Massachusetts doctors going the startup route

Plenty of CEOs at life sciences companies began their careers as doctors, but most practiced medicine for years before landing their jobs. More and more, however, executives in Massachusetts’ red-hot biotech cluster are taking a different route. After spending hundreds of thousands of dollars on elite medical schools, they decide they don’t want to wear a white coat — at least not most of the time. They believe they can do more to improve health care by being entrepreneurs.

“I realized that as a practicing physician or surgeon, the absolute impact I could have was constrained by what I could do with my two hands in 24 hours,” said Dr. Samuel Levy, 35, who planned to become a medical oncologist but instead helped found Allurion Technologies in 2009 to take on the obesity epidemic.

Now that regulators in Europe and the Middle East have approved his Natick company’s medical device — a capsule containing a balloon that fills with water after being swallowed to curb a patient’s appetite — Levy said he can help “patients halfway around the world while I am sleeping.” Allurion’s cofounder is a former Harvard classmate of Levy’s who also decided not to practice medicine.

It’s hard to pin down how many life sciences companies in Massachusetts are led by physicians who never, or briefly, practiced medicine, or who see patients only occasionally.

Of the CEOs running 131 publicly traded life science companies based in Massachusetts, 26, or roughly 20 percent, have medical degrees, according to Radford, a unit of the global professional services firm Aon PLC. Most are in their 50s or older.

But the survey didn’t include the more than 400 privately held life sciences firms Radford estimates are in the state. Those firms, often small venture-backed startups, are more receptive to young physicians with little business experience in leadership positions, according to experts and doctors at the companies.

Dr. Ailis Tweed-Kent is one of those physicians. The chief executive of Cocoon Biotech Inc., she founded the private firm as a first-year resident at Mass. General in 2013, the year after she graduated from Harvard Medical School.

Tweed-Kent, who hopes to use silk fibers to deliver drugs for eye diseases and other disorders, said she works at least six days a week and spends about a quarter of her time providing urgent care to MGH patients. The rest of the time she’s at Cocoon’s offices in Kendall Square.

“Seeing patients is gratifying, but it’s on a different scale,” said Tweed-Kent, who earned a bachelor’s degree in chemical engineering from the University of Notre Dame. “As an entrepreneur, I’m potentially helping millions of patients.”

Cocoon has raised about $4 million from investors and has five employees, including Tweed-Kent.

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Then there’s 39-year-old Dr. Adam Friedman. He earned a medical degree and a PhD in genetics in 2009 through a joint program at Harvard and the Massachusetts of Institute of Technology. Four months before he was set to finish his residency program at Boston Children’s Hospital and Boston Medical Center, he quit and decided not to practice medicine.

Friedman, the son and brother of physicians, said he had been on an “express train to medical practice” at least since he earned a bachelor’s degree in molecular biology at Princeton University. But he wanted to develop oncology drugs to treat different forms of cancer, including acute myeloid leukemia, which killed his father in 2014. This year, Friedman founded Vivid Biosciences LLC, a Boston biotech.

Years ago it was “pretty rare” to meet a young CEO or drug company founder who had earned a medical degree but eschewed becoming a practicing doctor, said Robert Surdel Jr., a Radford partner who has advised life sciences firms on executive pay for about 20 years. But “it’s not uncommon now,” he said, thanks to the explosion of venture-backed biotechs that are developing cutting-edge treatments.

Several factors are fueling the trend, including growing frustration among many physicians.

Over three-quarters of doctors report experiencing burnout, according to a 2018 survey of nearly 9,000 US doctors by the nonprofit Physicians Foundation. Their biggest complaints include burdensome regulations, hours spent wrangling with computerized health records, and a loss of freedom to make the clinical decisions they believe are best for patients.

“Many people start their medical training without knowing what it’s like to actually practice medicine these days,” Friedman said. “Direct bedside care is often a minor component of what a practicing physician does.”

Disillusionment is causing some doctors to look at other ways to use their medical training. In Massachusetts, the number of physicians who reported that they planned to seek a nonclinical job in health care within three years rose from 11 percent in 2012 to 16.6 percent in 2016, according to the Physicians Foundation survey.

Physicians tend to be among the highest-paid professionals, of course, but running a successful life sciences company can be even more lucrative. It’s also risky; the failure rate for such ventures is high.

Dr. Saurabh Saha graduated from Johns Hopkins in 2004 with a medical degree and a PhD in cancer genetics. He had planned to become a neurosurgeon but never applied to a residency program, preferring to create medicines. He took jobs at McKinsey & Co., several drug makers, and then Atlas Venture, a Cambridge venture capital firm that creates life sciences companies. He also earned a management degree at Harvard Business School.

In 2017 he helped sell Delinia, a fledgling Cambridge biotech he was running as an Atlas partner, to Celgene. The New Jersey drug giant agreed to pay $300 million upfront and up to $475 million more if the startup’s novel autoimmune medicines met certain goals. It was one of the highest returns ever in biotech.

Saha, now a senior vice president of research and development for Bristol-Myers Squibb in Cambridge, acknowledged that drug making can lead to big rewards. But he said he heeded advice he got from Dr. Bert Vogelstein, a pioneer in the field of cancer genomics at Johns Hopkins, when Saha decided not to practice medicine 14 years ago: “When you make a career decision, assume you have a billion dollars in the bank and make the decision based on your true passion.”

Not everyone was so encouraging to doctors who made a similar move.

Dr. David Berry said he consulted 33 mentors before he decided to join Flagship Pioneering, another Cambridge venture capital firm, in 2005. Berry had earned a medical degree and a PhD in biological engineering through a joint program at Harvard Medical School and MIT but didn’t apply to a residency program.

“Exactly zero people told me that I should do what I am doing today,” said Berry, now a 40-year-old general partner of Flagship.

But he has no regrets about disregarding the advice. He has cofounded and helped build more than 20 companies involved in life sciences, technology, and sustainability. He holds over 200 patents. And he credits medical school for teaching him how to rigorously analyze and solve scientific conundrums.

“It’s a way of thinking that allows you to take a life sciences problem — or even not a life sciences problem — and, no pun intended, start dissecting,” he said.

Jonathan Saltzmancan be reached at jsaltzman@globe.com.