Title: From Future Doc to Healthcare Industry Disruptor: Alice Yan ‘19, ‘20

[00:00:04,610] CHRISTA DOWNEY: Welcome to Engineering Career Conversations. I'm Christina Downey, Director of the Engineering Career Center at Cornell University.

[00:00:12,585] TRACI NATHANS-KELLY: And I'm Traci Nathans-Kelly, Director of the Engineering Communications Program. We are excited to bring forum where we will host lively conversations that we hope will inspire you.

[00:00:25,330] CHRISTA DOWNEY: Today we're here with Alice, who graduated from Cornell with an undergraduate degree in biomedical engineering as well as our MEng in mechanical engineering. Alice, welcome.

[00:00:35,690] ALICE YAN: Hi, Christa, so nice to be here. Thanks for inviting me.
 
[00:00:40,250] CHRISTA DOWNEY: It's great to have you. Alice, can you please start by telling us a bit about your career path and how you transitioned from engineering to regulation?

[00:00:48,815] ALICE YAN: Yeah. I guess it started out from the very beginning. I've always wanted to do something in the health care industry. In high school I wanted to be a doctor because that's the only thing that you think of when you think health care as someone at a very young age, not knowing much about the world. And it wasn't until the tail end of high school that I learned about biomedical engineering. I learned that there are kind of like the brains behind the cool technologies that doctors use. And I want it to be the person to make all of those cool technologies. So I was really fortunate that the timing actually worked out really well. The summer before my freshman year. Biomedical Engineering was officially announced to be offered at Cornell that summer. So I was super excited. And then I decided to do an MEng in mechanical engineering, mostly because they wanted to gain more specialized experience in R&D. And I felt that doing an MEng in mechanical engineering would help me get there. So that's kind of the background. Where everything started to change was at some point during my MEng, I realized that engineering doesn't suit my personality and my career ambitions very well. At first, I was really worried because why did I just spend five years at Cornell, like wasting my parents hard-earned money on something that I didn't even want to pursue anymore. But I felt bad and I tried to make it work at first and then I realized it's not worth it if I'm not fulfilled. I learned that it's okay and I'm allowed to try something new. So I did various internships, co-ops, at medical device companies, because pursuing something in health care was still something I was passionate about. That part didn't change. So I did internships in clinical research, quality, product management, everything that you can think of. At the end of it, I was really worried that my resume didn't tell a story like everyone else's. Such fragmented experiences, none of it really related to one another. But then I thought I really tried so many different things just to find something I'm really passionate about. And that does actually tell a story. My first big girl job out of college was at Abbott and it was in the medical device division, something that I was passionate about working on. It was in regulatory operations, so again, I decided to try something new. Operations was really interesting to me because I realized I love creating processes for companies. And regulatory was also really interesting to me because regulations are so nuanced and complicated, especially international regulations and even regulations within the US. This is where I realized I love solving challenging problems and digesting complicated requirements and creating processes that are efficient and integrate well with something that I also realized I like doing. However, this is something that something that always bothered me at Abbott is how difficult it was to make improvements and changes. I'm not someone with a personality that can sit still. If something is broken, if a process is not as efficient as it can be, or if the system just doesn't work I want to improve it. But it's really difficult when those processes have been around for decades. And at a company as large and established as Abbott, making changes can be really difficult and feeling impactful is even harder. So after two years at Abbott, I decided to try working at a startup. So that's kind of how I got to where I am, kind of a history of my career path. It's a really interesting story.

[00:04:46,985] TRACI NATHANS-KELLY: I love that Alice, the complications of finding your fulfillment along the way, right? It can be a very hard one sometimes it's fragmented like you said.

[00:04:58,325] ALICE YAN: Yeah, I think a lot of times, especially when you're in college, you kind of think what you major in this supposed to be what you're going to do for the rest of your life. So it can be really scary stepping outside of that.

[00:05:13,655] TRACI NATHANS-KELLY: I say so often to my engineering students that engineering is a systems way of thinking. And I think that you brought that out just now with that description of seeing the larger system and how to fix problems within it and so forth. So you lifted off with you're leaving Abbott and you made a jump into a new role. So how did you find your way into that new place?

