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Key Account Managers (KAMs) and Medical Science Liaisons (MSLs): The present and future of Pharma.

First, let’s look at WHY we think Key Account Managers (KAM) and Medical Science Liaisons (MSL) are critical to the success in Pharma (Healthcare industry)? 

Both these functions have been around for many years in Pharma.  That’s not news.  Like many other roles, the two have significantly evolved, and now need to be an even more significant part of the key strategies for development.  There are a number of reasons for this.  But before we get there, it is important to recognize that Pharma is a business and as such, strategies should always aim to optimal profitability while prioritizing the benefits to patients.  After all, patient centricity has been at the heart of Pharma’s efforts for many years.

KAMs, depending on their scope from one company to the other, are able to conduct the orchestra of stakeholders for the benefit of HCPs.  There are many versions of KAMs.  In this short article (and the following), we define KAMs as individuals that are responsible to identify customer’s needs in a wide variety of areas, help  develop solutions to meet those needs, and orchestrate the work of a number of stakeholders for the solutions to materialize.   The projects KAM manage or help create are often innovative, unique or essential to the advancement of the whole business model.  Very often, initiatives are not directly targeting prescription, or advocacy, or immediately measurable returns for all stakeholders.  Rather, they bring perspective, options and actions that foster an environment for better care, or effort allocation.  As an example, KAMs have led initiatives to better standardize the evaluation of people suffering from depression, increase the precision of the diagnosis and better orient treatment choices.  The initiative was created in concert with HCPs and eventually, led by the HCPs.  KAMs simply facilitated the discussions and brought resources together.  They are project managers and, hopefully, concentrate their actions where both industry and HCPs gain, for the ultimate benefit of patients.  We will explain WHY they are critical.

MSLs are scientific and clinical experts.  They are often physicians, nurses, pharmacists and PhDs.  Because of their formal training and role, they are able to discuss clinical aspects that commercial teams cannot, or will not.  MSLs also have the specific role to review the mountain of data in given clinical areas.  In oncology for example, some of the MSLs I know are so globally knowledgeable that HCPs count them as a part of their team, their brain power.  While it may be argued that MSLs may not always be neutral in their perspective, after all they do work for Pharma or Medical Devices companies, their training, and often their oaths to their profession (MDs, PharmDs, PhDs, etc.) more often than not counter the possibility to stray to unreasonable levels of partiality.  Not reporting to commercial groups and not receiving commercial incentives also help.  Yet, MSLs are able to guide HCPs in directions that better serve patients. 

So WHY are those two function so critical?

Both KAMs and MSLs have the ability and respectability to influence HCPs in optimal directions.  As I look back at the Principles for Persuasion by Cialdini, KAMs and MSLs can more easily (than others) leverage each of the principles.  Because of their superior knowledge they have Authority.  Their ability to relate and remain balanced in their approach makes then Likeable and inspire Reciprocity.  The capacity for KAMs and MSLs to be Consistent and bring fair perspective help their influence on Social Proof (people follow the lead of similar others).  Finally, when they are highly competent, and because there are far less of them at that level, they appeal to Scarcity (people want more of what they can have less of).  

KAMs and MSLs are able to generate more value for HCPs.  Commercial teams also have that ability, but they are significantly limited because of numerous factors.  KAMs can create solutions that go far beyond the treatment of single individuals and the “traditional” process.  The example I gave earlier with depression illustrates this.  KAMs can work on projects that help large clinics or treatment groups be more effective.  In the case of diabetes, projects have gathered a number of specialties to truly optimize the treatment approach and disease management.  This has produced significant cost savings for all stakeholders.  Helping HCPs make better choices will likely contribute to the profitability of project sponsors.   But this will not come via a distorted view of treatment options.  It will hopefully be generated by a rational approach, ensuring that the best option is selected for the right patient.  Think of the current opioid crisis.  Most of those drugs are necessary for patients that need pain management.  It can be argued that a part of the crisis is the result of incomplete understanding of pain management, and possibly an approach that did not involve a sufficient number of specialties.  While some companies have greatly benefited financially, the end result is extremely detrimental to reputations, credibility, HCPs that aim to do the right thing, patients and society in general.  KAMs can contribute to projects for which profitability will likely be established on actual best practices and ensure the viability of efforts.  As products are used more rationally, the results will improve for all stakeholders.   Increase in fairness, better results and fewer negative impacts will likely generate more synergy between stakeholders as opposed to acrimony and suspicion.  That is in part, WHY KAMs are a critical part of the future.

