Bill Firkus began his career in the healthcare investment banking world, but it wasn’t his passion. The idea of working in baseball was appealing, but like for so many others, it didn’t seem realistic.

That changed in 2013, when Firkus applied for a job with the Astros that he had seen online, ultimately beginning a decade-long run during which Houston won two World Series titles.

Firkus, who was promoted to assistant general manager in November, sat down with MLB.com’s Mark Feinsand to discuss his pre-baseball career, his work on the medical side of the game, how his Berkeley business degree has helped him in the front office and much more in the latest edition of Executive Access.

This interview has been edited for length and clarity.

MLB.com: You grew up outside of St. Paul, Minn. Safe to assume you were a Twins fan?

Firkus: Yeah. I grew up in a suburb called White Bear Lake just outside of St. Paul. Huge Twins fan; they won two World Series when I was growing up, so that kind of shaped my childhood and my passion for baseball.

MLB.com: Was baseball always your favorite sport?

Firkus: Big time. Between the success that the Twins had, some of the stars they had at the time that I became a huge fan of, it's really the way I closely connected with my father when I was growing up. He was a coach for my team, so I would make him hit me grounders and pitch to me all the time. Between the fan side of me and the family side, it became the thing that I wanted to do all the time.

MLB.com: You went to the University of Wisconsin for undergrad, getting a finance degree. Was a career in sports your goal at the time?

Firkus: I always had baseball in the back of my mind. I made some early career choices that weren't for passion and happiness; it was about where can I get a business background, and where, frankly, can I make money? I came to find out with years of retrospect that wasn't the best decision. I always thought about baseball, I just didn't put in the effort and didn't know at the time what the opportunities could be and just assumed that there weren't opportunities for people like myself. I always wanted to get in, but I started out the career more so going for money and understanding business better.

MLB.com: You went on to get your business degree at the Haas School of Business at Berkeley. What were your plans when you graduated from there?

Firkus: I did healthcare investment banking before business school. I wasn't all that passionate about the work, but the industry that I worked in, healthcare, I was very passionate about. I felt a connection to the healthcare industry and helping doctors and patients improve the quality of life and extending life. I took some time off from investment banking, was a little burnt out from there, and decided that I wanted to go to business school to make a transition into the healthcare industry.

I always sort of dabbled in sports; that was like a backup plan. Even while I was at Berkeley, I started a sports speaker series. I had [former New York Mets president] Sandy Alderson come speak at it and got to know him a little bit. I tried to make connections, tried to stay in the flow and stay on top of sabermetrics and other things that were evolving and taking shape in the sport. But I always had the goal of getting into the healthcare space on the industry side at the forefront; if I happened into sports, if there was an opportunity for someone like myself, then I would do that. I did end up landing a job in medical device marketing and followed the path that I actually planned to do through business school.

MLB.com: You joined the Astros in July 2013 as a medical analyst. How did that come about?

Firkus: I continued to have that itch in the back of my mind that baseball is where I'm spending my time and that's where my passion is. Product management is really about being the product’s CEO -- owning the product and learning everything across the business from finance to regulation to customer service to sales. It taught me how to learn different disease states, how to interact with doctors, how the healthcare system works -- I promise there’s a through line. Baseball was always in the back of my mind, but really towards the end of my tenure, I was just getting a bit burnt out. There's a bit of a pattern here.

I was doing international marketing towards the end which, if you allow yourself, you could just work that job 24 hours because when European customers go to bed, American customers are waking up, then there are Asian customers and so on. Towards the end, I was spending all my spare time continuing to research baseball -- even some of my work time -- and I started to network with the industry. I was trying to figure out where jobs are posted and how to get into the industry. It was really tough at that stage of my career. I would cold-call and cold-email people.

I got to know some folks at the Giants; some people were incredibly friendly and spent a lot of time with me, talking me through how I could get an opportunity in baseball. Some of those people have gone on to do great things; three of the guys that were probably most helpful are Chaim Bloom, Nick Krall and Matt Klentak, who have all gone on to GM jobs. I was convinced that just based on my passion, based on how much networking I was going to do, I was going to find my way in. That didn't work. [Laughs.] Ultimately, what ended up working is the Astros started posting jobs on a job board for sports. I just answered a random job posting that was on there for a medical analyst.

MLB.com: What were the biggest challenges of that first job in Houston?

