Hey, guys. Welcome to the podcast. My guest today is Bart Brown. He is a medical affairs leader. And we talk about the idea of how to gamify MSL metrics and KPIs. There's a really interesting concept. We never talked about anything like this before on this podcast. It's a new concept. I think you guys are really gonna like it. Don't forget to follow me on LinkedIn and try to check us out for MSL talk live, which is typically the 1st Tuesday of every month.
We do announcements and notifications on LinkedIn. So definitely keep posted for those, and we look forward to seeing you. And thank you for your support of this podcast. Welcome to MSL talk with Tom Caravella, a podcast specifically designed for MSLs and all things field medical. Hey, Bart. Thanks for joining me. Welcome to the podcast, brother. Hey, Tom. Happy holidays. Yeah, man. So I am excited, guys, because Bart I've known Bart a long time.
We've worked together in in different ways, and and he he's just he's an awesome field medical leader that is gonna bring you guys a really amazing idea that he came up with. So I'm excited to have him on and share him with you guys. But before we do that, Bart, why don't you do an introduction and tell everybody who you are, where you're from, and all that good stuff? Sure. So I'm Bart Brown, Farm d. I live out in Colorado between Denver and Boulder. Great view of the Front Range Mountains.
My background, I was a high school teacher before I went to pharmacy school. 5 years of clinical and academic practice in Des Moines, Iowa. Started in pharma back in 1997 at the old Forest Labs, so I'm now starting my 27th year. Hard to believe. This means we're we've been around the block a few times. 22 years of that have been field medical, about 4 plus years, or HQ type roles, medical director, medical strategy, head of medical affairs.
I have been at gigantic companies like Pfizer in the 2000. I have been at, US divisions of a foreign company where there were 18 US employees, of which 10 were my medical affairs department. So I have seen, you know, everything there is to see. If I haven't seen it, I've probably heard about it at this point. Most of my work has been in the neuroscience area, little bit of rare disease.
I think if I have one niche or one jam as it were, I've had the great fortune to start from scratch 3 MSL programs. And, boy, you really learn what's what when you do that. And having to integrate with so many departments within the company and and really network and get to know other functions, that's been a a real blessing. Awesome.
Well, we, you guys are in for a treat because we have a really good topic that, you know, Bart and I were talking, and and, we've we've done the topic of metrics before on this show, but this is a whole another spin on this. So I want you guys to, to get your pens ready, because this this for experienced MSLs and even for aspiring MSLs and people that are new to this space, this is a really interesting concept that I think everybody can learn from.
But before we get to this idea, Bart, why don't you just if you can explain briefly what our metrics, how our MSLs traditionally evaluated? Let's get that out of the way, and then we're gonna talk about your idea on what you think should happen next. Sure. So as an employee of a company, of course, you're gonna have your individual plan for the year, what you're expected to perform and produce, and you'll be evaluated against that plan at the end of the year.
Hopefully, there's, you know, at least a a midyear evaluation as well. Hey. Are you on target or not? And, typically, with these plans for MSLs, there's been a combination of what we call quantitative metrics. Right? Easily countable, easily measurable, such as how many KOL or HCP interactions did you have this year with a mix of more qualitative metrics, you know, things that are more impactful, things that we consider wins or highlights.
But frankly, they're very subjective, and it's hard to really define what is the impact or value of that. Often, there'll be 2 or 3 items, from each category, quantitative and qualitative, to make up this business plan in addition to general things like operational. Right? Did you do your monthly reports on time, your expense reports on time? Did you keep up with SOPs? Right? That's kind of across the board for everybody, very generic.
Often, these individual business plans are derived from a larger team wide business plan for the entire MSL team. What will the team accomplish? Of course, that's derived from an even larger medical affairs plan, maybe some of the brand plans for the products that are supported. And, of course, all that comes down from the ultimate corporate plan for the year. Mhmm. So all this kinda spinning down to an individual level. That's the the traditional method.
And frankly, I've been around long enough that, you know, I don't know everything that works, but I've been around to see what doesn't work. And traditional metrics like this do not work very well for field medical. Commercial, it's easy. You have sales numbers, sales quotas, sales dollars, sales volume, growth of of sales, all of those things. None of that applies to medical affairs or field medical. It's more subjective. So how do we really define that that value and that impact?