MSLs are able to put in perspective the mountain of data available.  They can speak to the present as well as the future.  Their interactions with leaders in their fields (clinicians, scientists, developers), and the fact that understanding data and trends is their main role, makes them moderators.  As such, they are able to calm down certain undue cravings for unruly usage of the new and improved.  MSLs have foreseen the opioid crisis.  MSLs are therefore better equipped to highlight dangerous paths and promote a balanced usage of all the worthy solutions.  Because of their credibility and balanced approach, MSLs have the ability to address situations in a manner that will bring a more universally advantageous approach to treating patients.  Just like KAMs, in their own way, MSLs can produce an increase in fairness, better results and fewer negative impacts to generate more synergy between stakeholders as opposed to acrimony and suspicion.  That is in part, WHY MSLs are a critical part of the future.

I mentioned Cialdini earlier.  Let me link his principles of persuasion to the intrinsic value of KAMs and MSLs in Pharma.  At the moment, some of the most acute problems faced by Pharma and Medical Devices companies are access to their customers, credibility, the perception of value (other than a treatment of quality), the impression that they don’t truly contribute to the overall healthcare environment (product focus instead of health focus), and the conviction that all that counts is industry progress as opposed to the development of the complete environment.  While it is not universal or unanimous, HCPs may see the industry as a taker rather than a contributor.  That’s where KAMs and MSLs contribute to change that reality.

Access.  While it has been advocated for years now that sales representatives need to “up their game” and bring more global knowledge and skills to their customers, regulations can significantly limit their ability to use such capabilities.  However one feels about the changes implemented in Pharma’s commercial practices, there have been both positive and negative impacts associated to new rules of engagement.  When we amalgamate those limitations to a persistently volatile perception of their value, the potential positive impact that teams can have, often remains torpedoed compared to their true capabilities.  This directly impacts access.

When time is precious, we tend to choose with more discernment where we invest it.  In most cases, HCPs will choose to invest where there is a potential return.  This is WHY KAMs and MSLs have more attraction and increased access.

Credibility.  Not directly promoting any specific product, in spite of being employed by a corporation, contributes to the credibility of KAMs and MSLs.  With the incredible amount of information available to HCPs, it is particularly critical to decipher the wheat from the chaff.  KAMs and MSLs both have that capability, which turns into an advantage.  Credibility breeds confidence which in turn, promotes loyalty.  Loyal customers are critical to profitability.  This explains WHY KAMs and MSLs need to be more strategically integrated.

Value. KAMs and MSLs bring ideas and perspectives contributing to the evolution of HCPs.  As such, they help enhance the reputation, productivity, precision of treatment, time management and resource allocation of HCPs.  It is rather easy to translate any of this into added value.  When someone has value to us, we tend to treat them well, and we care for their perspective.

Contribution.  As mentioned earlier, KAMs and MSLs are often able to become partners or consultants for HCPs. Projects such as the one I briefly mentioned with depression, help HCPs enhance their ability to perform at a higher level.   KAMs and MSLs that are able to contribute to HCPs’ scope gain significant impact.  Another reason WHY they are critical.

Progress.  Let’s face it, with the amount of new data generated these days, it is almost impossible as an individual or a specialized group to fully integrate what is available.  Humans are notorious for finding a level of comfort in their daily activities and cruise.  KAMs and MSLs will help HCPs shake their habits, inspire them to dare new avenues.  The generated progress will benefit the therapeutic areas and patients.  Who doesn’t want to be a part of that?

