Medical Affairs generates enormous value. Every day, Medical Science Liaisons have high-quality scientific conversations with clinicians who shape practice, influence peers, and test evidence against reality. Few functions in pharma have this level of access, trust, and depth.
And yet, much of the potential value from these interactions is quietly lost.
Not because MSLs are not asking good questions, or because insights are not being captured – but because learning is often unsystematic. Valuable signals remain fragmented, anecdotal, or underused, rather than being deliberately shaped into something that informs strategy.
The issue is not effort. It is structured.
Insight Is Abundant – Strategic Learning Is Not
Most Medical Affairs teams collect insights. Field notes are written, systems are populated, themes are discussed. But collecting insight is not the same as learning with intent.
Too often, medical strategies are defined early, and MSL engagement is expected to support and execute against them. Insights flow back, but they are rarely designed to test whether the underlying assumptions were right in the first place.
This means Medical Affairs frequently misses the chance to answer higher-value questions, such as:
- Which uncertainties genuinely matter to clinicians now?
- What evidence would change confidence, not just understanding?
- Where does the medical narrative feel internally coherent but externally fragile?
Without a systematic approach to answering these questions, organisations risk mistaking activity for progress.
Where Value Is Lost
The table below captures a pattern that many MSLs will recognise:
| What happens today | Value that is lost |
| Insights gathered opportunistically | Signals are hard to compare or prioritise |
| Conversations vary widely by MSL | Patterns emerge slowly or not at all |
| Assumptions remain implicit | Weak points surface late, when change is costly |
| Learning is retrospective | Strategy is adjusted reactively, not deliberately |
None of this reflects a lack of capability. It reflects the absence of a shared learning design.
Systematic Does Not Mean Rigid
When people hear “systematic,” they often worry about scripted conversations or reduced autonomy. In practice, the opposite is true.
A systematic approach does not dictate what MSLs must say. It clarifies what the organisation needs to learn, and allows skilled MSLs to explore those questions in their own voice, using scientific judgement and relationship awareness.
For example, instead of broadly asking MSLs to “gather insights,” teams might agree to focus learning around a small number of strategic uncertainties:
| Strategic uncertainty | What systematic learning explores |
| Data interpretation | Where clinicians hesitate or disagree |
| Evidence relevance | Which outcomes influence real decisions |
| Adoption barriers | What still needs to be proven to move forward |
This creates coherence across field activity without reducing authenticity.
Why Timing Matters
One reason value is lost is that learning often happens after key decisions are made. When insights challenge assumptions late, the organisation has limited room to adapt without disruption.
Earlier, more deliberate learning allows Medical Affairs to influence:
- Which data gaps truly need addressing
- How evidence is framed and prioritised
- Where future investment will have the greatest impact
In other words, systematic learning increases decision quality, not just insight volume.
What This Unlocks for Medical Affairs and MSLs
When learning is treated as a strategic asset rather than a by-product, several things change.
For organisations, Medical Affairs becomes a source of risk reduction and clarity, not just scientific exchange. Strategy is informed by external reality earlier, when it still matters.
For MSLs, the role becomes more clearly connected to impact. Field conversations are no longer just valuable individually; they contribute to a shared understanding that shapes direction.
This also elevates professional development. MSLs sharpen their ability to identify patterns, surface contradictions, and articulate what those mean for decision-making – skills that are increasingly recognised as critical for senior Medical Affairs roles.
Turning Latent Value into Real Value
Pharma already invests heavily in Medical Affairs. The opportunity is not to do more, but to use what is already happening more deliberately.
By designing learning systematically – clarifying what matters, comparing insights across stakeholders, and feeding them back into strategic decisions – companies can unlock value that is currently being left on the table.
The conversations are already happening. The expertise already exists. What is needed is a more intentional way of turning those conversations into learning that shapes the future.
In a complex medical environment, value does not come from knowing more. It comes from learning better, sooner, and together.
Disclaimer: This article was created with the help of AI (ChatGPT). All concepts and topics were developed by the author.
About the author:
Paul Riley, MBA, PhD, CMgr
Paul Riley is the founder of Nexcea, a UK-based consultancy that helps pharma companies commercialise medicines in a clinically meaningful way. He leads projects that turn real-world insights into strategy, supporting Medical Affairs teams in the UK, Europe, US, and Japan. He also serves as adjunct faculty at Alliance Manchester Business School.
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