Episode 08: John Bowman and his path from CRC to MD
John Bowman is a 2017 graduate from Washington and Lee University with a BS in Biology currently working in Charleston, SC as a clinical research coordinator . His goal is to become an MD with an emphasis on clinical trials as well as conventional medicine.
In this episode, we discuss clinical research as a path to becoming a surgeon, pediatric trials vs older populations, the importance of preparation, building trust with your patients, and building a routine.
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Intro: Hello, and welcome to episode eight of the note to file podcast collection of interviews, best practices and candid commentary for clinical research sites. I'm your host, Brad Hightower. Make sure to check us out at notetofilepodcast.com today on the show we have John Bowman. He is a 2017 graduate from Washington and Lee university. The BS in Biology, he's currently working as a Clinical Research Coordinator in Charleston, South Carolina. His goal is to become an MD with the focus on clinical trials, as well as conventional medicine today on the podcast, we talk about the nuances of working with pediatric populations versus older populations, the importance of preparation, as well as the importance of building trust with patients. So enjoy John Bowman.
Brad: All right, John Bowman. Thank you. A welcome. And I appreciate you coming on, man.
John: No, thanks for having me, I'm very excited for it.
Brad: Yeah. Yeah. It's a, again, we're still pretty new. I love talking to, you know, coordinators from all over the place. Uh, it's been very informative so far, and again, thank you for coming on and, uh, you know, curious, uh, tell me a little about, uh, how you got into clinical research. It looks like you were, uh, were you a surgical rep before you started clinical trials?
John: So, yeah, I, um, the, the ultimate goal of kind of, for what I want to do is, is to become a surgeon. Uh, it is kind of what I wanted to do since I was a kid. Uh, but once I graduated college, I wanted to take a year or two off, uh, save some money, get some experience before I jumped back into school. Uh, so I kinda just fell into the field. Um, I originally worked at a, uh, spine surgery center in Baltimore, uh, where I was a medical assistant part time during the week, a research coordinator the other days. And then I worked evenings, uh, in the, OR as a surgical rep for one of the spine instrumentation companies there, which was really, really cool. I got to see a lot of different aspects of patient care, uh, not only just, you know, clinical treatment, but also, um, kind of dabble in the research side of it. Now we were, we were just so sponsored. We weren't doing, you know, full blown clinical trials, um, at that point, but it kind of let me get my toes in the field and kind of see, see what research is all about.
Brad: Yeah, that's a, I mean, I've never really considered that option before. I mean, you've got, you got every angle there from a clinical side with the MA and then, you know, the research side and then really being able to be in there during procedures to see, uh, you know, how the sausage is made, if you will.
John: Yeah, no, exactly. Um, which I guess the goal is eventually medical school and to become a surgeon. So kind of seeing all aspects was really nice. Not only for you, you know, obviously trying to build my application, my resume for applying, but just to make sure that that is something I wanted to do and kind of see the lifestyle aspect of it as well.
Brad: Yeah. That's super important. And I think that's a really smart idea is, you know, it's, we all sometimes have these pre you know, predetermined notions of what it is to be something, what it is to be a surgeon, but, uh, if you can get in there and really see how, how it works and what their lives are like, then certainly that can save you a lot of time and money down the road, keep you from getting something that you're like, wait a minute. Uh, actually this kind of sucks. I wish I hadn't have done this. So at least you are, you had the foresight to get in there and really, you know, get your hands in it and see what it was like. So that's, that's a really smart move. I like that.
John: Yeah. And it was something I really enjoyed. Um, I went into it knowing it was kind of a one year gig as theory through a alumni of, of where I went to school, which was really nice. Uh, and then, so, so once a year was up, I started looking for, you know, other, other opportunities and I ended up finding a clinical research coordinator position down here in Charleston. Uh, so I moved and started getting to that. And honestly, when I first got the job, I had absolutely no idea what the position entailed. Uh, you know, when they were interviewing me, I was asking, Oh, well, did we get to write papers? And you know, how do we, how do we manage the data and all that stuff? Cause I was still thinking about it from the, you know, self sponsored aspect of more, um, kind of local local, if you will research. Uh, but they were, you know, they were really helpful and, and I was able to learn quite a bit there, uh, which, which was really nice. It was in a pediatric practice. So I still got to see some of the clinical, um, treatment side as well as then dive way more into the, the pharmaceutical research side of it as well.
