Chief Executive Officer (Chair of Executive Committee), Galderma Group AG
How Galderma's CEO is Navigating Change and Innovation in Healthcare (Ft. Flemming Ørnskov)
What does it take to lead both in high-pressure moments and during business transformations?
In the latest episode of Behind the Human, I sit down with Flemming Ørnskov, the dynamic CEO of Galderma , as we delve into his unique journey from neonatology to the boardroom. Flemming shares his insights on leveraging mental fitness and strategic planning to navigate leadership challenges and drive growth. Tune in to explore his approach to turning stress into success and hear his strategies on building resilient teams, crafting impactful business strategies and leading with empathy and determina...
About Flemming Ørnskov
Flemming Ørnskov, CEO of Galderma, has discussed his leadership approach and the company’s strategy in several podcast interviews. He stated that he runs Galderma as if it were a public company, focusing on financial rigor and compliance. Ørnskov said the company has nearly doubled its R&D investments and launched 22 new products or formulations in a single year. He highlighted two biologic programs: nemolizumab, an IL-31 inhibitor, and QM1114, an in-house developed botulinum toxin A, which he said showed a median onset of two days and duration up to six months in phase three studies. Ørnskov noted that the company maintained supply across its four manufacturing sites during the COVID-19 pandemic. Ørnskov has described his leadership approach as avoiding procrastination and sticking to a clear plan, citing the transformation of Galderma’s logo, website, and operations. He said he runs the company as if it were publicly listed, despite not needing IPO proceeds for funding. He emphasized the company’s focus on dermatology, stating that the company aims to "advance dermatology for every skin story" through innovation. Ørnskov, a former physician, said he draws on his medical background and described his role as being "all in" and focused on delivering for the team. He also noted that the company has increased investment in R&D and training for customer-facing staff.
Transcript (60 segments)
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Mark Champagne0:00
All right, welcome everyone to another episode of Behind the Human. My name is Mark Champagne, I'm your host, and it's my job to unpack the stories and mental fitness practices of just exceptional humans living at the top of their game personally and professionally. Today we've got a special setup: lights, cameras, the whole nine yards. Live interview here with Flemming, who is the CEO of Galderma. We're going to touch on change, innovation, leadership, mental fitness, and everything in between. So thank you and welcome, welcome to the show.
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Flemming Ørnskov0:33
Mark, thanks for having me. Really appreciate it.
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Mark Champagne0:37
Oh, it's my pleasure. I have a bit of an unfair advantage because I've spent about six weeks inside your head without you knowing it. Just scary, in terms of the research and whatnot. So I'm excited for this conversation.
But to start, before we get into any of the topics, if we could just put aside the title of CEO and everything you're doing day-to-day for a few minutes and tap into the question: who are you?
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Flemming Ørnskov1:09
Came from a small town on the west coast of Denmark, grew up also partly on an island. That forms you a little bit when you have to take a boat to school. I think that being a physician is really what has changed my way of thinking and is a large part of what I do. I always go back to my training as a physician. I trained in pediatrics and worked in neonatology, very newborn, very small kids, often very stressful situations. You have to act quickly, be good with your hands, prioritize. It's many times about survival, and you work in a team because it's not just the neonatologist, it's also the nurses. So I'm used to working under stress, I'm good at prioritizing, but I always go back to my roots as a physician.
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Mark Champagne2:08
So I'm curious: when did you know that you wanted to be a physician and start that role? And equally, I'm curious to see how that transition into a CEO role happened as well.
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Flemming Ørnskov2:20
Yes, so when I grew up, I was mostly about playing soccer. I wanted to be a professional soccer player and spent a lot of time on that. Then my brother started at university in Denmark. After I finished high school, I took a sabbatical, went to the UK, was thinking about going to university there. I came back and thought, what should I do? I enrolled in two studies: first literature, and the second was medicine. I wasn't quite clear where I was going. My brother was also in literature, so I thought that was interesting. We were both the first academics from non-academic families. At some point, I needed money to pay for studies, so I started working at night as a nurse. That was when I thought, wow, I've really found where I'm going to be good at. One of my first jobs was as a nurse assistant in an intensive care unit for neonates. That was basically the way I said, this is what I want to do. I finished med school, trained in pediatrics, and then stayed in neonatology.
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Mark Champagne3:39
Out of all fields, especially pediatrics. My youngest son was in the NICU for a week. He's fine now, but that was probably the hardest week of my life. I remember thinking, I don't know how these teams do it. You either can't be around that or you have to be around it to help. I'm assuming you're the latter, that you could see the impact of your skill set.
