Saralyn Mark, MD, a world renowned leader in women’s health, is an endocrinologist, geriatrician and women’s health specialist. She was the first Senior Medical Advisor to the Office on Women’s Health within the Department of Health and Human Services. She designed the first women’s health fellowship in the US, helped create the National Centers of Leadership in Academic Medicine, the National Centers of Excellence in Women’s Health, and landmark educational campaigns on critical health issues. She has published and delivered over 600 lectures and is a frequent health media expert. Dr. Mark works with agencies, academia, industry and NGOs around the globe. As President of SolaMed Solutions, LLC, Dr. Mark serves as a medical and scientific policy advisor to the White House, NASA and other organizations dedicated to improving health on Earth and in space. She holds 4 academic appointments including at Yale and Kings College-London. She is author of Stellar Medicine: A Journey Through the Universe of Women’s Health.
Tobin Arthur, Saralyn Mark, MD
Tobin Arthur 00:27
Hi, everybody, this is Tobin, Arthur, your host for Innovation4Alpha. And I am joined today by a very special guest, Dr. Saralyn Mark, who, if I read her resume, we would be concluding the podcast by the time I finish, she has got so many interesting things in her background. But Dr. Mark, welcome to the show.
Saralyn Mark, MD 00:48
Tobin, thank you so much for inviting me, it’s a pleasure to be with you.
Tobin Arthur 00:51
Well, it’s gonna be fun just getting to know you more. Every time I learned something about you. It just opens up more doors. But maybe let’s start out with as much of a synopsis as possible on your background, maybe starting with your medical, you know, training and early career and then up to the present.
Saralyn Mark, MD 01:12
Yes, so going back many moons ago, I am a physician I trained in endocrinology with a specialty in reproductive endocrinology. Also geriatrics and I created our country’s first women’s health fellowship at the University of California, San Francisco, then became the Senior Medical Advisor to HHS, the Office for women’s health, worked with the Surgeon General, and then also worked with NASA for over 18 years and then had the privilege to work at the White House in the Office of Science and Technology Policy. And in between all that I created a for profit boutique consultancy called Solomon solutions. So I get to provide scientific and strategic direction to corporations, organizations and agencies, across the globe, and across the US. And I also created a nonprofit, and everything has acronyms in Washington. So it’s called AI giant. And it stands for the impact of gender and sex on innovation novel technologies. And we’re really the only nonprofit accelerator for gendered innovation across health IT transportation retail sectors. So let’s unpack that just first. So when explain that a little bit. So what’s the mission of the goal kind of in a little bit more detail? Yeah, so the mission of AI giant is to accelerate the translation of research into sex and gender specific design elements. So let me explain what that all means. So design element can be a product, a policy, a protocol, and a program. And then the definitions of sex and gender we take from the National Academy of Sciences. So sex tends to be the biological construct, gender is more than the psychosocial. We know that everything seems interconnected these days, especially with the role of epi genetics. So as we Annamaya interact with the environment, the environment interacts with our genes, but we use this term sex, gender to kind of help define where we are. And our vision is pretty simple, but very profound. And that’s to improve the safety and quality of life for everyone in every environment, and including in the work environment. So we have a very broad stance, we take a non binary approach, but it’s really certainly critical. You know, as we talk about health equity, the only way we can actually achieve it, is if we ensure that everybody is given the resources and opportunities and tools to do their jobs while safely to live well and safely.
Tobin Arthur 03:33
Give an example, if there’s a simple one that comes to mind just to kind of illustrate the types of things that you’re looking at.
