Dr. Tania Small: Why Medical Affairs Is the “Special Ops” of Pharma

Dr. Tania Small: Why Medical Affairs Is the “Special Ops” of Pharma

What if Medical Affairs stopped being viewed as a “bridge” and started being recognized as an active force shaping drug development from beginning to end?

In this episode of **The Pharmaverse Podcast**, host **Michael Pietrack** sits down with **Dr. Tania Small**, Senior Vice President and Head of Medical Affairs at Bristol Myers Squibb and host of the **Doctors Unscripted** podcast, for a deeply personal conversation about patient impact, Medical Affairs, pharma leadership, innovation, and legacy.

Dr. Small shares the heartbreaking experience from her career as a pediatric hematologist-oncologist that ultimately pushed her from clinical medicine into drug development. After losing a young patient not to her disease, but to treatment toxicity, Dr. Small found herself asking a bigger question: **How can we do better?**

That experience continues to influence how she approaches her work in pharma today.

The conversation then challenges one of the industry's most familiar descriptions of Medical Affairs. Dr. Small rejects the idea that Medical Affairs is simply a “bridge” between functions. Instead, she describes Medical Affairs as the **nucleus** and even the **“special ops” of pharma**, with the potential to influence everything from unmet need and clinical development to physician engagement, new indications, gaps in care, and ultimately patient outcomes.

Central to her philosophy is what she calls **patient-driven science**: developing medicines around the needs of patients rather than developing an asset first and attempting to retrofit it to the patient later.

Dr. Small also shares leadership lessons from her mentor, Dr. Mitchell Cairo, including why leaders need to take smart risks, search relentlessly for solutions, embrace failure as part of innovation, and give people at every level permission to contribute.

For current and aspiring pharma leaders, her message is simple: **keep learning, trust your instincts, speak up, take the jump, and never lose sight of the patient on the other end of the work.**

### Timestamps

**00:00** – The patient story that changed Dr. Small's career
**01:30** – Where Dr. Small gets her seemingly endless energy
**03:11** – From pediatric oncology to pharma
**05:33** – When treatment toxicity changes everything
**07:19** – “You don't leave the patient” when you enter pharma
**09:42** – Why Medical Affairs must explain its value
**10:11** – Why Dr. Small rejects the “bridge” analogy
**11:06** – Medical Affairs as the nucleus and “special ops” of pharma
**13:00** – Unmet needs, patient journeys and drug development
**13:40** – Signal seeking and finding new opportunities for medicines
**14:00** – Introducing patient-driven science
**14:50** – What Nike and Michael Jordan can teach pharma
**16:05** – Medical Affairs as a vessel for patient impact
**16:45** – Leadership lessons from Dr. Mitchell Cairo
**18:48** – Innovation, smart risks and failing forward
**21:00** – Advice for the next generation of healthcare leaders
**22:39** – Why every voice in the room matters
**24:10** – What does Dr. Small want her legacy to be?
**25:25** – “Did I make a difference?”

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