From Lab to Life: Advancements in Dermatology and Patient Empowerment

[00:00:00] Joy Rios: Hello there. And welcome to the HIT Like a Girl podcast. My name is Joy Rios. I'm this show's host. And this is a show where we talk about the 30,000 piece puzzle of healthcare, where each one of our guests gets to bring in one of their areas of expertise and share that puzzle piece with our audience.

So I'm very excited for today's guest who's going to be bringing on a piece of the puzzle that we have yet to uncover, Doral Fredericks. Can you please take a moment to introduce yourself?

[00:00:39] Doral Fredericks: Sure, Joy. Thanks so much for having me. I'm very excited to be here. And I have to say I've listened to a number of your podcasts and have really found them to be, I think, not only educational, but inspirational.

So thank you for having me. As you said, my name is Doral Fredericks, and I am the Senior Vice President of Medical Affairs strategy at Dermavant Sciences. Dermavant is a dermatology company and we launched our first product actually in 2022. It's called the VTAMA 1% cream and it's for adult plaque psoriasis.

But the cool thing about it is it was a really unique mechanism of action and really new in the space. We can talk more about that if you're interested. I am a clinical pharmacist by training and have been in biotech for about 25 years. Have a lot to share on medical affairs.

[00:01:32] Joy Rios: Oh, that's great. I can't wait to pick your brain. And, all right, so your job title, tell me your job title again.

[00:01:40] Doral Fredericks: It’s Senior Vice President for Medical Affairs Strategy.

[00:01:42] Joy Rios: Okay. Can we start there and can you please tell me how does one get involved in medical affairs and also let's set the level the playing field. What exactly does that mean to be a VP of medical affairs? What does that role do?

[00:01:57] Doral Fredericks: Yeah medical affairs in general is, we always think about it as the bridge between the clinical development process. So the clinical trials that are done  and then the commercialization of the product. So generally we have a lot of field medical people that go out and educate physicians.

And that's really what our job is education. And then I would say data generation and dissemination, right? So we write the articles that you'll see in New England Journal of Medicine and things like that. Typically, people that join medical affairs organizations have a clinical background. So we have MDs or DOs, physicians, pharmacists. I'm a clinical pharmacist by training and that was my path. PhDs that have a science background or then things are other what we call advanced practice providers. So nurse practitioners, physician's assistants like that.

[00:02:55] Joy Rios: So you're really dealing with the information after a clinical trial.

So research has been done. You're helping to make that understandable and easy to understand for clinicians and then turning it into something that is a product. Am I understanding that correctly?

[00:03:11] Doral Fredericks: I think that sums it up nicely. Sometimes we'll be involved earlier on in helping clinical trials also be developed.

So we'll bring the face of the patient and the practitioner into the clinical trials about really things to think about while we're conducting those. And then we'll work with the commercial organization to come up with and work with them on research, the marketing messages or helping the sales organization understand the clinical data.

[00:03:40] Joy Rios: Okay. And in the world that you are living and spending your time, it's a lot related to dermatology. So can we help our audience understand more about psoriasis? What is some of the education that you would like the general lay people to know about taking care of their skin?

[00:03:58] Doral Fredericks: Just taking care of your skin in general is really important.

And so I'll say sunscreen, super important. From the baseline, but psoriasis is really a disease overactivity of the skin, and so patients will tend to have what we call plaques, so they look like thickened areas of skin that are a lot of times looks scaly. With some pink around it, and they can be very thick and painful.

You'll have patients that get it on the soles of their feet or on their hands and they can crack and bleed. I think the most important thing to realize for people is that psoriasis is not contagious because we hear that a lot. A woman will go in to get her hair done and she'll have a plaque on her scalp and hairdressers will be like, I don't want to, I don't really want to work with you.

And it's, it just creates so much anxiety in patients. It's a disease that again is chronic and so they'll have to work with it for their entire lives. But there are a lot of different ways to take care of it and it can be done. It just, it does take a lot of, I think, proactiveness of the patient in working with our clinician to find the right balance of treatment.