Brad: Sure. No, and that's, again, that's sort of the instructive to me because I think it's, you know, you say you work in clinical research or work in clinical trials. I think a lot, I would say even the majority of people use tell that to are, have no idea what that means. You know, some people think, uh, I tell them that, that I work in a lab and looking at microscope all day. Uh, I usually have to just say you ever see those commercials on TV that they're looking for people to try a new medication. That's, that's what I do. So yeah, it's interesting to hear, you know, coming in from that side and even someone who is, you know, you were connected with, you know, the clinical aspects and still not have that full understanding of what it is to be a clinical research coordinator.
John: Sure. Yeah, no, it's, um, it's honestly, that's probably a pretty good way of explaining it. Cause I always tried to do the same thing too. Oh, you know what I try to do, do research on new drugs or new treatments coming out. Uh, but it, it ends up, um, that actually might be the best way of explaining it.
Brad: So yeah. So you actually, you started in at doing Pediatrics.
John: Yeah. Which was cool. I'd never worked with kids before coming from a Spine Surgery center. We tend to deal with older folk just since that's, who has spine problems back problems. Uh, which was, which was interesting. But then, you know, going straight from dealing with, you know, 60 to 90 year olds to dealing with two month old to two week previous, it was, it was kind of a shock, which, which was cool. It was just a whole different experience, a different atmosphere. Um, more fun, honestly, cause kids are happy people. So that was fun being able to work with them.
Brad: Sure. Yeah. I mean, I, I feel, uh, I haven't done a lot of PEDs. I did a PEDs migraine study, but for some reason, just the, the idea of pediatric research is a little intimidating to me. I don't know why, uh, for some reason I feel just more of a sense of responsibility to, you know, if you're working with children. So, uh, again, I, I applaud you for that and it seems like most people, I know start kind of the other way around, uh, you know, dealing with, you know, adolescent and adult and then, you know, move over to pediatrics. So that's, again, that's a sort of interesting, you've had a very interesting career path. I find that
John: it's, it's been fun. Uh, and honestly you were kind of speaking to, to, uh, feel more responsibility for the trials. It was, that was kind of the, um, biggest hurdle for them was the recruitment aspect of it. Once, once a child was in it and their family, you know, had experience with the , the trials and with the staff, they were almost always very happy to do many more trials as long as they were eligible, but, but convincing them, especially a first time parent, you know, you're talking to them at their baby's first checkup in the clinic saying, Hey, we have this vaccine trial coming up when your baby's two months old, would you be interested in to them? That's they maybe hadn't even thought of if they were going to vaccinate. So that was kinda the biggest hurdle was just convincing them that what we were doing was, you know, as safe as we could make it and explaining the risks and the benefits and trying to get them on board with, with kind of expanding the, the medical knowledge out there.
Brad: Yeah. Now I can, I could see that being particularly challenging when, you know, you're still figuring out just how to have a kid and then being approached with the idea of putting them, you know, through, through a trial. So that's, again, that's a, that's always been an interesting, uh, area to me. So, uh, again, that's, uh, I just find this an interesting way to start. I don't know that I've, I've seen that. Uh, it's a very cool, so where does that put you now? What are, what are kind of studies and what kind of populations are you dealing with right now?
John: Sure. So I ended up, uh, getting new position at a different company, uh, Coastal Carolina research down here in Charleston, uh, back at the end of December. So kind of right when the year is slipping over and we work mostly with adults and adolescents doing kind of everything. Uh, it's a lot of, you know, migraine vaccine, uh, different treatments, dermatological disorders, uh, just kind of a lot of different different disease States, which coming from PEDs was nice. Pediatrics was, was very cool and interesting, but it was also just a lot of vaccines and a lot of vaccines and a lot of vaccines, uh, just cause it is, you know, kind of a vulnerable population, uh, but being able to work adults and healthy volunteers and testing out a lot of different medications is, is pretty cool. Cause you're not only able to interact with the different population age-wise but also learn a lot more about the different diseases that you're trying to treat.
Brad: Yeah. I know it sounds like it's a lot less, uh, a lot, less homogenous as far as the types of trials. So, and I know that, uh, so you guys are multi therapeutic. I mean, I've definitely heard of Coastal Carolina research center. It sounds like you guys are a relatively large, uh, institution. Is that fair to say?
