Medical Science Liaisons face a range of new challenges and organizations are increasingly leaning on them to engage with HCPs to build both market performance and brand reputation
The MSL role is fast emerging as a principal player across a post-COVID landscape where HCPs are demanding high-caliber information that addresses their specific needs. Delivering the science and data in a compelling fashion has always been a critical MSL function, but it has gained added significance as HCPs move away from traditional patterns of engagement with pharmaceutical companies. It is an arena of great promise, yet it is littered with barriers if field medical teams are not given the skills to match their new responsibilities to tailor high-value scientific information to individual needs.
Providing MSLs with coaching above and beyond process-focused training has been identified as an integral part of a business strategy that generates field force excellence. But this involves more than bolting on coaching sessions. It is a culture change. This whitepaper highlights the need to resource coaching initiatives and empower medical managers – who may have no coaching experience at all – to drive programs that deliver long-term performance results.
The structures of coaching MSLs as they range across pharma’s new frontier are still being defined, which is why it is important to share learnings and experience and address issues and technical chokepoints to enable medical field teams to prosper. Coaching initiatives should become a part of an organization’s DNA and play a significant role in creating an environment where MSLs can flourish and return increased value.
Reframing attitudes to coaching
The dictionary definition of coaching is clear: it is an act of preparing someone for a task or event or to improve their skills. However, the meaning has somehow become clouded and corroded to the point of negativity. Despite best endeavors and intentions, coaching gets confused with training and mentoring and often struggles to secure a permanent or targeted presence in an organization’s approach to building market share and enhancing medical field team performance. “Sometimes when people address coaching, especially in the corporate world, they think of it as a sort of punitive exercise. In other words, somebody’s not quite performing up to speed so let’s give them some coaching and help,” says Leon Rozen, who has more than 20 years of management and leadership experience in the health, pharmaceutical, and biotech industries. “But it is not about that. Coaching is helping someone perform at their best.”
For MSLs, in particular, it is an important distinction. “As with a sports team, you may work on correcting or refining some approaches but – Number One – it is about making sure people have the right skills, and to coach them in those skills regularly,” adds Rozen, who has worked at senior executive level in the US, Europe, and Australia and is now country medical director at Ipsen. “It is also about coaching a mindset so that they’re delivering on those skills to the best of their individual ability and as part of the whole team.” Rozen, who has a passion for people development, with particular interests in coaching, mentoring, and the developing field of neuro-leadership, believes the road to more effective performance from MSLs starts with an acceptance that coaching should be welcomed for its ability to generate benefits for the individual and the organisation.
Coaching is vital, according to Helen Kane, CEO of specialist training consultancy One MSL, who highlights: “The MSL role of today is complex, and they are really under the spotlight. It is not enough for them to be a scientific expert, they also need competencies in business acumen, engagement excellence, teamwork, and leadership. “As a developmental tool, coaching is critical. It is about continuous professional development. It is about learning something every day and having a culture where that is possible.” Anchoring performance to pre-pandemic expectations fails to understand just how much the MSL role has developed, believes Alyson Evans, who leads a medical device company’s high-performing MSL team. “MSLs have always been critical to pharma, but times have changed, and we have to be more digitally interactive and [have] a native use across platforms,” she says. “Tech savviness is a new core competency. Our existence revolves around science, and we are hubs of information, but we have to present our information successfully and quickly.” “We can’t often sit down with HCPs for two to three hours,” she explains, “so, our information exchange has to be more rapid. You need to know your data even more than before and be able to get it across on screen to have an impact. The presentation, both personally and technically, has to be assured.” “MSLs didn’t go to broadcasting school. We didn’t learn these skills at college or university – but we have to learn them now,” she states.
The Coaching Culture
“Coaching has to be part of the culture,” asserts Leon Rozen. “Most organizations will have performance management systems setting objectives once a year, with possible half-yearly reviews to see how people are doing, and people think that is coaching: if you are doing it that way, you’ve missed the boat.”
“It has to be an exercise of continuous improvement, a journey to understand all the micro-skills that are required to perform the role and become good at each of them,” he says. “This needs someone there on an ongoing basis to say things like: ‘Hey, that was great, keep doing that’ or ‘That was good, but you could improve if you do this and try this’. This is not something that can be bolted on.” But a huge gulf exists between both the perception and provision of coaching. A global survey by One MSL of almost 600 MSL leaders and MSLs revealed that only 40% had a dedicated first-line manager responsible for their coaching and professional development.
A disturbing 19% of MSLs said they had had no coaching conversations with their managers over the last 12 months and a further 39% had one to three conversations. “This demonstrates the level of disconnect because if you asked a commercial first-line manager what is their number one priority, they would say developing their people to enable them to be their best,” adds Helen Kane, who has 25 years of medical affairs experience as an MSL and MSL leader, and who established One MSL to support global pharma enterprises and biotech start-ups. “But, too many are reporting to individuals weighed down with other priorities without the time, or even the confidence and competence, to coach,” she says. Findings from the same survey showed ‘Presenting scientific data with impact’ and ‘Building trusted scientific partnerships with external stakeholders’ were the most prized skills for MSLs. These are skills, experts confirm, that can be developed, refined, and enhanced with coaching.