[00:05:12] Joy Rios: Now is psoriasis, you said the word disease, is it a disease or is it something that happens? Occasionally, this is really speaking to my understanding or lack of understanding, ultimately.

[00:05:23] Doral Fredericks: No it is a, it's a disease. You hear things like eczema or atopic dermatitis, right? That may be known to more people and psoriasis is in that.

It's an imbalance basically in the way that the skin turns over and grows. It just it's a thing that occurs in a lot of patients over time and it's just something that they have to deal with for their entire lives. It is a chronic disease and it's important because I think a lot of people think about dermatologic conditions as being cosmetic and something that's not really serious. But this can be very serious

[00:06:04] Joy Rios: When you have it, it feels serious, especially if you've got something that people are responding to, or even just the way that you think of your when you're looking in the mirror at something, but I'm sorry to interrupt you. Go ahead and finish that.

I keep thinking about so a friend of mine she has stress splotches. She's been going through a lot of changes right now in life and just a lot of heavy. And it's been really interesting and sad really to see that how stress presents in our skin and how it can show up. And I'm sure that is something, so if we can treat psoriasis, is it also stress related?

Is it something that if you take better care of yourself and like to your point of being proactive that you can prevent it?

[00:06:52] Doral Fredericks: I wouldn't say that you can prevent it from emerging originally, but certainly diet and stress can affect how severe it becomes at certain times. So patients tend to be really sensitive to certain things in their environment that can exacerbate things. Or like you were saying, stress can certainly bring things on.

Everything else, as much as you can have a healthy lifestyle, that will certainly help the disease. Yeah, but it's still something that you can't I don't know. Some people say that they can control, and I think in milder psoriasis, that may be the case with certain dietary changes, but over time, the majority of patients need medications.

[00:07:38] Joy Rios: Gotcha. Can you tell me more from a pharmacist perspective, because we haven't had too many pharmacists on the show, so I'm curious to know what your career trajectory has been. What have been some of the highlights? Unexpected and expected. I'm sure that you might have had a plan of where you were going, but I would also guess that you didn't plan to end up where you are.

[00:07:59] Doral Fredericks: 100 percent true. I'd always known that I wanted to be in healthcare and it changed from veterinary medicine to human medicine and I ended up in pharmacy. I liked the pharmacology. I like the chemistry of things. And so ended up doing actually a doctor of pharmacy and a combined with an MBA program, which was unique.

And then I did a residency and practiced in actually adult primary care. So I took care of diabetic patients in health maintenance organization setting in Southern California where I live. We never really learned a lot about industry. I didn't know anything about it in pharmaceutical industry.

And I happened to be participating, we had a clinical trial going on in the clinic. And at that time, we just had a couple of representatives that came in. And I started digging more into what industry was because I thought, no, that might be a great way to put together not only the medical knowledge that I have, but the business knowledge.

And so interestingly, after I finished residency and was working came into this. I saw an ad. I'm going to date myself here, but it was in the L. A. Times of all things newspaper right in the job section and it was for a medical science liaison, which is what we call a field medical personnel. And basically the job was to work for this company to learn about the products and go out and talk to other clinicians about the product answer their questions.

And then that was really my first foray into it. I originally didn't even think that I was going to be applying for the job because they said, oh, you need, and I think this is a good learning, the job description said, you need three to five years of experience. I'm, oh, I'm not there yet so nevermind.

My husband's just try, you never know what you're going to get. And it's true. So I did, I got the job and that was the start of really my career. So you just never know where opportunities are going to come from.

[00:09:59] Joy Rios: Now I also, I'm curious, so born and raised Southern California. That's my territory, and moved from San Diego several years ago, but I'm curious about when you got into health care.

How much of it has been static where you've basically been in the same place, or has it taken you to places that you might not have expected? And the reason I say that is because when I got a job in health care, I then began traveling 80 percent of the time and it was a road warrior scenario. And I'm curious if that had happened to you too.