Saralyn Mark, MD 03:41
Absolutely. So I giant has a toolkit. And in our toolkit, we have round tables and summits, which is especially round table. And these round tables provide awareness, they empower individuals to be ambassadors to go back to the respective organizations. And there are also opportunities to share best practices. And before I start, really the the exponential experiential component of a round table, I ask questions such as Has anyone ever had a drug side effect? And almost invariably, everybody has said yes. And so we know that men and women metabolize drugs very differently. I also believe the vaccine dosages need to be altered, we’re doing that for age, you see this far just for younger individuals, older individuals tend to get a larger dose. But we also know that sex and gender can can influence that as well. And so we see, for example, more side effects from women. So perhaps the dose could be a bit smaller because women have really robust immune systems. And another area that’s so fascinating is the issue of it. We know men and women process information very differently. So we see increased burnout, for example, among collision clinicians when they use electronic health record, because the programs are really designed for the way a male brain operates. We also see increased repetitive stress injuries in women compared to men because women have Greater tactile sensation. So they think they’re pressing down on the device, but the device isn’t registering it. So imagine, in the world we live in today, 24/7, we’re attached to all our devices, we sleep with them not only on the bedside, but in the bed these days, because they’re just so connected to us. But pushing down on these devices day in and day out, we’re actually seeing increased repetitive stress disorders in women. Car injuries, you know, we’ve seen 47%, more likely chance of having a more severe neck injury for women, neck musculature is less the way women are positioned in the seat of the car, influences it so we can do better in car design. And then the other is retail. And this one was actually really fascinating. We’ve seen this in the pandemic. And I just published an opinion piece in The Hill in early, mid February. And it was looking at respirators and face masks, and they’re not designed for anyone that is not an average size, Caucasian European, male and clean shaven male. So we know we can do better, it’s just that we haven’t done it until often we’re really pushed against the wall. It makes a lot of sense. In some ways, it sounds like some of the things we talked about in personalized medicine, which is the fact that we’re not all genetically the same. And so therefore, any drug, any nutritional application is not going to impact us the same way. And given computing power and lots of advances, there are things that we can do better for sure. You touch on just by describing what you do is a lot of what I would, you know, look at as public private partnerships, and we’ve talked a little bit about this.
Tobin Arthur 06:39
Talk a little bit about some of the things you’ve learned in terms of how can we get better, socially, societally, and working with government because it’s not us against them kinds of a situation, government pays for half of our health care, on and on and on. There’s lots of reasons but what are some of your experiences and thoughts on public, private or private partnerships and how we can improve on those.
Saralyn Mark, MD 07:05
I think public private partnerships are absolutely essential. This is really where you get the cutting edge of technology, because keep in mind, the shareholder for the government is us, the taxpayer. And we tend to have a longer lag time before we want the return on our investment, compared to what we see in the private sector corporate environment. So for example, when you look at health care, we have many different examples. I worked at HHS for many years, and I’ll give you the name of one program was missiles to mammograms. We knew that conventional mammography was very old, outdated, over 40 to 50 years old misses a lot of breast masses over raised breast masses. So we needed more sensitive, specific technology. And so what we did is we partnered with NASA and the CIA and the Department of Defense to start using some of their technology, the neural networks, for example, so that you could image where you’re going to launch missiles, the Hubble telescope uses important silicon chips, we could incorporate that into digital mammography. So we began doing that. And now today exactly that we have digital mammography, we have the ability to image breast tissue more specifically, and in a more sensitive manner, and hopefully less invasively. So again, that’s a wonderful example. The NIH National Institutes of Health, they have the Center for Translational Sciences. And they’re they’re trying to bridge that so called valley of death, which can mean that it could take many years, over 15 years and billions of dollars. And then some of these wonderful ideas just die, and they fall into that valley. So now with some assistance from the government, we can move these ideas from concept to actually product. I love it.
Tobin Arthur 08:50
And you mentioned NASA, just maybe touch on some of your experience at NASA. How did you get involved in that to begin with?