 Hopefully, this has provided an illustration for WHY KAMs and MSLs are so critical for the future of Healthcare efforts.  The next article in this series will address HOW to best integrate and develop KAMs and MSLs in the industry.

But wait.  As much as this text supports the continued development of KAMs and MSLs, bestowing upon them a strategic importance, it should also be an indicator for the orientation of commercial teams in the Healthcare industry.  Commercial teams can still play a strategic role and remain of critical value.  Knowledgeable individuals that are not solely dominated by their personal performance or metrics, that care about a balanced approach supported by evidence, and working to look at possibilities and valid options are arguably the most profitable sales people imaginable.

For a few immediate ideas on the HOW, please visit http://aseret-uido.com/programs/


Hiring based on Values rather than Skills

How much of the time allocated for job interviews is spent on trainable skills rather than unchanging values and traits?  It is completely reasonable to hire people on account of their immediate ability to perform tasks.  Employers often open a job because the need is immediate.  As such, teams are looking to find a person that will be able to perform very quickly.  There is nothing wrong with that.  What becomes problematic is to put too much value on skills, and too little on values, traits and synergy.

Imagine someone joins your team because they have ALL the skills you are looking for but clearly disrupts the team dynamics because of their attitude and mismatch in core principles.  How do we evaluate the added value of skills against the tensions and disruptions in the team?  Let’s say the new person is hired because of their strong ability to include social media initiatives in the company’s efforts.  The positive may be that the corporation will be able to post news, innovations, events and other important information, frequently and with effectiveness.  In turn this will likely create new business, or consolidate the corporate image to retain existing business.  Now, while the new person is able to perform their task, this individual also makes many others on the team very uncomfortable.  Let’s assume that the discomfort comes from the rudeness, and lack of respect and understanding of the new person.  In addition, the new employee has no interest in understanding the realities of the people responsible for creating the news, innovations, events and other important information to be added to the social media initiative.  As a result, what ends up being published may be of lesser quality.  Why?  Some of the reasons may be linked to pressure to meet new deadlines, lack of clarity on the format necessary for best social media impact, reduced motivation to help a colleague that treats us with disrespect, stress, and a multiple of other aspects.  Why is that the problem of the new person?  It isn’t.  If the team in place has always been competent in their roles, the problem resides in the person that hired the new person.  If the current team was not effective for some reason, the problem lies with the leader of that team for not managing the problem, and hiring the new person at the time they did.

Now imagine that the new person is not as skilled as the other we just described but is determined to mesh with the existing team, learn from them,  about their respective roles, and explain what needs to be done for the social media initiatives to work.  The new person’s ability may, in the short term, be less impressive than the other person but still, their abilities are very decent, and the information that is transmitted is of higher quality.  Which of the two situations seems most productive?  Looking at both examples of new people, which one is most likely to learn from others and increase their social media competencies in the next 6 months.  Furthermore, depending on the stress and disruption of hiring the fist new person, what will be the costs associated to one or two or more people from the existing team leaving?

I have been in rooms full of new hires to provide development of various skills.  I have experienced the disruption of individuals thinking that they were above such efforts because their perception was that they were stars, hired specifically for their existing skills rather that their determination to work as a team, or to learn new approaches.  I have witnessed the decrease in productivity of the whole team because of mismatched values, traits and synergy.  And, I have been privy to teams loosing up to 50% of its members within a year or two of “prima donnas” being hired.  In the vast majority of cases, the corporation (and its clients) lost much more than they gained.

Competencies can be learned and developed.  Values and traits are deep seated and seldom change.  A corporation needs to hire accordingly.


The evolution of dynamic communication

In line with the trends identified in the last 12 years, Dynamic and Engaging Communication continues to rank as one of the highest needs in Talent Development.

What is Dynamic and Engaging Communication and why is it important?