[00:10:31] Doral Fredericks: So yes to all of the above. I have been fortunate in, for the most part, I've always been based out of my home, no matter what my role is, which is a little unique. And I've always been in Southern California. But I will agree. I've definitely, I haven't been, had to be a road warrior, which I am thankful for, but I have definitely got to see a lot of places that I had never been to.

I think I've been to every state at this point, been to a lot of international conferences, which is great. And it's so wonderful to connect with people from all over and hear about the work that is delivered. I really enjoyed that piece of it, but I agree. I think there's a point when it becomes so much, it consumes your life. Unfortunately, I haven't been there.

[00:11:16] Joy Rios: I just keep feeling like it's never enough. We're just, doesn't matter how much you're doing. It doesn't seem like it's ever enough for healthcare. Healthcare is a hungry industry.

[00:11:24] Doral Fredericks: It is definitely a hungry industry and it's 24/7 technology. I think has really changed things to where I am always attached to my phone and have my company work.

On my phone and it just I'm not good necessarily as good as I should be about putting it down and that is something you have to definitely put your own guardrails on.

[00:11:45] Joy Rios: But I also think that it opens up opportunity, to your point about travel, and to see I think that when people enter health care, they might not necessarily make that connection of how far it can take you because obviously health care happens everywhere.

And so I'd be interested in some of the places that it's taking you that have been the most unsuspecting or that you have memorable. nAd I can share. Mine is two hours north of Fairbanks, Alaska, Chaska, I think it's called Chaska Falls, but I'm, oh yeah, I'm out in the middle of winter with the moose talking about dermatology.  

[00:12:20] Doral Fredericks: Okay, that is a unique one. I don't know that I have anything that unique, but one of the things that I had really enjoyed was when I was a field medical person, part of my territory, and I know I get this all the time, was Hawaii. Oh, so hard to work in Hawaii, right? And it was great, it really was, but I did get to spend a lot of time with the local individuals that a lot of times were native to the Hawaiian islands and learn a lot about their just how different they are.

I think we group everything of just it's Hawaii. It's this great top of our tropical location, but there's so much difference in between in microclimates and just history and culture in all of the islands. And that's been one of the kind of the coolest things because I did that for a number of years.

So I really got to spend time there on all of the islands or just the main. I think that's what made it unique is you tend to have one or two that's your favorite that you go vacation to. But I spent a lot of times. And even the really small ones.

[00:13:19] Joy Rios: Considering that's actually been a topic of conversation that's shown up in my world a little bit lately is just the remote and rural communities specifically to Hawaii.

And so how do we bring healthcare and get it more accessible for them? And I don't know, do you have any commentary on how to do that?

[00:13:52] Doral Fredericks: I don't know that I can comment, but what I will say I think is happening is there. They're definitely in dermatology, especially, but in all of medicine, we're really seeing telemedicine become more mainstay.And I think that's a really important piece for. rural communities or areas that don't necessarily attract a lot of clinicians just in the area and so we've seen a really large uptake in telemedicine teledoc platforms in the dermatology space and what's interesting is I think you'll also see the emergence of a lot more on skin apps so applications on the phone that can help diagnose different disease states, even through artificial intelligence.

And there have been a couple of studies looking at that and it's shown that the AI is as good and in some cases better sometimes than the human element of it. Of course, you still need the human element for treatment, but that may really help, I think, close that gap. Disparity in different areas.

[00:14:41] Joy Rios: I love that and I was going to ask about, that as far as skin checks and whatnot, can we start relying?

It's one thing to look at a clinician over Zoom and have a conversation but to be able to do skin checks Is that something that's reliable and where that's happening now? That's our reality.

[00:15:01] Doral Fredericks: It is actually. That is actually how a lot of the Teladoc platforms started, which is some of these, I have this rash or this weird mole and you, cause you can get really close to that and share pictures and things like that.

[00:15:17] Joy Rios:  That's incredible. You just can't do any, if they need to go in to see a doctor to get something removed, obviously that requires a human touch and a follow up. What else is it that you're seeing and excited about in the, in dermatology? And are there other specialties that you work with or are you full time dermatology?