John: I would think so. I don't have too much experience with, with how big research companies can get, but I'd say we're a decently sized company able to handle a pretty large number of trials
Brad: as far as your role there. Or do you, do you get sort of the broad range of experience or are you a little more specialized in your guys's roles there?
John: A little bit of both, it kind of depends on what's going on with the trials and how many we have going on with. COVID kind of slowing everything down. I'm sure for everyone, uh, we weren't bringing in any new patients kind of put screenings on hold. And I was just working with the healthy patients that we had just to try to re reduce risk for everyone. Uh, but we were able to work on recruit movement a little bit more, uh, able to call some more patients, get those screening visits set up for, you know, a few weeks or months out, uh, work on some archiving and regulatory work, which, uh, I do like seeing patients the most that's, that's probably the most fulfilling part of the job for me, but I also have a decent bit OCD. So being able to kind of go through old files and studies and, you know, get them, get them filed and archives correctly is pretty satisfying to fill in the downtime.
Brad: Sure. No, and that's, that's a good point too, as this, uh, this is a great opportunity to, to broaden your skillset. You know, if you're at a site that's on limited availability to see patients, uh, it's a really good time to either, you know, learn a new skill or hone the skills that maybe you don't normally use otherwise. Uh, I'm kind of in the same boat. I prefer the, you know, uh, interpersonal relationship building and, uh, seeing the patients and, uh, but I hate paperwork. I am not, I am the opposite of a OCD. So, you know, I, I do not, uh, relish in having to get everything cleaned up and .
John: Dot the I's and cross the T's,
Brad: Exactly, exactly. So it's, it kills me to not be able to get patients in and, uh, you know, have those informed consent process discussions.
John: sure.
Brad: And, uh, so it's been a, but again, again, I think it's a fair point that, uh, you can find some opportunity in the downtime to, again, either learn a new skill or hone the skills that you already have that maybe you're not, you know, maybe it's not your strength. So that's a good, uh, a good point. So let's say you're, you're looking at what about three years now of being a research coordinator?
John: Yeah, just about two, two of, you know, full time clinical trials researches, you know, we do now and then a year just kind of getting into it and get more patient research experience.
Brad: Sure. So I know that like for myself it was, it took me a good year to really understand and kind of have my arms around, you know, the clinical trial process. Um, and a lot of that probably speaks to the way I was trained in the environment that I started in. Uh, so just, you know, sort of subjectively, how do you feel in, you know, where you at, where you're at in your career and your understanding of the full breadth of the clinical trial process
John: kind of depends. Uh, when I was finishing up my, uh, I guess, you know, year and a half at the pediatric practice, I felt very comfortable with pediatric trials. At least the ones we were doing. Um, you know, we've been doing many of them for that year and a half, and I felt comfortable with the protocols and how all of that worked. And then as soon as I got to Coastal Carolina Research here, it was a whole different ball game, a lot higher throughput, just because the patient population is a little bit broader, uh, a lot different, a lot of different indications and a lot of different sponsors that hadn't worked with. And that was kind of the biggest loop I think, was that ` Uh, so I feel comfortable where I'm at, but I definitely know that there's a lot that I don't know. I don't know.
Brad: Right. Yeah. And that's, I think that's, again, perfectly put that. I spend a lot of time not knowing what I didn't know. That's again, I love that way of putting it, but you're right. I mean, it's just, when you think you've got it kind of nailed down another sponsor or study comes along that you're like, well, Nope, this is a little bit just different enough to where, you know, you've got to get to really stay on your toes. But truthfully, I mean, for me, that's, what's attracted me to the industry is that you're never going to be doing the same thing the same way. You know, you're, it's not like working on a, on a factory line where it's, you know, doing the same job over and over again every day.
John: Yeah, I would totally agree.