[00:05:37,175] ALICE YAN: I had heard of Forward before, and sorry to backup, I do now work at a startup called Forward. It's a health tech startup and I can get a little bit more into what exactly we do later. But exactly how I got here is I'd heard of it before. I keep this note on my phone that has all my dream companies on it that I hope to work at one day and Forward was actually on that list because I'd heard of their incredible mission to save the US health care system. I thought it was such an ambitious and lofty goal, but I think that's what really intrigued me. So when I saw a job open up on LinkedIn at Forward for compliance operations, I thought this is my dream job and I'm passionate about the mission. I felt qualified, I had some experience under my belt. I felt confident, so I applied. I think the interview process is a really good indicator of what it would be like to work at the company. So for me personally, I was surprised at how much I enjoyed the interview process at Forward. I went into it thinking I would be stressed and anxious but to be honest, I look forward to every interaction with the people who work there. And for some people, the processes is like a hit or miss. But I think that, that's how you know if the process is actually working. If you didn't enjoy that interview process, you probably wouldn't enjoy working at the company and that's okay. That's the natural way of things working out. I remember in one of the final rounds I needed to make this presentation on some case study questions. So I had that interview right after a vacation I had planned, but I got so sucked into the project that I missed out on my entire vacation. I was literally sitting in the hotel room all day long, all night working on it. I didn't have to, I could've just worked on it for like 6 hours or 4 hours. But these were actually really interesting projects and problems that I was tasked to solve. And I was actually having a lot of fun and I didn't remember the last time I had fun working. So I think that was a really good indicator that I would really enjoy working in this company.

[00:07:55,415] CHRISTA DOWNEY: I love that concept of having so much fun working. I mean, not to encourage everybody to give up their vacations, of course, but just to think that you had that much fun, that is a great indication that you would enjoy the work. I love it. It's very inspiring. And speaking of inspiring, I'm curious to hear more about how your work contributes to a healthier, more equitable, more sustainable world.

[00:08:23,675] ALICE YAN: Yeah, so first and foremost, Forward's mission is to build the world's best health care for billions for free. Full stop. The best is to address quality of care. The billions implies the scale. The free helps us address access. And to be honest, this is a really ambitious goal. You're probably sitting there thinking, how the heck are we supposed to ever get to this place? And that is true. It's going to take us a long time to get to this point. But this is what every single person who works at Forward is here to do. All of our decisions are for that single goal. So where are we now? Our current model is we are a subscription-based model is $149 a month. For that subscription, that gives you unlimited access to in-person and telemedicine healthcare. We focus primarily on primary and preventative care. Our key tenet is that we don't take insurance. We think that the current insurance-based health care system has created the wrong incentives. Preventative care equals behavior change so it's really difficult to do that in 15 minutes with a health care provider once a year during your annual checkup. When you visit the doctor now it's probably more reactive, which means that you don't go until something is already wrong. And the current system has no incentive to help you be healthy. If anything, they want you to be less healthy because that's how money is made. And kind of a fun fact here, healthcare spending in the US was almost 20% of GDP in 2021. So that kind of shows you how much we rely on healthcare spending in our economy. As a Forward member, your primary care as a flat fee. You get the partnership and the support that you need, it doesn't matter if it’s one conversation in an entire year or if it's every single day, you start to build the relationships and get the care that you need. Another aspect that I think is really different from your traditional doctor's office is how we leverage technology. So think about service businesses. Services get more expensive and not less so the cost of living adjustments raises clinician shortages. They're expensive as you hire more people. And then if you think about technology, it gets less expensive over time and scalable to billions. As a good example, the iPhone. I'm by all means not claiming technology is perfect. Technology makes a lot of mistakes, but it's easier to find those mistakes and fix them in technology and it's kind of the opposite in people. It's really hard to monitor quality in people. And I don't believe in my lifetime that everything will be fully automated, but wouldn't it make more sense to save clinicians for making the discoveries and not doing the small things that machines can automate.

[00:11:25,700] TRACI NATHANS-KELLY: I think you have some really interesting points here. And I love the approach that this is a, well, it's one of those disruptors, right? So do you feel that energy when you're at work like, we're working on disruption of the system? I was so taken by the 20% of the GDP in the United States as being healthcare-related so all of a sudden, health care preserving the status quo makes a lot more sense to me.