Firkus: The job itself was kind of vague. Leadership at the time said, "There's an opportunity in baseball to build a competitive advantage in the sports medicine performance world. We don't know exactly what that looks like, but we need someone to come in and take the bull by the horns, learn about the space, figure out best practices, figure out how to apply that in baseball and then if needed, make the changes to build that competitive advantage."

Coming into baseball was strange. Most people start out with an internship and build their way up; I was starting later in life. I felt I had perspective from being outside the world of baseball that certainly helped, had some life experiences that helped with that, but at the same time, I hadn’t worked in baseball. This is a whole world with its own intricacies and nuances and unwritten rules. I was 33, so it was challenging, to say the least. It wasn't all smooth sailing, but I tried to come in and be humble. I tried to learn and observe, take it all in and go from there.

MLB.com: Two years later, you were promoted to director of sports medicine and performance. You oversaw a group of athletic trainers, physical therapists, sports medicine doctors, strength coaches, a dietitian, a sports scientist and mental skills providers. With so many chefs in the kitchen, how important is it for everyone to be on the same page?

Firkus: I am very much a generalist in that I don't have expertise in strength and conditioning, I don't have expertise as a physician, a dietician, performance or mental coach. Really, my job was to get the best people possible -- some internal, some external. Be innovative about how we hire for those, set those people up for success, make sure that they're talking and collaborating and that we're focusing on the athlete and coming at him with a holistic plan. Then just get out of the way.

You have to know what you know and what you don't know. I would never go into the training room and tell our head trainer, "You're taping that wrong." It's more asking him the questions of, "Are we looking at this from a collaborative standpoint across all the different disciplines? Are we using data to the best that we can to put the best plan in place for this athlete so we make the best decisions for him?" Then just continue to ask how we can get better, and if anything gets in their way, just help those issues get resolved.

MLB.com: The Astros went through some lean years during your early years with the club. How difficult was that?

Firkus: It's funny, because looking back, I didn't know what I didn't know. I had these mixed feelings of working in my dream job, coming to the ballpark every day to work with players, work with the staff that I do. This is baseball and I was just so happy. Then watching us go out and lose 100 games in 2013 and more than 90 games in 2014, it was challenging. The pressure in sports is so much higher than the industries that I came from; there's so much turnover, there's wealth, there's celebrity. Having had a career outside of baseball, it's really a fascinating industry to understand and study.

A lot of the people I work with have only worked in baseball, so I tell them, "These are the best jobs in the world. You guys have no idea how great this is. You could go work outside of baseball and not be passionate about what you do." It was mixed feelings, but I certainly believed in what we were doing, the mindset that we had at the time, what people were building. I knew that I was working with very talented people, but it wasn't actualizing on the field. I felt like I was fine, but at the time it was tough to go through all those losses. You kept thinking it was coming at some point, but you just hoped it was coming soon.

MLB.com: In October 2019, you were promoted to senior director of baseball strategy. In that role, you were involved in roster management, contract negotiations, salary arbitration and more. What was your favorite aspect of the job?

Firkus: I look at my job right now as I'm still very much a generalist. The best thing that I can do is coordinate with the experts both in the front office and down in the clubhouse to bring about the best information and the best decisions possible. I don't know if I am good at any of it, really. I work with incredible people, so I just feel like my job is to help them put the best product on the field and make the best decisions possible with regards to the Major League team. The one I probably enjoy the most is roster management, going back to what my passion was growing up and what I was most interested in.

MLB.com: If there is one aspect of your job you want to improve upon, what would that be?

Firkus: There are the things that I can fix and the things I can’t. One is I never played beyond high school, and not having played in college or pro, that's always going to be a challenge for me because I can't put myself in a player's shoes. I think that's so important when we’re thinking about transactions, who we add to the team, who we promote, those kinds of things. I can't do much about that, so continuing to learn about that as much as possible and talking to people on staff who did [play], just to help understand that perspective better.

What I can do better at is probably get out of my office more, get down and interact with the players and coaches to figure out what we can be doing to better our team. Based on my job, I do end up sticking in my office too much and I need to get out there. I need to learn Spanish; that's certainly something I could do better at. I'm old for a baseball executive, so watching all these younger hires that we make come in with skills that, some I've never even heard of, is certainly challenging.

MLB.com: What is your favorite part of the job?

Firkus: It probably sounds a little cliché, but winning. The team I work with, the pro scouting, advanced scouting, Major League operations, coordinating our efforts in the front office with the really smart people in R&D, amateur, international scouting, we have an incredible team. Just seeing all that hard work come together and actually succeed on the field with the great players and the great Major League staff that we have, there's no better feeling.