Brad: So there's a lot of value and beauty in that. So that's, that's, that's what again is attracted me to it. So it's good to hear that, you know, you putting yourself in those different positions is helping you grow as a clinical research coordinator. And even beyond that, and more importantly than that, uh, as you pursue, uh, becoming an MD, you're going to be, you're gonna have a huge leg up. Um, most, you know, I work with surgeons and they don't know anything about what I do, you know, they think, I think that a patient shows up for surgery and, you know, that's just what happened. That's all there was to it. And then they're the man and it's there that's their patient now. Right? Exactly. They don't, they don't realize what goes on in the background and everything leading up to that point. Uh, so that's going to put you in a very advantageous position to understand, and, and very likely have your own, you know, nice revenue stream doing clinical research and being able to incorporate that just because you have that, that knowledge. So I think that's a, you're taking a really, uh, I mean, whether it's purposeful or not, your, it seems like you're taking a very purposeful approach. Um, so I, I applaud that. I think that's, that's awesome. And it's gonna pay off for you in the long run. I, I can almost guarantee it
John: well, thanks. I definitely hope so. It's clinical trial is definitely wasn't something I, you know, going through college knew much about or had planned on incorporating into my practice in the future. Uh, but now that I've been in it for a few years, it's very much grown on me and it's definitely something that I want to incorporate and want to, to have the main part of my practice moving forward, not only in the revenue stream, that is nice, and obviously it's gotta make a living, but it's also pretty, pretty neat to be on the cutting edge of what's coming out there, especially different treatments and different ways of thinking about how to tackle a disease, whether, you know, that's through, through different pathways or a different technique or different instrumentation or whatever it might be. It's, it's pretty cool to, to kind of broaden your horizons in that aspect and, and hopefully be able to provide the best care for the patients. Cause I mean, at the end of the day, that's what both clinical treatment and clinical trials are about is getting the most effective least disadvantageous treatment.
Brad: Yeah, no, absolutely. I mean, it's a, it's a win, win situation, you know, as long as you're, uh, running things right. And doing, you know, providing that quality, it's, it's obviously a great benefit to your patients. It's a great benefit to your practice and it is a revenue stream. And I go, that's that's, uh, I sometimes, you know, I sort of sometimes promote that part first, even though it really is maybe the last, the least important thing. I mean, we are, we're doing this because we are helping to advance scientific discovery and to help patients. I mean, it's, there's nothing more fulfilling than, you know, actually seeing you change a patient's life by including them in a clinical trial. Uh, it's, it's, it's an amazing thing. And it's something that we're, we're lucky to be a part of. So I guess throughout your, your three year, two or three years here, what are some best practices you've picked up for some things that you, uh, would share with the community?
John: I would say preparation as much as possible, and as far ahead as possible, not only for just getting, you know, a clinical trial up and running just in the startup phase, that's, it's always nice to be, you know, one of the first sites where the first patient first visit and get that under your belt and kind of rock and roll right out of the gate, but also just for the patient's comfort and the patient's experience with clinical trials, you know, looking at their pre screens ahead of time, giving them a call, if you have a question, just so they don't make a drive in, you know, whether it's only five minutes or an hour to be turned away because they didn't qualify, uh, you know, have the lab work, prepped and EKG machine ready and all the questionnaires ready and how are going to fit that all in, in the scope of the visit, you know, you know, what order, when does the PI need to be there? When does the sub, I need to be there, whoever whoever's seeing them, I went to his lab work, what other patients are there and what, uh, what timing are they going to have? So that way you don't have a patient show up. And, you know, you go through the consenting process, which is going to be their first impression, which is obviously the most important. And that generally goes well. Uh, but they can only take you so far, you know, if the consenting process goes great, that's, that's, you know, 30 minutes or so, depending on consent and the study, uh, but they're there for potentially two hours, if not longer, depending on what the visit is. Uh, and if they're sitting around for an hour of that, not having anything, you know, no, no labs being drawn or questionnaires, um, no contact, just kind of sitting in a room, it doesn't leave the best impression, especially if they think it's unorganized or just kind of a jumble on, on the, uh, the site's end.
Brad: Yeah. And again, that's very astute observation. I think the more I think about it and the longer I go, I start to consider that what we do is very much rooted in customer service. I mean, you want to create that experience for your, for your patients, so that they want to come back so that you can retain them in your trial so that, you know, as you grow more trust with them, they'll, they'll share more with you. Maybe you can capture AEs that are side effects that they may not have otherwise shared with you if you hadn't, you know, provided that experience for them. Uh, so I think that's, that's great that you're, you know, you have that foresight to recognize how important that is, because I mean, and I've been guilty of it, you know, I've been guilty of just, you know, trying to pump through a visit, uh, and look, sometimes we all have to sit and wait for a PI to show up. Uh, it can be,
John: Oh, sure.