An essential element to coaching and learning new skills is having it embedded in corporate culture, adds Alyson Evans, a clinical nurse specialist who has an MBA in healthcare management and has spent the last six years working at the medical affairs front line. “It is important that coaching is resourced properly, and leaders of the organization are involved. I think leaders have to be at the heart of it,” she says. “Growth, for all staff, is critical for a company.” “The success of any coaching program is highly dependent on the values of a company and its leadership team. Good coaching that is championed by a company’s leaders is really indicative of those organizations who, in the long term, will be winners – and those that will not,” she says.
Coaching for growth
Coaching has differing aspects, depending on where the MSL is in their career journey and their distinctive roles, but the central aim is to empower them to reflect on performance and problem-solve to improve.
“Coaching should be non-judgmental, and it should encourage individuals to reflect and consider how they are approaching a particular task. It is not an exercise in telling them what to do,” says Helen Kane. “Coaching provides them with feedback that enables them to identify how best to improve. The message from the organization, from top down, has to support that. The company has to make it clear that it will support you to grow and be the best that you can be, and the way to do that is through constructive, positive feedback.” “If the organization promotes positivity, growth and development, then MSLs are going to be much more receptive,” she states. Coaching is nothing if it doesn’t encourage an environment for growth, but that should not lead to a hothouse approach where development is forced; MSLs need to be nurtured along the growth path and be allowed to develop agile mindsets.
In a world where performance metrics and balance sheet statistics dominate, it is difficult to both define and enact a culture. For each organization, it will involve tailoring delivery to meet facilities, resources, and experience of coaching. But the investment of time and resources pays dividends for both the MSL and the company, adds Alyson Evans, who is director of Sirtex’s MSLs, but is speaking in a personal capacity. “My hope is that an MSL who receives coaching will have a positive attitude to growth; they will see it is an opportunity earned, not a handout, and this plays to the point of the critical role of an MSL. Their performance is business critical,” she says. “We are not here to sell or to promote, but the information we are able to give, if we are doing our job correctly, should be highly influential. It could make or break relationships, so it has to be valued,” she explains. Coaching MSLs requires an understanding of the fundamentals of personal development and growth. It is something that requires a distinctive skill set and the tools to enable it.
“Of course, coaching is a skill in itself,” adds Leon Rozen. “It incorporates being able to observe, being able to understand, and being able to communicate, to improve what people are doing, and how they’re doing it.” “It is a culture that is only created if it has the right support. If you don’t resource and support it, the true quality that can be derived from coaching will not be realized. If improvements in you and your team are not expected, you are not going to do it,” he explains. “You are going to focus on deliverables, which for an MSL might be how many interactions with HCPs or meetings with KOLs are achieved. These are legitimate targets but having them doesn’t mean they will happen with the quality needed.” “The companies where I have worked with successful coaching programs make sure they provide huge support for the coach, such as forums to challenge best practice and actively seek to drive a coaching culture,” he says.
Coaching will always have to meet evaluation criteria and uncertainty can erupt when qualitative and quantitative metrics collide.
“MSLs are highly intelligent, highly motivated people who will be, to some extent, goal-oriented. They will want to know how well they are doing and to be able to measure themselves against targets,” says Leon Rozen. “For MSLs, it has always been difficult to show value to the rest of the organization because we can’t be measured on sales and market share; it’s more about quality than quantity and that’s a lot harder to measure.”
“There need to be surrogate measures of quality that are agreed, such as how much time an interaction takes – if you have HCPs willing to spend 45 to 60 minutes with you, then that is a pretty clear indicator that you must be providing them with value,” he says. “We have done surveys, focus groups, and net promoter scores and I think value is an area of coaching where we do struggle. It really needs to be something that is agreed at the top of the organization and the internal value across an organization should not be overlooked.” Alyson Evans believes that coaching should be an MSL fundamental: a baseline requirement such as competence with functions, like documentation and compliance.
Coaching is a springboard to success
Coaching has to be deployed as a force to build improved confidence and performance, but it also has to be tailored to the new, more agile, and encompassing nature of MSL teams. Good coaching also has a direct bounce in performance for MSLs who are taking on broader roles, with more personal contact that is critical to a business. Learning how to present key data and messaging and being comfortable and assured in delivery across digital platforms, is a ‘gateway’ to corporate success, says Alyson Evans.
“Paying attention to how we look, our body language, clothing, mannerisms, and voice modulation are more important than ever. We only have a limited time and getting it wrong could ruin an opportunity and a relationship,” she adds. “If you are engaging, people will tune into you. An MSL really has to show up as the best version of themselves and practicing these skills is vital to reaching that.”