 

An effective communicator is an astute influencer in all areas of Leadership, including Presentation/Facilitation, Decision Making, Hiring, Change Management, Executive Coaching, Key Account Management, Stakeholder Management, and one of most impactful skills, Effective Listening.

Our customers come to us with both urgent and increasing need for Engaging Communication Skills.

 

Over the last few years, we led over 20 programs involving Medical Education Professionals, Medical Science Liaison Specialists and a large number of Physicians, Advance Practice Nurses and Pharmacists in 10 Biopharmaceutical Therapeutic Areas.

We propagated best practices in Case Study facilitation, Remote Meeting Management, Clinical Discussion Facilitation, Educational Facilitation as well in Dynamic Presentations Skills.  In all of these courses we heard loudly from our customers, this is EXACTLY what they needed in order to clearly deliver impactful, dynamic, scientific presentations which keep the audience fully engaged, throughout the presentations and well into the Q and A Sessions, along with feedback from participants on the need for more information.

 

For the last 15 years, Leadership Development has been our most active sector.  While coaching and development of teams have been the main areas of interest, hiring skills specifically dynamic interviewing methods – are gaining interest. So much so, that we are in the process of writing an e-book.  We also developed a half day workshop on the topic, in an effort to adapt to growing requests.

Due to the numerous transformations in Healthcare Commercialization, Change Management and Key Account Management have regained momentum in our curriculum.  Decision Making/Risk Taking, which was usually reserved for C-Suite executives, is now being offered by many organizations to their employees in order to empower them with skills to better think outside the box and to adapt to the constant change in business realities.

Executive Coaching works in concert with Leadership Development activities.  Our sector specializing in the development of competency models and career paths.  Clarity of roles and expectations, along with the proper support by leadership teams, generate increased dynamism in the workforce.

New kids on the block are programs on resource allocation (QQTR) and managing challenging situations.

The question organizations need to contemplate is this, “are we part of the innovative and dynamic leaders that are creating the new present, or are we deciding to follow later, and play catch up?”  If you are in the first group, we want to collaborate and help you make that difference.


Gratitude

Fifteen years seem a long time and yet, the whirlwind of projects, innovations and progress happens in what seems like seconds.  A business is a wonderful vehicle to make a difference in many people’s lives.  It impacts the individuals that work in the corporation as well as those who contribute as partners and suppliers.  In more than one way, an enterprise such as Aseret and many others like us, contribute to the development of talent and consequently the profitability of clients.  Yet we often forget to recognize the difference every single one of the people and groups mentioned previously have made for us.  I am referring to the perspective we gained through our efforts to clearly understand customers’ business realities.  The impact is also felt via challenges offered to us, confrontation of ideas and discussions on strategies to optimize our services.  Over the years, individuals and teams that trusted our intent have supplied the platform for new product development.  As a result of this, we evolved from one niche product to over 17 different programs, each existing in various iterations to meet the needs of different stakeholders.  Aseret is now active in 3 spheres of Talent development, each intimately connected and yet often worlds apart considering the depth of collaboration they carry.  After 15 years in business we need to recognize the incredible synergy we have had the chance to develop and the priceless contribution clients have imparted on the difference we strive to make in our daily efforts.  To all our past, current and future partners, we offer our most sincere gratitude.


ADULTS WANT TO LEARN. ARE WE HELPING?

In challenging times for business growth, development is not a priority, right!?  In fact, hardship is often the spark that ignites incredible creativity and innovation.  Difficulty may be the best trigger for adults to learn and evolve.  Are we helping?!

Just like Daniel Goleman was a pioneer in demonstrating the existence of Emotional Intelligence (Emotional Intelligence, 1995), Malcolm Knowles may have been the first, back in 1980, to make educated assumptions for how (and why) adults learn.  His assumptions were elaborated on key differences between adult learners and child learners.

Knowles identified 5 assumptions.