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Flemming Ørnskov4:13
Yeah, so a lot of these kids need intensive care. They need someone standing next to their bed, making sure they have the right temperature. You're working in a room with very high temperature, constantly alarms going off. These very small kids are often intubated, have all kinds of IV lines. There's a lot of stress, and all the time you can be called to the OBGYN department for another delivery of a high-risk baby that you have to immediately put on life support and get back to the NICU. So you really learn how to constantly work under stress in humid conditions, in teams. It's something you never forget. It's the way you think and act the rest of your life. Most other things you meet in life get into perspective. You often had the very unpleasant situation of talking to parents who went through IVF, maybe advanced in age, get this kid, the kid comes out extremely early and does not survive. So you also have to have some really tough discussions. You learn all aspects of life, the early parts, at a very early age.
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Mark Champagne5:46
So Flemming, how did you, in that period of your life and through that profession, handle that level of pressure and stress? Did you have any techniques or practices to leave some of that behind in the hospital? Because you can only hold so much space. When you go home, there has to be some sort of disconnect or you'll melt down.
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Flemming Ørnskov6:25
The first thing is you need to stay physically fit. When I trained, the working hours were crazy. You were basically on call for days, mostly at night. You had weeks where you were working all the time. So you really needed to put time into physical exercise. I also wanted to study literature, so I used spare time to read or relax. You need to get your mind around something else because it becomes all-absorbing. You can't deal with the stress then. I learned that when I'm at the clinic, I'm 100%, maybe 150% there. When I'm not there, I'm somewhere else. But given that I basically lived at the hospital as a resident, I had to do physical exercise, play soccer, and read a lot.
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Mark Champagne7:32
What kind of stuff do you read?
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Flemming Ørnskov7:33
A bit unusual. I like to read more classical literature. One of my favorite authors is Chekhov, who was also a physician and unfortunately died of tuberculosis. I like classical literature and short stories. Chekhov is one of the best at writing short stories. I go back and read a lot of stuff that most people would say, why are you reading this? I stay away from the latest fashion or hyped novel. There's so much fantastic literature, but I often go back to the same sources, and Chekhov is a constant source for me.
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Mark Champagne8:13
What do you think it does for your mind when you read things from Chekhov and these short stories? People don't talk about the why behind it. So what does it do for you?
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Flemming Ørnskov8:36
What I like is that the most difficult thing in life is to take a complex situation and describe it in a few words or sentences. Chekhov and others have an ability to describe something in very few words, which is impressive. It takes much more work. The insight into human behavior is amazing. Chekhov was a physician, often poor, practiced as a physician, wrote short stories about people in tough conditions, and knew all the time that he had a death sentence from tuberculosis. That puts the whole thing in perspective.
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Mark Champagne9:38
It is true. I'm by no means comparing myself to those authors, but having written my book, it is so hard to distill concepts and thoughts into very few words so anyone can pick it up and see the relatability. I do a lot of talks for companies. The worst is when you say, can you do the keynote in 20 minutes instead of 50. That's harder. You have to be concise and bring people in. That's a skill set in itself. As a physician, you're drawn towards other physicians who are also writers because you can see the insight from their medical practice. The ability to distill problems into simple things and focus is transportable not only to medicine but also to a role like the one I have today.
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Flemming Ørnskov10:42
Yeah, well, I assume it trains you to ask really good questions and look for the small details. Sometimes it's the details that surprise you. People say you shouldn't be obsessed about details, but often the devil is in the detail.
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Mark Champagne10:57
So let's continue. Where did you go from there? You're not a practicing physician right now. What did that transition look like and why?
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Flemming Ørnskov11:10
I trained in Denmark, then went to France to train further. Paying for medical school was tough, so I used my vacations to go to Sweden, up to the north part, where I would be the only doctor in a very big geographical area. Even though I was focused on pediatrics, I had to deal with many other patients in the emergency room. I learned a lot about dealing with stress, challenging physical circumstances, intense cold, accidents. You really learn to operate and think under extreme circumstances. At some point, the director of the University Hospital of Copenhagen came to me and said, I think you'll be a good representative of the young physicians. He involved me in a reorganization project with McKinsey. They wanted to combine OBGYN and pediatrics into a mother-child unit. That was my first exposure. A few years later, they helped me get to Harvard to do an MPH focusing on healthcare administration. I thought, this is a perfect fit. But when I was at Harvard, it was mind-blowing to see all the other things you could do with a business and administration background. After going back to Denmark to finish my physician education, I decided to try something else and went into research at Merck.