Brad: You know, it can be sometimes out of our hands, but as much as you can mitigate, you know, those exterior factors, then the better, the experience is going to be for the patient.
John: You bring up a good point there , hadn't really, thought about too, too deeply is that, um, our responsibility is one to make sure the patients healthy, but two is to provide good high quality data for the sponsor. Um, that's the whole point of the trial is to, to get that data and see, see how well the IP works. Uh, so if you're right, it's the patient, you know, trust you more and you build a good rapport with them. They're much more likely to give you honest answers or, or let you know about so stuff that they might've been too embarrassed to mention it.
Brad: Yeah. And I, I can't tell you how many times in early part of my career, I would sit down with the patient. I would ask them if they've had any AEs or SAEs, any illnesses, injury, sicknesses, doctor's visits, anything, and they'd be like "Nope, Nope, Nope." And then as soon as the PI came in, they had a long list of things. I was like, "Man, I just asked you that. Why, why do you, why are you telling them" I don't, I don't understand.
John: Oh, that, that has definitely happened more times than I would care to admit.
John: But I think again, that's something that, that can be mitigated by developing that relationship. And now it happens all the time. I mean, I, you know, it's a double edged sword, but I give my patients my cell phone number and, you know, sometimes they call them, sometimes they call me at 11 o'clock for something that's got nothing to do with anything. But on the other hand, we've, you know, build a relationship a lot more easily. And therefore I know what's going on, you know, if they're not going to flake out and no show at a visit, they're going to tell me if, if they're having a nausea or diarrhea or something like that, something that they otherwise might not be comfortable telling you, if it's just a transactional relationship versus a real, uh, relationship where you're both of your goals are to help them get better.
John: Sure. And I do think it's, uh, the more I do it, obviously hasn't been too terribly long in the grand scheme of things, but the more I, I have kind of realized it's, it's a pretty fine line trying to, if you spend a decent amount of time with the patients, depending on what the study is talking about, relatively personal things, their health and everything going on with them, uh, it's kind of a fine line. You have to walk between, you know, being, being their coordinator or, or being there for their treating physician, if you're the PI and being their friend. Cause if you spend that much time with someone and talk about, you know, what you end up having to talk about with the patient, their health and whatever else is going on in their life, you do end up developing some sort of bond, whether that's friendship or otherwise, and just, I've had to remind myself, Oh, you know, this guy's great. Is that talk to him, you know, every, every other day, depending what the study is. And I think we're pretty good friends, but we're also, you know, it's a very professional setting and you just kind of have to maintain that, that boundary a little bit.
Brad: Sure. Yeah, no, it's a fair point. It is a fine line. I mean, pretty soon, you know, I know about every grandkid that my patient has and what they're all doing their lives and, you know, that is a great thing. And I don't think that necessarily, uh, muddies the water or biases the data or anything along those lines. And in fact, again, I think that it can be useful, you know, useful to again, keeping them in the study and for them to open up a little more to you. But yeah, it's a, it can also turn into a, you know, a one hour visit can turn into a two hour visit real fast. You, if you don't watch.
John: Yep. Oh, I totally agree.
Brad: I'm moving on. Are there any, uh, sort of tips, tools or resources that you use that, uh, again, anything you would like to share with the community, something that, uh, whether it's, uh, a book or a process or a piece of software or something along those lines,
John: I could think of three kind off the top of my head. And two of them kind of go hand in hand. And one of them's a process that, I mean, I call it in my head maintenance routines, um, just little things that you have to do daily just to stay on top of everything, whether that's for the sponsor or patient care or whatever it may be. Um, you know, I have to do lists, which is kind of the second system that I would definitely recommend. I kind of have to have some sort of, to do lists in order to do the job effectively, I would say. Uh, but it's gotta be something that, you know, it's easy to use, make sense to you and you can, you can see pretty much whenever you need to buy yourself how it looks, got a great one that I use, that the tasks you can tag it with different colors for different sponsors, or look back at what you completed on what day, if you're trying to remember something. Um, but you can build in, you know, repeating tasks within there, uh, that you can, once you check them off for one day, that's pop right up the next morning for you. So, you know, clearing your emails, checking UDC for queries, checking labs, um, checking diaries to make sure everyone's compliant, uh, checking folders for signatures from PIs or SUB-Is, and, uh, trying to get everything out there on time. Uh, just being able to do those little five minute tasks, if you let them all build up, they can, they can take quite a long time at the end of the day or the week to finish. And maybe then you're not getting in everything as timely as you probably want to, but if it takes five minutes, just do it something. One of my coaches in high school used to tell me which kind of stuck with me ever since then.