Saralyn Mark, MD 08:58
Well, I think like all of us products of the Apollo age, again, dating how old I am, but I am so grateful, actually, that I got to see human beings walk on the moon. And I still remember that. And I think for some of us who are listening to it to this, we remember that moment in time, because it was really inspirational. And for that moment, I knew I wanted to be an astronaut. Fortunately, no one told me that women weren’t part of the astronaut corps until the 1970s. So I was able to continue with my delusion that I could be an astronaut. But the the wonderful part of this is that if you have dreams, you can make things a reality and actually became an astronaut finalist. So I had an opportunity to begin working with NASA on some of my other areas that I’m passionate about. And again, that’s issues of health equity. And I joined NASA as a Senior Medical Advisor to help me Battlelog and so it was just an extraordinary opportunity because I was part of this space shuttle program and then began to see us As we transition from the shuttle to the International Space Station and then beginning to put the roadmap in for Artemis, to go to the moon and working with other groups to envision going to Mars, you have to set your sights high. So it’s just been, for me an extraordinary experience. And one of the other things that I did do for them was public health preparedness. So for example, at the time, we were dealing with Ebola, I was working with NASA as well as the White House. And I got to see that public health issue from many different perspectives. But to stay the translation of technology for NASA to improve what we were doing for treating and caring for Ebola was fascinating from everything from remote sensors to robotics, to protective equipment. So it’s just been an extraordinary journey to have these really incredible experiences.
Tobin Arthur 10:48
That’s pretty neat. And I imagine you, as a result of those interact with some incredible people with just intelligence and passion and all kinds of characters.
Saralyn Mark, MD 11:01
Absolutely. I have a book. It’s called stellar medicine, a journey through the universe of women’s health. It’s a part memoir, part guide book on controversial health issues. And I look at the political, the economic, decisive psychosocial constructs, which shape our decisions. But what I love about it, because it’s part memoir, every chapter has a space focus. So I get to talk about some of my friends and colleagues. And to this day, we’re in touch, we are constantly in touch to even through the pandemic through all our life’s experiences. Because there’s some of the most brilliant people I’ve ever met, they just see the world so uniquely, and they are so I don’t want to say risk adverse, because it doesn’t really allude to what they do, but it’s just a balanced view of what we need to do. It’s that risk benefit equation that’s constantly measured in space exploration, as well as our life here on this planet.
Tobin Arthur 11:57
Any interest by the way of ever jumping on the Bezos Expeditions?
Saralyn Mark, MD 12:04
Absolutely, I if you asked me today, I would be there in five seconds. And I would carry the aAngelMD banner, because we can bring it to space. Hello. Yeah, absolutely. And I think that’s the exciting part for me is to see the commercial space sector really democratize space exploration. I’ve talked to some of my colleagues in that world. And one of the issues that we do need to do is to ensure that the public can connect to it because right now, it seems to be the wealthy person’s adventure. Right? And again, it had its very foundation in the government. We’ve paid for some of this. Yeah. So I would really love to see that we do a really good job, providing sort of that corporate social responsibility component and bring commercial space to everybody who is on this planet. I think that would be a benefit, and also to find ways to bring individuals into space who may not have $55 million dollars to be able to do it.
Tobin Arthur 13:01
Speaking of space, just while we’re on that topic, you had mentioned some issues here in Colorado, which has a big space presence. Can you maybe just mentioned a little bit about that?
Saralyn Mark, MD 13:11
Yeah, so I am a proud third generation Colorado. And I am so excited to see what Colorado has really pioneered. It’s really the largest commercial space sector in the world. And there’s the car out of space Business Roundtable. We had alair Saman, who was who was the president for Colorado space business roundtable, as a board member for my nonprofit. And I’ve had the privilege again, to provide a keynote to that group and to run a challenge competition and do roundtable. It’s really exciting, because I think what we see here is you when you bring these type of new innovative technology sectors together, they amplify. And I just see, Colorado is just, you know, truly the front range of where we’re going in the space program.
Tobin Arthur 14:00
Love that endorsement, while we’re on the public side of things public sector, your White House work, you know, for most people, they’ll never have access to the kinds of things that you’ve done there. And so when you say working with Whitehouse, give us a good example of what that looks like. Is that briefings? Is that committee meetings? I mean, what is the process of working with the White House look like for for somebody at any given time?