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Mark Champagne13:20
Okay, where does this passion for business come from? Your family upbringing wasn't on that path. Where did the spark come from?
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Flemming Ørnskov13:32
The academic part was pretty unusual. I was the only one in the family, together with my brother, to go to university. My friends were like me, playing soccer, and many ended up as postmen or fishermen. It was gradual. When I got into something, I really put my mind to it. At Merck, in research and outcomes research, I figured out that to get further, I needed to understand business. I went to my boss and said, send me into the field as a rep and manager. He thought it was crazy, but that's when my career took off.
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Mark Champagne14:30
Wow. I'd love to know what it's like being a CEO at your level. For those of us who aren't running multi-billion dollar operations and working on deals like the $60 billion deal with Shire and Takeda, what do we not know about your position?
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Flemming Ørnskov14:55
The way I focus on a CEO job, whether at Shire or now at Galderma, always starts with the same thing: understand the business plan, where we're going to be in five years, the drivers of the business, how to set up the business, build a team, and what performance criteria to use. It goes back to the physician part. In an emergency room or NICU, you figure out the diagnosis, treatment plan, get a team around it, and lay out a plan. It's no different in business: diagnose the challenge, lay out a plan, and execute with a team.
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Mark Champagne15:45
Do you have a certain routine or rituals when you start big projects or new initiatives? Is there something that works well for you personally to allow your mind to be calmer and let the answers surface?
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Flemming Ørnskov16:10
I like to have three to four months to think and study. When I became CEO of Shire in 2013, I arranged with the board to shadow the outgoing CEO. It gave me three months to travel, see all subsidiaries, and get an idea about the business. One aha moment was a visit to Boston, where they had bought a small rare disease company. After three months, I thought, we're going to pivot this company to be a rare disease company. We focused on the smallest part of the business and built it into the world's largest rare disease business, later sold for $62.5 billion. With Galderma, the owners approached me in February 2019, bought the business in June, and I took over in October. I spent three to four months studying every detail, sitting in on presentations by Nestlé, visiting manufacturing sites, speaking to people, traveling the world. That allowed me to immediately know the three areas to focus on: aesthetics, consumer, and prescription medicine. Those months were pivotal to developing a crystal clear strategy.
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Mark Champagne18:06
You're probably answering my next question. How do you have the confidence to make big decisions like this? It sounds like you go into it with a lot of data, months of study. It reminds me of your version of doing residency within these organizations.
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Flemming Ørnskov18:29
Yes. In residency, you learn that you really need to know your stuff and respect that others know more. Practice is important. After diagnosis or analysis, in the medical world there are round tables to discuss the case and get challenged. In business, I try to surround myself with people for a round table to challenge me. We all have biases, so you need a group to challenge you. Once I get going, I'm pretty steady. You cannot procrastinate. Once you set the plan, stick to it. At Galderma, we changed the logo, website, way we operate, talk about ourselves, and organized ourselves. It was crystal clear from the beginning.
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Mark Champagne19:48
That's inspiring, impressive. I'm going to pivot a little. There's a quote from a recent documentary on Roger Federer. I think you guys know each other. He said, 'People would say my play was effortless. I had to work very hard to make it look easy. Effortless is a myth.' Any initial thoughts on that line?
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Flemming Ørnskov20:39
Yes, I had the opportunity to have lunch with him during a promotional tour for his book. One thing I could identify with, though no comparison, is that when asked about his formidable years, he said it was when he left home at 14 to go to the Geneva area by himself to play tennis. It was really hard, but the discipline, stamina, and learning to deal with pressure and rely on himself were formative. I learned some of that in medical school and working in neonatal intensive care units. You always have a part of your life that is formidable and that you take with you.
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Mark Champagne21:49
It makes sense. For me, watching Roger play is the definition of being mentally fit. He's levelheaded in the highest pressure situations. I saw that in interviews when people talk about you and the way you set vision. You just came back from 17 hours of travel and you're here, present, making it look easy. How do you do it? How do you make some of these elements look effortless?
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Flemming Ørnskov22:58
You always have to put your job into perspective. If I compare this job to being in a neonatal intensive care unit, everything is in perspective. But you carry responsibility to many stakeholders: investors, your team, colleagues, people who have put faith or money into the business. The best you can do is be all in. I feel gifted with an opportunity and need to do my best with my team. You're in a privileged situation, but you have to deliver. I can live with that pressure because I've lived with pressure all my life, particularly as a physician. The effortless is just the appearance outside. It's hundreds of hours of study, analysis, thinking. Even when running or with my kids, I'm always thinking about the business and writing notes. I know the plan and goals. I always adjust how to get there, but I never steer away from the overall plan.