Brad: Yeah. I think that's a, an old, uh, if I believe, uh, the book getting things done, I believe was, uh, one that I read that it's, if it takes less than five minutes, do it now and took me out, took me awhile to learn that too, because that stuff can get away from you real fast. And, uh, well you don't want is, you know, you're monitoring your monitors coming tomorrow and you're like, Oh crap, all right, I gotta get all this stuff together. And again, something I've been guilty of far too many times in my career. Uh, but yes, using it to do list and there's so many different, uh, tools out there to do that. Now I, I'm more of a Google person. I use, you know, a Google, I use, uh, a sauna, which is a nice, uh, sort of project management tool.
John: I'm a big fan of notion. I don't know if you've heard of that one.
Brad: I don't think I've heard of that one.
John: more from our personal life, but it's, it's kind of a mix of a sauna things three, or to do list kind of, kind of an, uh, everybody seems to try as soon as to turn into kind of like a cult favorite and I've definitely drank the Koolaid on that one. So highly recommended if you're looking for, for something to try out.
Brad: Nice. Yeah, I'll definitely have to check that out. We, we, our team uses Slack communicate, so I've, I've tried to find something that's, uh, integrates really easily. Uh, I did notice that a sauna did also check out notion and see, well, very good. Uh, anything else you want to add?
John: No. Uh, it's been great talking to you. It's, it's pretty fun to, you know, get different, different, uh, aspects of different viewpoints on the job, uh, you know, different locations around the country and, and different experiences.
Brad: Yeah. I mean, I think we do, we all come from such different places, not just, you know, geographically and, you know, in our way that we do what we do. So it's a lot of reason again, why I started this. It's a, I, every conversation I have, I learned something new. I think this is a way to sort of share that with the broader clinical research community. And I think that that's sort of sorely lacking. Uh, I've got a lot of other ideas in the future of, you know, things I want to share. I wanna, I want to talk about, you know, I want to do like a CTMS showdown. I want to compare all the different tools that are out there.
John: That would be very cool. We're trying out a few, a few ones at our site trying to move more towards, um, irregulatory and E-source and all of that just since, especially the COVID. That's definitely seems to be the way everything's moving. It's a very fun, try, not to a few different ones, you know, once we've worked with in the past that are rolling out new implementations and brand new ones too.
Brad: Yeah. It's definitely driven the technology. Uh, you know, the pandemic has, but you know, for me, I've, I've tried a few throughout the years. I know there's more out there. I think it can be, uh, it can be tricky to really compare. And so again, it's one of those things that you don't know how well it works for you until you start using it. And by then, it's, you know, it could be too late. It could be stuck in the contract for, for two years. And you're like, well, then you bought it for a year. You're like, well, I wish I'd tried this other one instead. So I think that's a, I'd love to be able to get buy in from the community and their opinions on the ones that they've used. So again, that's just an extension of the whole idea of hearing from everybody and sharing those experiences. And I think, uh, hopefully this is something that is valuable to people, uh, in, at sites. You know
John: I definitely agree with that.
Brad: Where can `, people find you onlinC
John: Uh, just that LinkedIn, uh, John Bowman, I don't think I have a special link or anything like that. Uh, and then, um, just coastalcarolinaresearch.com. If you're in the Charleston area, we'd definitely love to see if we can help you out.
Brad: Very good. So I will link your LinkedIn and, uh, a link there to, uh, on, in the show notes so people can reach out to you and, uh, thank you so much for coming on. I really appreciate it. And until next time, thank you so much.
John: Yeah. Thank you.
Outro: Alright, thank you guys so much for tuning in. Please make sure to check us out@notetofilepodcast.com for full episode transcriptions links to any resources mentioned in the show, as well as the guests contact information. Once again. Thanks for listening. [inaudible].