[00:15:34] Doral Fredericks: I am full time dermatology now. I've done a lot of different therapeutic areas in my past, but right now, totally dermatology. And it's an interesting question because I think we could spend the whole podcast just talking about the future of where I think dermatology is going and it's in a pretty dynamic space right now like we talked about.

We have the teledocs, we have the artificial intelligence with regards to some of the apps. There's really interesting work going on. Even Google and IBM are investing in this type. So really large companies are invested in the these technologies, but we're seeing things like artificial skin being developed.

What is crazy, but for burn victims or just even being able to do studies on skin where you don't necessarily have to do patients. This is all futuristic, but you have that you have 3d printing. That's really changing medicine as well. There's research going on into nanoparticles and nanotechnology and how those things can affect skin healing or disease.

So there's a lot of research going on in these areas. A lot of it's really early phase, but I think it's really going to. revolutionize dermatology and probably other areas over the next decade.

[00:16:53] Joy Rios: I imagine from where you sit that you get to see one research that is being conducted and also how it is being connected.

That must be a really fascinating place to spend your time.

[00:17:04] Doral Fredericks: Well, I do this every day.

[00:17:05] Joy Rios: Okay, now I want to know more about nanotechnology. And I'm just, okay, what are the things that's not even on my radar of how it could be supportive of skin health?

[00:17:15] Doral Fredericks: I am certainly not an expert in that. I just read on the side. 

[00:17:24] Joy Rios: But I imagine it's beyond our own ability to even really truly comprehend as an individual. You don't need to be an expert in all of the things, but just being able to understand where the technology is going. And it must be very different than it was even five years ago.

[00:17:43] Doral Fredericks: Oh, absolutely. The advancement that we've seen in just being able to crunch big data and learn from that is changing the way we view the future of health care and where we apply our resources because resources are always finite. And so you need to think about where it is that you can have the most impact.

And I think also look at underrepresented groups or disease states that haven't been looked at before and how you can approach that differently.

[00:18:04] Joy Rios: Alright. So I'm thinking about our audience and I want to ask two final questions and they both go in different directions. So one is what do you want to choose?

Which direction do you want to go in? You want to go in the patient direction or do you want to go in the career direction?

[00:18:19] Doral Fredericks: They're both really good.

[00:18:21] Joy Rios: We'll probably end up with both of them to be honest. It just, we'll start with one.

[00:18:25] Doral Fredericks: Okay. Let's start with the patient then.

[00:18:27] Joy Rios: Okay. So then I wanted to ask, for listeners, what should we be doing to be good patients? And I think, okay, prioritize sleep. We should always be prioritizing sleep and taking good care of ourselves. Having a healthy diet and understanding that having a healthy diet can't necessarily, if you don't have a healthy diet, then you can't necessarily exercise enough to counter it.

There's a balance there, but apart from wearing sunscreen and the things that we can get into a routine of doing, is there any advice that you have for folks of just maybe drink more water and how much that affects your skin?

[00:19:12] Doral Fredericks: Yeah, water's definitely important. I think the majority of people, including myself, probably do not drink enough.

I think part of it's just being mindful of all those things that you mentioned. And it, but it's hard in today's world, right? And you have to give yourself some grace. So I think part of it too is we try to be so good at everything, and we can't. So you got to give yourself some grace. But I think one of the other things, and I mentioned this earlier too, is being a proactive patient.

You are your own best advocate. When you go in, ask the questions. Your clinicians and your pharmacist, just any healthcare professional, they want you to ask questions. The most frustrating thing is passive patients. If there's a disease that comes up or you think something's going on, learn about it and learn your treatment options.

I'm amazed even with all the resources out there, for example, in psoriasis, there's the National Psoriasis Foundation, and they have a great website, talks about the disease, talks about different options for therapies, and it still amazes me how many patients don't know, even for something they've been diagnosed with, what's available for them.

And they depend on their healthcare provider to give them all of the information, but it's too much. It's just too much to go over. So you have to be your own best advocate. That's the thing that I'd like to leave people with from a patient perspective.