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Mark Champagne24:46
What do you struggle with, whether it's a skill or mental narratives? Is there something you're working on?
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Flemming Ørnskov25:07
The biggest challenge is to avoid distractions. You get so many invitations, meetings, things you can do. It's a constant struggle to be friendly and say no. I get more inspired by being with physicians in China, with my team, at conferences, at educational events. You constantly have to battle and say to your assistant, yes it's interesting, but where does it fall in our priority? Calendar management is the biggest challenge. There are so many nice-to-haves, but you have to ask if this is where you should focus your time. Some of that plays to your ego. People want you as a keynote speaker or for articles. You have to battle that and say, I'm not here to polish my own ego. I'm entrusted to do a job. The investors have built trust in us. That's what I should focus on. On Sunday evening, I look at my calendar and sometimes think, why did I say yes to that? I was too nice. I would like to be less nice with things that are less important.
To your point, sometimes we say yes to things that are farther out, and then we get to that moment and think, ah, shoot. But it's not only calendar management, it's also managing your own ego. I like to be an anonymous CEO. I don't want the show to be about me because it's really not. I don't own the company. There will be another CEO one day. You have to be an anonymous CEO, not that no one knows you, but you always say I'm second or third in this show. The main character is the company, the performance, what we do for patients. You have to look at your own human frailty and ask, is this for me or for the company? That goes back to Chekhov. Even though he was living with tuberculosis and under challenging financial situations, it was always about describing, and it was less about him. That's why you learn so much from people under much harder circumstances. They learn how to focus.
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Mark Champagne27:40
A friendly Canadian challenge here to you. Having interviewed a lot of people, ego often comes out, and I don't feel that with you. You're a very humble person with a tremendous amount to give. I'm grateful for this interview. Maybe it's not this phase in your life, but I feel an interview circuit or a book in you, going back to your literature desire. There are powerful ways of thought you're sharing that could have an exponential impact. So maybe not now, but I want to plant the seed selfishly because I'd like a little more Flemming wisdom in this world.
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Flemming Ørnskov29:13
You know, when much is given, you also have to give back. A few years ago, the small Swiss town where I live had a struggling soccer club nearly bankrupt. Parents were unhappy their kids couldn't play, the waiting list was very long, and no one was doing anything. So my family decided to step in: my wife became a coach, and I became club president. We implemented a system where parents who coach get priority, and it's a joy to see families bonding, even if the kids won't all become Messi or Ronaldo.
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Mark Champagne31:28
Yeah, I love it. I'm going to pivot a little bit, but I think there is a link to business and operational rhythm. The quote I love from the book 'Co-Excellence' where you said: 'When people know there's an organizational rhythm, it allows them to be more efficient.' And you also said, 'Creating the right operating structure that is intense and focused enables me to leverage great people and have time outside of meetings to think, meet customers, take time off, exercise.' I'm curious—where do you start when trying to instill a healthy operational rhythm?
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Flemming Ørnskov32:58
I've always been obsessed with structure and process. Without it, it's hard to be successful. Going back to my neonatology days, there was a daily rhythm: morning reports, rounds, lunchtime meetings with colleagues, evening handovers. That rhythm was critical. When I came to Galderma, that was lacking—they met once a month as a big group. So I created three committees: the Inline Committee (commercial performance, meets monthly), the R&D Committee (pipeline and business development), and the Corporate Committee (capital allocation and hiring). They all meet the same week every month, and the Executive Committee handles conflicts. Simple, transparent, and the minutes are well-known. We also have three themes for all meetings: Performance, Platform, and Growth. Every presentation ends with one slide: 'My Asks'—what decision do you need?
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Mark Champagne36:02
This strikes me as a defense against distraction—bringing people back to what we're doing. It goes back to calendar management. You told your assistant to put issues into boxes: Inline, Pipeline, or Corporate. That way you avoid constant one-off meetings that take time from customers.
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Flemming Ørnskov37:27
Yes, it's very template-driven but not with thousands of slides. Each presentation ends with one slide that says 'My Asks'—what are you asking us to decide? Then we track those asks and follow up on actions. It's a simple, efficient system.
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Mark Champagne38:15
Right, you're delivering on performance and board expectations, but you're also working with humans. How do you balance high performance with empathy and avoid burnout? What strategies do you use?