That's always been the big question, is how do you evaluate and define value for MSLs? And every conference that you go to, any every medical affairs conference, there's always several discussions, if not one discussion on the value proposition for MSL's infield medical. So this ties into that. And just to add, and that was that was beautifully described because it is true. That's what it is. It's always some combination of qualitative and qualitative.
Now the other thing is that there's no real standard from what I can tell from all people I've had on this podcast. All years I've been doing this, there's no standard. There's no one way to do this. Everyone does it differently. Yep. So now, Bart, you have this idea, which is very creative, on how you could take a totally different approach with the idea of metrics and KPIs and a totally new way to evaluate MSLs. So why don't you share that and explain what that idea is?
Sure. So, you know, I've I've struggled, Tom, over the years with the qualitative component of this. Often at the end of the year, there can be a disagreement between a manager and an MSO. And I know as an on both sides, over what the true impact of value of some of these, activities were, some of these more qualitative wins as it were. As an MSL, I used to think, oh, well, I exceeded expectations.
I really am due for a fantastic assessment at the end of the year and and all the perks that come with that. Whereas, maybe my manager or when I was a manager was like, well, no. Those those impacts were good. They weren't great. I think, you know, maybe you just met expectations for the year. And it always leads to this disagreement and then this negotiation and this debate.
And it's either right here before the holidays, which is the last thing you want, or it's right after the holidays when you're trying to kick off a nice, clean, refreshed New Year, and you've got this hanging over you, this conflict with of your employees. So that always bothered me. How can you eliminate these disputes by agreeing upfront to what these qualitative metrics would be?
So my idea is to define, at the very beginning of the year, and if everyone agreed to it, what value can we apply to these impactful activities, these, you know, subjective activities, by using an agreed upon point system? I love it. So it's basically a gamification, turning it into a little bit of a game by attaching a point system to the activities that an MSL would be responsible for performing. Exactly.
So can can you go into a little more detail about that system and how you would set it up? Absolutely. So the key is to, again, define upfront what these values will be. And I think the best way to do that is with a committee composed of the MSL manager, maybe 1 to 2 senior MSLs representing the team, perhaps your HR agent that works with the MSL function, maybe a medical director who really knows the priorities and what are the high potential impact activities for that year for the brand.
And this committee would essentially put together several lists of whatever activities they can think of that might occur that year and assign points. So there'd be a one point list, 2 point list, a 3 point list. Example of a one pointer, MSL nominates a KOL for an ad board that the marketing team wants to do. You know, it's someone new to them, and the person is chosen. They participate. They do a great job. They bring incredible insights, fresh perspective.
They're really a rock star at the ad board. That might be worth one point, for example. Something more complex. Let's say you have a KOL, really believes in your drug and its benefits, really wants to see it added to the state P and T, formulary for Medicaid, and agrees, you know what? I'm gonna travel to the meeting, the the P and T meeting, and actually give live testimony for your product. That's how strongly I believe in. And they go. They rock it.
Ultimately, the committee agrees, accepts it, adds it to formulary. That could be a 3 point win, you know, a big win. So the key is to list out all these possible 1, 2, 3 point wins. That same scenario, let's say that KOL can't travel actually to where the meeting is. They write a letter instead in support of your product to get it added to formally maybe that's a 2 point, for example. So there can be, you know, different degrees.
The other thing the committee agrees on is that, okay, at the end of the year, how many points have to be garnered by the MSL to hit the different levels of ratings? Meets expectation, exceeds expectation, or, unfortunately, sometimes only partially meets. And let's say, you know, 10 to 12 points at the end of the year is a meets, 9 or below is a partial, 13 and above is an exceeds. So that would be the other thing that the committee would do.
Finally, these documents, as always, should be living, breathing documents. We can't forecast ahead of time what might fall in our lap. Right? What great opportunities. Though sometimes business plans try to do that. Let's say, for example, your KOL is involved in writing new guidelines in a therapeutic area. Those only happen, like, every 7 to 10 years. You really can't predict.
But you meet with the KOL, you really educate them, they call you over a period of months, more and more data, more and more explanation. And lo and behold, the new guidelines come out, and that KOL is very influential in getting your product incorporated into the guidelines or moved up in terms of importance for the guidelines. Something tremendous that never would have been, you know, expected at the beginning of the year to even have occurred. The MSL and the manager can negotiate.