[00:20:40] Joy Rios: It's interesting. I can imagine a lot of times people find stuff out about themselves and then just get quiet about it and don't reach out. And how much of an impact time is of the essence right that if you find something the sooner you address it the better off you're going to be and the better off you you can manage it, hopefully.

[00:20:58] Doral Fredericks: And don't rely on Dr. Google. So do your research, but validate your research with your healthcare professional. That's another key thing. Yeah, for sure.

[00:21:07] Joy Rios: Alright. So now transitioning to career. If somebody wants to vie for your job, you had said that it needed three to five years of experience, which you're, okay, let's push past that and try anyway.

But what did things and if somebody was interested in pursuing a career that led them to medical affairs, it sounds like there's multiple paths. They could follow in your footsteps, but what advice would you have knowing what you do now versus when you first started?

[00:21:34] Doral Fredericks: So there's a lot of different roles, I think, within medical affairs.

There's the field group. There's what we call the headquarters teams. Which do a lot of the scientific communications and things like that. So number one is I think be open as to where you start. You may have an idea that I wanted, I want to do this, but if you can just get your foot in the door and industry, that's a really important thing and networking is incredibly important.

It's a very large, I always think of healthcare and the pharmaceutical industry as being a very large sort of net. It's a really small group of people that do this, and it's amazing the people that come back into your life over time. So make sure that you're really leveraging that network that you have.

My role has taken me, I've had different roles in industry, obviously, over the last 25 years, and it's taken me a while to get to this role. But be open for experiences. You heard me say that I was really open to a lot of different therapeutic areas. And I've worked in many, just be open for those opportunities and experiences.

Don't limit yourself because every door that opens is something really spectacular can happen.

[00:22:51] Joy Rios: Yeah, I definitely have. Experience that working in health care will take you to places that you wouldn't have ever predicted. And it's not the kind of thing that it would have been on your vision board, but it might be even better than what it would have been on your vision board.

And I definitely agree with you in terms of networking and making sure that you get a name for yourself. I've met a lot of young folks who don't yet. They don't see. Because of social media and the social media platforms that are out there that they'll heavily invest in like an Instagram profile, but not so much in a LinkedIn profile.

And I'm, oh, you need to build that up. That is an area that showcases your history and is also a great place to network with other professionals. It's not the same as showing your picture of your, whatever you're eating or your dog.

[00:23:37] Doral Fredericks: Absolutely true. And there's a lot of good organizations out there too.

There's, for us, the healthcare business women's association. There's the Industry Pharmacists Association there's just a lot of one. So I really recommend that people look into those opportunities and get involved, because that's how you meet people that are in the roles that you want to be in and can learn from them.

And that's where you get some great mentors too, that you can leverage to help your career over time.

[00:24:02] Joy Rios: Do you ever mentor folks? Is that something, have you transitioned from mentee to mentor?  

[00:24:10] Doral Fredericks: I have definitely. And I think the great thing is when people come in and ask, “Can you mentor me? Can I learn from you?” 

And I love doing that. I don't do it formally through any like organizations or things like that. It's really for me happened just organically. I'm just trying to come up with that word, but yeah, it just happened organically. And I think that's a great compliment because it means that you've touched somebody's life in the career and they see something that they want to emulate and learn from.

But I love that. I wish I could do it more.

[00:24:44] Joy Rios: Okay. On that note, are you open to people reaching out to you? And if people did want to reach out to you where would you point them?

[00:24:52] Doral Fredericks: Absolutely happy. I talk to students a lot and I definitely would love to help out anybody that I can. I think two ways that you can do it that are pretty easy is, I do have that Linkedin profile that you just talked about. So you can always look me up on Linkedin and can contact me through that or through my email address at work, which is dorel.fredericks@dermavant. com

[00:25:16] Joy Rios: Thank you so much for sharing all of this information and getting, just giving your insight to where you stand. So I really appreciate your time and your sharing your expertise and the piece of the puzzle that you hold in healthcare. It means a lot to me.

Thanks for listening. You can learn more about us or this guest by going to our website or visiting us on any of the socials with the handle HIT Like a Girl pod. Thanks again. See you soon.

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