What makes a truly high-performing team?
Inspired by the precision of Formula One pit crews, where the difference between winning and losing is measured in milliseconds, Ted and Liam explore what clinical trial teams can learn from elite performance environments.

Ted outlines six principles that drive high-performing teams: clear objectives, defined roles, mapped processes, and a culture of continuous improvement. Liam draws on his experience in professional sport to reflect on why teams that truly operate at that level are rarer than we think, and why clinical trials are no exception.

The episode leaves listeners with one question: what if we did the debrief before the problem existed?

In Part 3 of 3, Liam and Ted continue their conversation with Frank Watanabe, CEO of Arcutis Biotherapeutics discussing work-life balance, building social capital, and management vs. leadership.

The conversation explores leadership at a practical level, from building trust across remote teams to creating flexibility that allows individuals to balance work and life in a way that works for them.

Finally, he outlines his vision for Arcutis and what “meaningful innovation” really means focusing on solving real problems that matter to patients and clinicians.

In Part 2 of 3, Liam and Ted continue their conversation with Frank Watanabe, CEO of Arcutis Biotherapeutics, focusing on what it takes to hire and build high-performing teams in high-risk environments.

Frank shares how he approaches hiring beyond technical skills placing strong emphasis on cultural fit, risk tolerance, and the ability to innovate.
The discussion also explores how to create a culture where people feel comfortable taking risks and learning from failure.

From encouraging teams to challenge the status quo to fostering psychological safety through leadership, Frank outlines what it takes to build organizations that continuously improve.

They also dive into aligning incentives, building a mission-driven culture, and ensuring that when a company succeeds, its people succeed too.

In this episode, Liam and Ted sit down with Frank Watanabe, President and CEO of Arcutis Biotherapeutics, to explore his journey from a Navy officer to a biotech executive and the leadership principles established along the way.

Frank shares how his early experiences in the military and his transition into pharma and biotech influenced his approach to leadership, highlighting a key idea that defines his philosophy: leadership isn’t about authority, it’s about earning trust and loyalty

They discuss how operating principles can become the “DNA” of a company, not just words on a wall, and what it takes to embed culture into everyday decision-making.

A patient in a database is not a patient in a trial. So why do we keep treating feasibility like a headcount?

Fresh from a week deep in feasibility work, Liam introduces four characters who show up and cause chaos in almost every feasibility process.

There's Spreadsheet Larry, who confuses a number with a truth. The EMR Oracle, who offers psychological safety dressed up as data.

Prevalence Pete, who chases the sexiest percentage instead of the biggest addressable population. And Motivation Mabel, the patient who technically qualifies but simply isn't interested.

Together in this episode, Liam and Ted make the case that real feasibility isn't about being right it's about being useful. Understanding the conversion funnel, knowing how confident you actually are in your data, and recognizing that patients are humans driven by trust.

In elite sports, races are often won or lost in the transition, and Liam and Ted argue that the same is true in clinical trials. Drawing on the precision of Olympic relay racing, they make the case that the handoff points between sponsors, CROs, and sites are where trials quietly succeed or silently fall apart.

From recruitment referrals that never get followed up, to sites given the green light before they're actually ready, the gaps are rarely dramatic, but the cost adds up. The culprit, more often than not, is assumption over communication.

Tune in to find out why fixing the handoff might be the simplest, and most overlooked way to run better trials.

Using a David Letterman-inspired “Top 10” format, the conversation highlights common feasibility pitfalls faced by sponsors, CROs, and clinical trial sites, including overly complex questionnaires, unrealistic enrollment expectations, delayed communication, and last-minute fire drills.

The discussion goes beyond surface-level frustration to explore how sponsors and CROs can rethink clinical trial site feasibility by simplifying processes, questioning legacy requirements, and focusing on identifying and supporting sites with the highest potential for success. Ted and Liam also examine how better feasibility strategy can improve enrollment outcomes, reduce operational burden, and ultimately lead to more efficient clinical trials.

This episode is for professionals involved in site feasibility, trial startup, enrollment strategy, and clinical operations, and for those who want to move beyond broken processes and drive better trial performance.

Why do clinical trials struggle even when teams are experienced and well-intentioned?

In this episode, Liam and Ted explore why these outcomes are rarely about individual performance and far more often about system-level misalignments. They unpack how incentives, information flow, and decision rights across sponsors, CROs, and sites shape behaviour and why execution tends to break down logically, not randomly.

The discussion reframes “execution issues” as predictable outcomes of how trials are designed and governed, offering a clearer lens for understanding why good teams can still produce fragile results.