Saralyn Mark, MD 14:27
Yeah, so again, I was with the White House 2014 2015 As a senior policy advisor, so I actually got to go over to the White House compound. And at the time, we actually worked in offices. And I have to say that every moment that I walked through those gates, I was so proud to be able to work at the White House. There’s just something about our history, and about the importance of what we were doing because it had impact to so far and wide. Most people know that I giant my nonprofit actually had it’s just In the White House and I always tell people, we were given advanced technology to put our ideas down. And it was a whiteboard, we were given a chalkboard, each of us had a chalkboard we had chalk and eraser. And I had to laugh because we would develop these wonderful ideas. And then at the end of the meeting erases. So in that sense, you didn’t you were never hacked. The old lesson technology, no legs, exactly the old fashioned technology. So I developed the blueprint for my nonprofit on the chalkboard, which was great, because it allowed me to go back to that childlike ambition that I think all of us still have, and allowed me to to be a bit bit creative. So I created a giant because I saw what was happening with Ebola people, especially women were getting infected when they were donning and doffing their protective equipment. We were also working on the Precision Medicine Initiative at the time. And so to me, the low hanging fruit was looking at the human factor of sex and gender. And that’s how I began to develop the blueprint for a giant. I think what’s exciting about the White House is that you have access to meet with so many interesting people all over the world. And we had extraordinary briefings. And the other part of it is it’s the people’s house. So every day people far and wide would come and they will share their ideas and their concepts. And we would have this wonderful mutual exchange. I also have to say it’s a 24/7 job. It’s absolutely exhausting. I think being a doc prepares you for that, because we’re all on call or used to be on call all the time. So it was just an extraordinary experience and one that I truly treasure.
Tobin Arthur 16:35
So just walk us chronologically you finish up that stint. Then where did you had after that? Was it starting to build a giant was that the next piece here?
Saralyn Mark, MD 16:46
Well, I think I’m I’m from my life. I’ve never really done anything that was sequential. They all tend to be at the same time. So let me backtrack even sure there. So when I was in my fellowships, I started off with general endocrinology after I did my internal medicine residency, and then got so fascinated with reproductive endocrinology. So began working with Rupert intergroup at UCSF as well. And then I realized I was really fascinated by the health of older women. And at that time, that was women over the age of 50, which now realize is 30 It’s exactly. So it was rather funny how you know, in your mind’s eye when you are 30, what you think is old, right? So I became a geriatrics fellow as well. And then as I started to put the dots together, I realized, you know, we can’t do things by our reproductive status, there really has to be an integrated, holistic view of it, and I began putting it into place, but later became a women’s health fellowship. And so I was doing research and clinical care for many, many different divisions at UCSF. So I was working with radiology department cardiology, general endocrine, OBGYN, repro, Endo, geriatrics, so it just, you know, truly multi specialty, and just on call, again, 24/7. This was sort of the pre having a cellphone that you can actually fit in your pocket, it was more what you could put in a backpack, right? So Oh, in quarter, so that’s the quarters to make phone calls. So that was the world back then. But it was really, for me a wonderful lesson in how to prioritize time and how to foster collaboration and to seek connection. And then I had this idea that we needed to create national centers of excellence for women’s health, where these are multidisciplinary centers that provide a clinical care and research and education, outreach and career development. So as a young fellow, I pitched the idea to the Deputy Assistant Secretary of Health at HHS for my call room. And she liked it. She was coming out to California, and I briefed her and literally in 15 minutes, my life changed because she said, we’ll bring it to Washington and to do it on a nationwide scale. I was really fortunate that UCSF gave me a faculty appointment, I just finished my fellowship, to allow me to come to Washington to do this. And you know, you get this so called Potomac fever. And I ended up staying, because when you get to create programs, and you get to scale them up to such huge dimensions, it’s really exciting. And that’s just sort of the nature of what I do. If I see something that hasn’t been created. I try to create a blueprint. And then I try to find people who can help make that a possibility in reality, and I think that’s what we all do, in many ways. So over the journey, HHS, NASA worked at NASA at the same time as HHS then decided I wanted to work more closely with companies and I created solomid solutions. And then while I was at the White House, I was working also with NASA and became the medical director for Olga V. Because we needed to ensure communication. So it’s just the nature I think all of us multitask. Ask very few of us get to do just one thing. But there’s richness in it. It’s exhausting, right? There’s richness to it, because you get to connect all the partners you work with.