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Flemming Ørnskov38:57
If I look across Galderma, we have many subsidiaries that are best places to work. When I started in 2019, the organization wasn't performing well, and the mood was low. Now performance is much stronger, and the mood is better—even though stress has increased. High performance drives positive energy and resilience. In high-performing countries, people ask for more resources; in lower-performing ones, there's self-doubt and negativity. The best cure for organizational issues is creating success and celebrating wins. At Galderma, we didn't buy new companies or launch many new products; we improved incrementally—more focus, better prioritization, smarter investment. That incremental growth feels attainable and motivates people. Constant talk about doubling the business in five years doesn't motivate. People are motivated by what they can achieve now.
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Mark Champagne42:04
That ties into interesting data from Indeed's workplace well-being report: a portfolio of companies with the highest well-being scores outperformed the S&P 500 by 11%. When our minds are healthy and flowing, we do great work. So progress and a sense of performing well as a team are very motivating.
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Flemming Ørnskov43:48
I agree. Growth through incremental steps makes it attainable. Empowering people is key—if I feel I can play a role and get recognized, I go the extra mile. When I arrived at Galderma in 2019, I saw a lack of passion. People didn't even like their own products, like Sculptra—a biostimulatory product that had some side effects from misuse. We changed the mindset, rebranded, and built enthusiasm. As a leader, you need to show passion even on bad days. It's infectious.
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Mark Champagne46:00
There's a striking statistic: globally, about 60% of employees feel stressed daily. As a leader, how would you approach reversing that trend?
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Flemming Ørnskov46:54
In our customer-facing organization, we focus on support for those lonely reps driving around visiting doctors. First-line managers are crucial. But if people feel they work on great products, if managers are well-trained, if the company celebrates wins—then they can handle the stress. And the CEO must be positive and engaged. I walk around, shake hands, thank everyone, remember names. It's the small things. At presentations, I start with a new product or customer feedback—not about me or results. If the people who see customers every day are not positive and enthusiastic about the products, you have a real problem.
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Mark Champagne50:02
I want to respect your time. A final question: who would you like to learn from? Is there anyone you'd love me to interview—whether you know them or not—and what would you want to know about their thinking?
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Flemming Ørnskov50:25
Many inspirational CEOs, but I get inspiration from soccer. Coaches like Pep Guardiola at Manchester City—year after year winning trophies, nothing left to coincidence, meticulous. Carlo Ancelotti at Real Madrid—managing big egos, fresh squads, seemingly laid-back but intensely detailed. The stress of those coaches is immense. How do they stay calm, deliver results, adapt to opponents? That's fascinating. They focus on small details, work hard, and always talk about the team, not themselves.
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Mark Champagne52:36
I'll make it a personal mission to network my way to one of those individuals and share that interview with you. I think that would be a fascinating conversation—how they handle the pressure after a win or loss.
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Flemming Ørnskov53:09
Great coaches also talk about the team, the performance, and their players. It's not about them. For example, Ancelotti just won the Ballon d'Or for best coach, but he talks about the players.
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Mark Champagne53:43
So Flemming, you're at your five-year anniversary at Galderma. I'd love to know what you're most proud of.
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Flemming Ørnskov53:51
The mission was clear from the beginning: the investor wanted an exit, and we had a successful IPO this year. But what I'm most proud of is the team we built, the new products, all three businesses thriving, expansion into 90+ countries, tripling growth, and a phenomenal outlook. Phase one is done; the next five years will be even more exciting with a better pipeline and more growth opportunities.
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Mark Champagne55:01
That was going to be my follow-up question: if you had to pick one word to describe the next phase, what would it be?
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Flemming Ørnskov55:10
Growth. Yes, well said.
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Mark Champagne55:13
Last question for you, coming full circle. Once you're gone from this planet, if I sat down with your now teenage kids, how do you hope they would describe their father?
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Flemming Ørnskov55:31
I hope they say I'm a good coach for them, that I give them all the space they need. I know how different they are. I want their success to be their success. My role is to use my experience to help them along the way. The best thing you can do for your kids is to give them freedom, encourage them, stay with them when things go wrong, and be supportive no matter what they do.
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Mark Champagne56:06
They're definitely lucky to have you as a mentor. I want to thank you, Flemming, for taking the time to be here, but also a higher thank you for being you and for the journey you've gone on. The impact isn't just with you—it's exponential. For that, I thank you.
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Flemming Ørnskov56:44
Thank you, Mark. Thank you very much for having me. Enjoyed the conversation.
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Narrator56:53
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Chris Gethard57:35
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