[00:11:57,770] ALICE YAN: So yeah, you feel the mission every day that you work here. So we're 100% in the office and it does help with creating that culture and collaborating. So I do feel that every day at work. So, for example, you feel the culture around you like, we are a role agnostic company, so what that means is there's no hierarchy. There's no managers, directors, C-suite. Everyone's on the same level. We feel comfortable talking to everyone as a peer rather than thinking like, oh, this person's above me. Or like this person wouldn't listen to my ideas because they've had more experience. We're all on the same level here and essentially trying to solve the same problems so it shouldn't matter what is your rank or level. We know and collaborate with everyone at the company because at the end of the day, again, we're all here for the same reason and that resonates every day with you here, every second. Every person that I talk to here is passionate about the same cause. It's really incredible. I've never been in a place where every single person you talk to you is so passionate about the cause. Usually when you're working at a company everyone's there because they get paid to be there and just their day job, and they go home and they have a life. But their job is not something that they're really passionate about. And I feel like that's a huge difference here and it does motivate me to constantly push myself and do better. Something else that I think is really different here is the way that we make decisions. We're not tied to our ideas, so debate is really friendly here. And that doesn't mean that we don't debate hard or that we don't have our differences. It just means that we remind ourselves that at the end of the day, you're not your ideas. And what that means is, for example, I shouldn't be arguing that my solution is the best solution because I was the one that came up with it. Someone else may very well have a great point that proves that my suggestion doesn't help solve the problem or isn't the best solution. And that should be okay because we don't take things personally here because we're all here to just find the best solution. The decisions that we make together should, in the end, be the best solution to the problem that we're all trying to solve.

[00:14:40,985] TRACI NATHANS-KELLY: As somebody who spends a lot of time in the classroom, as you remember being around here, the undergraduate classroom, it seems like such a contrast in approaches. Because, with tests and with papers and even some presentations or whatever it is, you use to cement your learning in your engineering courses, it's like, this is my idea and I'm bringing it here to be judged, or evaluated, or to be taken on by the team. And your work atmosphere just seems so different than that. Was that an interesting adjustment for you? Was it easy, or hard, or welcome?

[00:15:21,500] ALICE YAN: It was an adjustment, yeah. And it's something that I think there's a right time and place for pushing your own ideas further. But I think in this case of working at Forward, you kind of have to remember why you're here and having the reasoning behind it. There very well could be a good reason for tying yourself to your solution, for example, when you're in the classroom and you're debating to learn and all of that. But here it's like, what are we trying to do? We're trying to build a product that is the best product and in the end, if you tie yourself to your solution, you're just going to take it too personally when someone comes with facts and says this is actually a better way to build a product, you want to be receptive to that. Because at the end we're trying to just make the best decisions for the company.

[00:16:30,020] CHRISTA DOWNEY: So, you've found this fulfilling work for a collaborative, mission-driven organization. What have been your greatest challenges in your work, and how did you overcome those challenges?

[00:16:42,050] ALICE YAN: I think the biggest challenge is learning how to be a leader here. Something that's really different is like, when I was working at Abbott, I was basically being told what to do. You don't really get much opportunity to actually make decisions and improve processes. You can improve processes incrementally but in the grand scheme of things, you're basically there because they have a process built already and you're supposed to execute on it. At Forward I had to learn how to be the leader, not just someone who does what they're told. You learn how to be an expert on topics that you never thought you would be an expert on and you drive decisions. And that's been the most challenging thing, that transition between executing and now driving, being the person to drive a decision. Another really challenging thing here is thinking that someone somewhere should know how to do something. I think that's just the challenge of working at a startup is you really have to be the one doing the dirty work, doing the research, because chances are no one else is going to know. You have to become the expert at something and that's something really difficult because there's uncertainty. At a larger company you have the certainty of knowing what you're doing is the right thing. At a startup, it's the opposite, where you just have to embrace the uncertainty because resources are scarce. There's only a certain amount of people and a certain amount of time and a lot of work to do. So just embracing the uncertainty here is probably the most significant challenge.

[00:18:33,980] TRACI NATHANS-KELLY: I think that takes us really nicely to the next thing that we wanted to ask you. So we're asking you to hop in the time machine and go back to when you're finishing out your sophomore year. That's the time that most engineering students affiliate. That's why I am asking about that point. Remembering that moment, what do you wish you knew when you were a sophomore?