Tobin Arthur 20:10
Well, let’s touch on the other group that you just referenced. And that’s the commercial side of the house industry. And obviously, there are additional, you know, huge r&d budgets on that side of the world, whether it’s pharma or device or what have you. So walk a little bit through your experience working with industry, and then we’ll touch a little bit on on how industry and the public sector can work more effectively together.
Saralyn Mark, MD 20:37
Yeah, yes. So I’ve had the opportunity to work with Fortune five companies, some of the world’s largest companies and some of our startups, both in the pharmaceutical world as well as the medical device sector. And I think what has been fascinating for me is that I watch ideas go from pre conception to development, the actual, out to the public. And I think along that spectrum, you see where there are roadblocks and landmines that need to be crossed and bypassed. And then the, you know, some wonderful ideas just simply die on the vine, I think we’ve talked about it, where they’re phenomenal concepts, but they’re just not viable, because they’re just not feasible, whether they’re too expensive, or they really don’t meet the needs of that marketplace. So I think it’s really important that the preconception phase that that exercise is performed, it can probably save a lot of time, money dollars. Yep. And I think the other part of it is early on, start to think about your potential partners. I work across multiple stakeholders. So certainly industry, but also government and NGOs and advocacy. And the academic center, academic centers are very rich treasure trove for for brilliant incubators and accelerators and try to engage them as well. But you really have to see who is your audience? And how are you going to market to them? And then how do you make this viable so that it can survive in the marketplace?
Tobin Arthur 22:07
Do you see this trend? Or have you, you know, been involved in this? Where industry seems to be doing less internal r&d, and instead looking at the market, ie startups, and more actively acquiring them, letting them effectively be the external r&d? And as they see things that are building traction acquiring them and maybe witness that? And what are your thoughts on, you know, the opportunity there for entrepreneurs, and others to know that ultimately, industry is treating the market like that?
Saralyn Mark, MD 22:39
I do see that. And it’s not to say that there is an independent r&d within industry. But yes, that acquisition phase, and I’ve often talked with a lot of startups without circle, they just want to have an exit, they want to find that larger partner to scale up their concepts. I and I certainly could appreciate that. I think, again, as we know, it takes a considerable amount of revenue to bring an idea from concept to development to actual production phase. I think if you could work in tandem, maybe a greater collaboration at the start could be very effective. So I know, a lot of companies will go to incubators and help to mature ideas to fruition, guide them. So I think that’s valuable. I think the hardest part is when startups invest so much time and effort. And if they really did the right thing early on, they didn’t know whether it was something that was really viable, and with survive, or just to exit off and start something new. There. That’s where the guidance comes in. Yeah, and we see with the NIH and companies that come through NIH programs, in particular, they’re very good at that they’ve adopted the lean startup methodology that Steve Blank popularized. And they really spend a lot of time upfront on that, you know, product market fit to the point where they don’t have the mindset of build it, and they will come they want to figure out if somebody’s willing to pay $1 for this thing I’m building because if they’re not, this is probably not going anywhere. And so ironically, the government has done a very good job in their programs at the NIH, as I mentioned, whereas a lot of other incubators and others may not necessarily pay attention to that marketability, or that commercialization. It’s sort of a cool shiny widget. And then they hope something comes of that later.
Tobin Arthur 24:36
As you look forward and you know, is as obvious when people listen to you. You do have your hands in a number of different pots. They’re interconnected. As you start to learn more about what you’re doing. There’s a there’s a rhyme to the reason. But over the next year, two years, what are the things that you’re particularly passionate about? What does success look like for you? You know, if you look back 24 months from now.