  • First, adults are self-directed in their learning. As such they can make a conscious decision to learn.
  • Second, experience becomes the most significant learning vehicle.
  • The third assumption addresses the readiness to learn by adults. This readiness is directly related to the role and responsibilities of the adult learner.
  • In fourth place comes the orientation towards solutions rather than simply a subject matter interest.
  • Finally, Knowles underlines the internal nature of the motivation to learn.

 

Since 1980, hundreds of publications have discussed the principles of adult learning.  The majority seem to agree with Knowles with only slight variations.  For me, the revelation came from Dr. H.B. Slotnick of the University of North Dakota.  His principles were quite similar to those of Malcolm Knowles.  In short, adults need a reason to learn and the learning needs to provide a solution to a current problem.  Learning also has to be experiential.  The main difference is this last point, the learner needs to teach back as soon as possible.  I believe this last point is significantly responsible for the many successes we have had in the last 15 plus years.

Before I elaborate on this, let me summarize a number of observations from the hundreds of development programs on which I have been directly involved.

 

Adults fully engage when a development effort is directly and intimately associated to their daily activities and when the learning allows them to figure out solutions or new approaches to challenges they are facing.  A good example of this is the work we are able to accomplish around case studies.  We use a combination of existing (generic) cases as well as customized situations.  While case studies in general are very effective, the value and impact of the latter often seems superior simply because situations are so close to participants’ realities.  A case is created following interviews with participants and supervisors, even with customers.  In our Coaching/Leadership program, a guide is provided for learners to create their own case.  Each customized case is based on a current and meaningful situation… and only names and places have been changes to protect the innocents.  Countless participants have reacted so positively to the learning process that they want to “leave immediately and go apply what I learned with my colleagues/clients”.  With generic case studies, the results are often similar as long as we facilitate a discussion that links the learning to participants’ reality.

In the previous paragraph, I mention “allowing adults to figure out solutions”.  This a critical factor.  Whereas we are constantly asked to “give” solutions (identified here as the “want”) it is when participants figure out their own solutions (we believe it is the real “need”) that such solutions become most viable.  While examples of this would fill pages of text, one in particular illustrates the idea quite vividly.  Years ago I was managing a team of sales people.  One day, one of them asked me for solutions to gain better access to a groups of customers.  Even then, I was reluctant to “give” solutions.  I wanted the individual to figure out best options and guide them through the process.  Still, that person insisted that I share some of my ideas.  So I did.  And for each one, here is what I heard as a reply: “I tried and it did not work” or “that’s not my style” or “that will not work with them”.  No solutions were found at the moment.  About 6 months later, the salesperson in question called me, very excited to share that they had found a solution.  Which was almost word-per-word, one we had discussed some 26 weeks prior.  Whatever happened in that time period, the solution came from the person and as such, became much more valuable.  Some solutions should be offered in development programs yet, helping participants fine-tune or craft the solutions to their specific situations is often the best way to go.

Adults participate more actively when the training initiative is put in place as a result of a needs assessment.  When corporations or teams deliver on what individuals have identified and defined as development requirements, the resulting level of engagement is usually very high.  Robert Cialdini would explain this in part though Reciprocity (Harnessing the Science of Persuasion, Robert B. Cialdini, Harvard Business Review October 2001.)

If a training program is organized by management on a topic that may not be top of mind for learners, it is necessary to clearly state the reasoning behind the choice and the expected outcomes/benefits for the efforts.  It is true that learners don’t always know what will help them.  It certainly isn’t the rule however, and I do believe that people usually have a good sense for what they need to improve in order to be more productive.  This is especially the case in a well-functioning team.  Nevertheless, a clear and value-based reasoning for any developmental effort usually increases the engagement level of adult learners.

In spite of what can be significant differences in learning styles, adults tend to value a structured and productive exchange of ideas between people holding similar roles or responsibilities.  When adults get together and are in a position to provide each other with solutions, options and perspectives, we have to give them the opportunity to do so.  When done correctly, the payback can be enormous.  Since adults also need to limit their time away from their daily activities (read accountabilities), it has shown increasingly valuable to cover the more theoretical aspects or methodologies with preparation work.  This allows individuals to “study” on their own and at their favored pace.