“We need coaching to help deliver our messages and understand how that is landing, which is why being able to do it live and get feedback is an essential part of coaching. We need to practice delivering a message in a way that mimics the physical proximity and cues we get from face-to-face meetings. “HCPs want to engage with someone who can rapidly provide information in context. They are smart and can read all the relevant papers, so the person who understands their needs and has the best storytelling – that is who they will keep going back to.”
Helen Kane sees coaching as adding even more: “MSLs might not have the confidence to engage and challenge a KOL with strong views, and through the coaching conversation you can identify where they feel in need of support and so help them get to a position where they are confident to both challenge and know when it is appropriate to challenge in a respectful way,” she says. “Coaching has moved them from ‘I don’t feel I can do it’ to ‘I can and need to do this because if I don’t, the patient won’t benefit’,” she states. “That is a significant shift for the MSL, the company, and the patient.” She advocates time and resources for coaches within organizations to upskill and get the best from their staff, while adding: “We start by defining what a company wants and then structure support and resources so they can develop both their coaches and the coaching they deliver. It doesn’t have to be in-house because there are self-coaching, peer-to-peer coaching, apps, external experts, and virtual coaching that can be used to great effect.” “The clear feedback we have is that the companies that coach well derive great results from it. Importantly, the number one reason for staff leaving organizations is lack of career development. It is a false economy not to invest in coaching,” she says. Alyson Evans feels many companies are still on the journey to appreciating the advantages of coaching the modern MSL and adds: “If companies value people development, then they will do it. These skills are absolutely fundamental.”
Leon Rozen believes that coaching is the only route to help MSLs develop the micro-skills needed to serve a new era of pharma-HCP relationships. He sums it up: “Without coaching, you will never get the best out of your team.”
The first year of post-pandemic activity has been confounded by the difficulties of adapting to forced, and rapid, change. A clearer horizon is settling now, and the real advantages are in recognizing a changed world and what it offers. MSLs are the blood flow of the industry, the constituent that keeps everything moving and operating at optimum levels. The rise of the MSL has already started. They have to be equipped to make the best of their expanded roles and be coached into an agile and adaptable force that connects medicine to the masses through high-quality HCP engagements. It is a vital role and will draw on all their core scientific skills, and a few more, if they are to usher in a new era that delivers the best for pharma companies and patients.
About the interviewees:
A senior-level pharma and biotechnology executive with over 20 years of management and leadership experience in the health sector, pharmaceutical, and biotech industries – Leon has worked in senior management positions in Australia, Europe, and the US, during which time he has led strategy development, set up teams and functions, and led major international projects. He has a passion for people development, with particular interests in coaching, mentoring, and the developing field of neuro-leadership. He has trained in elements of psychotherapy, has accreditation as a practitioner of Extended DISC personality profiling and NLP, and is a certified Performance Coach.
Helen is the CEO of One MSL which was born out of Helen’s passion to bring the global MSL function into one community. She has 25-plus years of medical affairs experience and in this time has lived in the shoes of the MSL and a MSL Leader. One MSL is recognized as a specialist training consultancy, with a core focus on driving standards of MSL excellence. It has a deep connection with the MSL community and is on a journey of continuous learning to meet the changing needs of the industry and the individual.
Alyson is a DNP and clinical nurse specialist with an MBA in healthcare management and a master’s in legal studies. She has a history of working in the pharmaceutical and device industries, with a concentration in oncology, neurology, and ophthalmology including roles with Sun, Aerie, and Biohaven Pharma. Alyson, who is an MSL Leadership Award winner, is director of medical device company Sirtex’s MSL teams in the US and Canada. She was speaking in a personal capacity.
About the author:
I have directed 35 plays and coached performances for 30 years. I have worked with the likes of LA director, Robert Benedetti, US playwrights, Edward Albee and Will Eno, voice coaches, Kristin Linklater and Cicely Berry, Alexander teacher, Nadia Kevan, LA acting coach, Ivana Chubbuck, British playwright and screenwriter, Stephen Jeffreys, LA screenwriting master teachers, Steven Kaplan, Chris Vogler and Michael Hauge. I use these experiences with the world’s leading performing arts practitioners and my own background in theatre, to inform my work in presentation coaching. I work with a host of CEOs and their firms around Australia including KPMG, DLA Piper, CBA, QBE, Merck, and BOQ, as well as politicians and barristers, to help them present their message with punch. I am also a talent coach with Seven, Nine, SBS, ABC, and Fox Sports working with reporters and presenters on their presentation and storytelling skills, as well as many of Australia’s leading sportspeople. Clients have included Michael Slater, Wally Lewis, John Aloisi, Sharelle McMahon, Lara Bingle, Mark Ferguson, Ben Fordham, Allison Langdon, Mike Baird, Jonathon Brown, Glen Boss, and Tom Carroll.
In the past five years, I have created a new performance coaching app called 60 Seconds which is a crystallization of my experience.