Saralyn Mark, MD 25:04
So is that important question, and I think I’ve told you, I tend to see my world through the prism of space using a sex gender lens. So I think all of us have guiding principles. And once you follow that, that even if you go on many different tangents, you still have your direction of where you’re heading. For me, I have this nonprofit. And we have a really exciting tool kit. As I mentioned, we have round tables and summits, we’ve also created a seal of approval for design processes, so that companies can use this skill to actually foster expanded commercialization. We have other areas that we work with, such as challenge competitions. And I think for everyone who’s worked to challenge competition, again, some of the issues we talked about are important, the viability of a concept, how innovative is it? How disruptive is it? And how viable How feasible is it to actually develop and implement. So for my goal with the giant, I want an accelerator for the accelerator, I’ve certainly seen during this pandemic, we need that we have had over 100 events and five challenges, and we have corporate advisory councils, but to actually have that accelerator to get companies to take these ideas to marketplace. So it’s important, I think, in order to actually have innovation, you need to ensure that you’re seeing it through the various what I call human factor lens, are you looking at sex, gender, age race, when that improves, it mitigates the economic, the legal, the financial challenges that one will face, then improves employer, employee client satisfaction improves the market share. And it really expands innovation. So for that, I think that’s one driving goal. The other and we’ve talked about this communication, finding really wonderful platforms to be able to share our messages, and do it in a way that is clear and consistent with all the facts that you know. So that’s extraordinarily important. And then the other part of it is that tech transfer element, and to work in sectors that haven’t been traditionally touched to expand what we’re doing in healthcare. So reaching out to some of our partners in space and intelligence and in military, and sort of the unusual suspects to bring them into the marketplace to expand healthcare. I mean, we talked about in government, we have DARPA, we have E ARPA, there’s now a new initiative to work at it from health. And I think that’s where I see that public private partnership really expand. But we individually in our own efforts can do that. So whenever I work with clients, I always think about potential government partners that should be brought in to either provide advice or guidance or extra say about partnerships. That’s neat. Speaking of human centered design, have you worked with some of the design firms? Because I think of, for example, idea one of the leading firms, and that concept of human centered design seems like it’s embedded in most of what they do. Are these groups that you’ve also interacted with in your various projects? Yes, yes, they’re important. So we did a design summit at Google, before the pandemic, we had some really interesting partners on board there. And I think many companies actually have a design component. It just, they often are not brought to the table at the start. And I think that’s difficult. So if you’re not actually looking at the user interface until the very end, it’s much more expensive and more time consuming to actually go back in and redesign. So I really think at the start, they need to be part of the discussion to be at the table. Yeah, that makes sense.
Tobin Arthur 28:45
Speaking of Google and space, my co founder, Jens Francis, I’m going to pick on him a little bit. he’s one of my favorite people in the world. But he’s a member, might even be a board member, of Seti. So looking for extraterrestrial life. Where do you come down on this on this topic? Is there is there life out there? Or is there not?
Saralyn Mark, MD 29:07
It’s so funny, you you brought that up, I was cleaning my boxes yesterday, I finally he did that, after so many years of letting everything be in piles. And I found an article I wrote, and it was, after the Kepler found that we have some of our exoplanets that are just perfect for life that Goldilocks effect rice, right. And I actually wrote an article that was published and I talked about it being the universal driver that is, as we find life outside our own little planetary system here. We will all become human we will all become one. We won’t be divided by geographic geopolitical boundaries and other social determinants that divide us we will all be human beings are Earth planets. So yes, I think there is I mean, there’s zillions of stars and heard all these stars we have incredible number of planets. So why wouldn’t therapy may not In the way that we recognize it, but I also I also think we’re all aliens were all made a start us from the beginning of time. So we are actually the aliens that might be a sci fi novel. Another another, another list on your resume. Oh my goodness, we will be very busy. lots lots to write about. Lots to write about.
Tobin Arthur 30:26
Well, let’s wrap it up there. I think we definitely need to have many subsequent discussions, where we can go down any number of these things in more detail, but it’s a great introductory piece. And I hope that everyone watching, listening continues to lean in and listen, we’re going to put in the show notes, links to AI giant and any other programs that you would like to highlight, including talks that you give your book and and invite people to lean in learn more and more to come. So Dr. Mark, thank you so much for spending time today on the show.
Saralyn Mark, MD 31:05
Tobin, it was a pleasure. Thank you so much for having me. And I just hope everybody reaches for their own stars. Well, and while you’re doing that, we are looking forward to getting you back to Colorado and bringing you home as a native. Absolutely, my bags are packed.
Tobin Arthur 31:23