As facilitators of learning, we have to understand that people have a spectrum of reasons to be motivated (or not) to accept and eventually integrate new elements of information and skills.  Over the last 12 years and following published experimental results, we have developed a better understanding (and guiding principles) on motivations.  The determination of adults is based on the importance and ability for them to express their innate values, competencies and traits.  For example, a person that cares about collaboration, precision, quality, integrity, and adaptability, will likely be more interested to learn when the competencies or principles covered in a program will contribute to those natural traits.  The same individual may “tune out” if developmental work is oriented towards competition, rapid fire solutions, generalities or strict step-by-step processes.  Recently, I facilitated a session on project management.  In part because a system was already in place in the company and also because key projects were already in place, we opted for a step-by-step approach, filling each step with actual actions that needed to take place.  Many participants gained from this approach, it made sense to them and helped find solutions.  In the program evaluation, others expressed they would have preferred a more general discussion on project management rather than covering each step.  The need expressed is based on the necessity to better understand how to manage projects and then associate efforts.  We were facing 2 sets of needs based on different motivations. Humans are self-motivated either via internal needs or external factors.  Internal aspects address conformity or quality of task.  External motivators are either of a social nature or one of tangible rewards.  Adults will learn when and if their motivation is triggered.  An internally motivated person will be more interested in learning skills that will allow them to perform in a manner that is safer or more elegant rather that increase their reputation or short term impact.  Unless of course reputability is also associated to safety and stability.  Because learners intrinsically have different motivators, or facilitator’s approach to learning has to appeal to every participant.  It is therefore our responsibility to help learners see and feel the value of the experience.

So far we have identified six essential aspects of adult learning.

  1. Learning needs to relate to the current role of people or at least to a relatively immediate future.
  2. Learning efforts have to lead to solutions. Sharing and building of adapted solutions is necessary.
  3. Learning should be organized on expressed needs.
  4. Learners often demand to fully understand the reasoning behind growth efforts (the Why).
  5. Learners will need activities that match a variety of styles in order to engage all of them as completely as possible.
  6. There are a number of reasons for learners to be motivated to accept and integrate new concepts. It is essential to address each of the motivations.

In the paragraph following the introduction, I made a point on the necessity for “teach back” and our experience over the last 15 years.  Even when learning efforts are in line with the principles of Knowles, Slotnick and the 6 aspects summarized herein, deep learning and associated sustainable changes happen in earnest when adult learners are given the opportunity to put concepts to practice, get results, internalize the reasons for their outcomes and explain how their actions have generated such payback.   Adults need to teach back.

Adult learners will truly commit to their learning when they have the chance to teach others.  That is in large part the reason for us to continually insist on a structured follow-up program after any learning effort.  Imagine a learner that is initially sceptic on some methodology and has no hesitations to say so.  Then move forward a few weeks and hear the same learner explain to others in the group that they were “wrong” and how beneficial the previously vilipended concepts have since been on fixing a major issue and change outcomes for the better.  The Big Fish principle explains in detail how practice, results and sharing of such results influence integration of new behaviors and propagate the solution-based evidence for others to learn.  Evidence has consistently demonstrated that even the best efforts for learning cannot yield optimal results without sustained teach back.  For all the teachers, facilitators, trainers and leaders reading this, you intrinsically know that teaching, facilitating, training and leading has forced you to better understand, grasp, and integrate any concept or methods that needed transmission.  We owe it to adult learners to offer every opportunity to do the same.

 

Ideally, learning and development prepare us for challenging times and help propel the longer term planners ahead of the proverbial curve.  Reality has shown that most efforts are exerted when our noses are painfully pressed on the wall of adversity.  The upside of this is an increased determination to learn when the current ways do not work anymore.  It is however critical that efforts are oriented in accordance to the principles of adult learning.  Otherwise we only contribute to the misconstrued perception that learning efforts are an expense we cannot afford rather than an investment we have to make.