, whether it's from a cultural perspective or language perspective or a time perspective. But as horrible as the pandemic has been, there are some bright spots of digital health that are really being advanced in improving access.
I did a panel at our conference in the fall and the title was, Is Digital Health Living Up to its Means? And in a lot of ways, the consensus is yes. And fortunately, with some of the Black Lives Matter efforts, cultural and racial disparities are on the table now, They're more on the table than they have been. So I am hopeful. I'm very hopeful; in the end, it's a curiosity. It seems people are more open to consider new ways of delivering and receiving health care.
It's wonderful... fascinating and let me say for a doctor, you make a pretty good marketer.
Ha! I have to tell you, I didn't mean to use marketing in a disparaging way because you know what I've learned, I've actually learned that I like sales. And I learned that I like marketing because it's so easy to speak about something that you're proud of, that can help people.
At the end of the day we're, we're all in sales in some way, shape, or form. I do believe that to be true.
I've really enjoyed this and I've learned a tremendous amount about this journey. It's filled with all sorts of concerns, which are completely rationale all sorts of opportunities and which can excite people and I hope that something, you said triggers something in our audience members and for them to maybe take that next step and consider what might be possible for them in either moving entirely from a clinical position to a corporate one or as you've done finding a way to have both.
So, thank you very much. It's been really great to speak with you about this.
It's my pleasure. And if you have anyone's listening to the podcast, they're welcome to contact me and I'm happy to share my experiences. I don't have a right or wrong answer, but I understand the angst of leaving that stability.
So anybody's welcome to reach out.
We'll be sure to include your LinkedIn profile in our posts.
Jennifer, thank you.
Take care, Greg. Bye. Bye.