[00:18:59,480] ALICE YAN: That's a great question. I was really anxious all throughout college. I think at that point in your life, you're just anticipating what your future is going to be like. I really wish I told myself to just take a breather and not stress too much about finding a job. I really wish I knew that my career was not linear. You should do what you're passionate about, not what you majored in, but if they're the same, that's great and if not, that's no big deal because you should do what makes you happy and what makes you want to get up every morning for. You're not meant to know exactly what you want to be doing for the rest of your life at the age of 18 or even 22 or even 50. Life is about discovery and finding new interests and if you found what you want to pursue for the rest of your life, I'm not saying that's a bad thing. That's awesome. But for those of you who are lost or unsure, I'm here to affirm that that's totally normal. And I actually highly encourage having a career with some flexibility as you might end up really miserable having a job that you don't love, just because it fits your major, or because you've been in this industry for five or ten or 20 years already. It's never too late. I think honestly, I'm really passionate about regulations right now and solving those really difficult problems that connects regulatory and health care, but I'm not tying myself to that. I think it's totally okay if in ten years I'm not passionate about anymore and I find a different passion. It's okay to jump to a new career or find something different to work on.

[00:20:58,210] CHRISTA DOWNEY: Excellent, Excellent. Well, I look forward to seeing where this journey takes you. Okay, so are you ready for the speed round? What do you do to relax, have fun and re-energize.

[00:21:10,705] ALICE YAN: I like going on long walks and runs with my dog. I have a husky, so she is super energetic and I constantly have to be outside with her. I like going to the beach here in the Bay Area. Lots of nice beaches and sunshine. And I also like to source music and create mixes. I actually picked up deejaying as a hobby during COVID because there was no live music, so I just decided to start doing it myself.

[00:21:40,085] TRACI NATHANS-KELLY: That is so good. I have a lot of music people in my life and I'm sure they would all say, yeah, I should've done that too. Sounds really great.

[00:21:51,065] ALICE YAN: Yeah, I think it's really nice. I think it's a good idea breaking up something super technical that you do during your daily life with something creative and then can have a mix of both.

[00:22:03,155] TRACI NATHANS-KELLY: Right, it's good. You have to have that, totally,
a different way of thinking about balance, it's that creative outlet. And then I'm going to pull you back to work here just a little bit. What's one place that you really like to go for information in order to stay current where you are now at your job?

[00:22:20,215] ALICE YAN: Yeah. So actually the main source of information that I use is we use Slack and we have a hashtag random news Slack channel, where people share news articles about health care and the latest tech, even things that are not healthcare-related, so I kind of rely on that a lot. But Healthcare Dive is actually a really good healthcare-specific news source if you're interested in learning more and keeping up with current events in healthcare.

[00:22:53,240] CHRISTA DOWNEY: Excellent. And I know you shared a list of books with us as well, and we will be listing them on the page for this for this episode. Excellent. Okay. One more question. If you were not doing this work right now, what would you be doing, and which of these is closest to what you dreamed of when you were a child?
 
[00:23:11,930] ALICE YAN: To be honest, I would probably pursue deejaying because I think that it is totally out there and different and I'm young right now, so you can always come back to a nine to five job. I think right now my life flexibility is really important. I think to be honest, I still may pursue it someday. Who knows? Right now I'm really focused on the mission here at Forward and I really enjoy solving these complicated problems. So deejaying is just a hobby. But actually believe it or not, I put it in my fifth grade yearbook that I want it to be a mathematician someday. So I guess that's closer to what I'm doing now than deejaying but it just shows l that life really is not linear.

[00:24:03,140] CHRISTA DOWNEY: It is not. And I don't know if I'm more impressed with your deejaying skill set or the fact that in fifth grade you want it to be a mathematician. I love it. Excellent, Alice it's so fun chatting with you again, it's great to see you again. This has been wonderful. Thank you for sharing.

[00:24:18,050] ALICE YAN: Thank you so much. Yeah, and I encourage everyone,
if you want to chat more about career paths, I'm very open to chatting with anyone in the College of Engineering or if you're not, feel free to add me on LinkedIn. Find my name.

[00:24:33,485] TRACI NATHANS-KELLY: Thank you for so generously sharing where you are and where you came from and what that arc was for you. Thank you so much for today.
 
[00:24:43,100] ALICE YAN: Thank you so much for having me. I appreciate it.

[00:24:48,860] CHRISTA DOWNEY: Join us for the next episode where we'll be celebrating excellence and innovation among engineers whose impact contributes to a healthier, more equitable and more sustainable world.







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