CEO of Precision for Medicine, Margaret Keegan traces a refreshingly non-linear path from mathematician at the Bank of England to leadership across Glaxo, PPD, Quintiles/IQVIA, PRA, private equity, and now Precision Medicine Group. They unpack how CRO expertise became the engine of trial execution and where Functional Service Provider models help or entrench silos. Margaret shares a pragmatic view on regulation and AI, lessons for early-career professionals about following curiosity, and her goal to move Precision from a best-kept secret to the go-to partner in oncology and rare disease.