Hey. Was that a 4 point win, a 5 point win? It's obviously huge, very impactful. So things can be added on after the fact as well. But the main goal with all of this, again, is to try and prevent that end of the year, frustration, the need to debate and negotiate. Oh, I think it was more impactful than you did. No. We're predefining this at the beginning of the year exactly what value those qualitative activities will have. I think it's awesome.
I I, I could see their I could see the challenge of setting this up, but I like the idea of having a committee because it's not just one person. There's a committee that is setting up this strategy and the system, whatever that that ultimately is gonna be. And then once it's agreed upon, then it just becomes, okay. Well, this is how we're gonna track this. And it takes, like, as you said, it takes the guest a lot of guesswork out of it. But I also think that it it can create a real motivator.
I think anytime you gamify something, it it gets the competitive juices flowing, and it changes the the thought process. But before we get into to that piece of it, I'm curious. So now you you have the system set up from the this this board. Right? And then who's responsible for implementing it? Like, there is there a lead person? Is it the manager? Is it you? Is there somebody that's like, okay. This is this is my job to implement and enforce this.
Yep. Who's who's actually the person that's gonna roll it out? So I think it's best done jointly by the MSO manager and the HR agent. Okay. Because we are talking about formal evaluations Mhmm. End of year assessments that will have impact on the size of raises, the size of bonuses, potentially the number of things like stock grants and all the rest. So, obviously, it's a very important, very sensitive subject for everybody.
Mhmm. And to have HR involved as a partner with rolling this out, I think, would be great. And it's a chance, you know, there might be last minute suggestions by members of the team of things that were missed or thinking that certain weightings were not accurate. Maybe, you know, some one should be twos, things like that. There there's a chance to, again, do a final check on what the committee had recommended. The main thing is that there's this buy in by everybody at the beginning of the year.
Okay. This is what we're going to have. And and from then, hopefully, avoid the problems down the road. Yeah. And it's like it it's encouraging the MSLs to go out and collect wins. Collect wins, get points. The more wins, the more points. Maybe you change the the way the point system works a little bit here and there. And, you know, but the idea is to is to encourage and motivate MSLs to go out and just collect wins. Absolutely. Yes. So and I think yeah. Go ahead.
Well, I was gonna say and and whether you're a layup artist and you wanna have 10 to 12 one pointers through the year to get there, that's fine. If you're Steph Curry and you only wanna have, you know, say, 3 to 4, 3 pointers to get there for the year because you're more experienced, you're focused on those bigger types of impactful wins, that's fine too.
However the MSL goes about it based on their experience, based on the opportunities within their region, because we know not every region is created equally in terms of opportunities, it gives more variability to how they actually get those points accumulated. Yeah. No. I think it's great. I I think it's a it's a really cool concept. So how do you think this is good for MSLs? I think there's a couple things that immediately come to mind, one of which is consistency.
Okay. If you've been in MSL, you have, been in a situation where you did an activity exactly the same way as, you know, MSL Billy Bob in another region did an activity. But but maybe Billy Bob is in New York, and the KOL he worked with is well known by headquarters. And and the, you know, case series that that KOL wrote has gotten lots of play, and and headquarters just thinks it's absolutely wonderful.
Whereas you and your KOL and, you know, Iowa, Nebraska, who also did a case series and published in a great journal, you know, it's not playing so well. Well, sometimes at the end of the year, there can be a very subjective difference in the impact, right, and the value that is seen because one KL just happened to be better known than another. But you as an MSL under this model, you know upfront, nope. That's 3 points for me. That's 3 points for Billy Bob. There's consistency.
There's not, you know, hate to say it, favoritism Mhmm. Or this subjective bias. We know upfront, hey, you have a KOL, get a case series published on your your compound, on your product. Boom. That's a 3 point win right there. So I think that's probably the the biggest thing. Yeah. I already mentioned how you go about your work, whether you wanna focus on a bunch of little things or just a few big things or a mix thereof. That's up to you.
I think you have better understanding through the course of the year, whether it's quarterly, at the midyear, how am I tracking? Oh, I need 10 points by the end of the year. Here it is, July 4th. We're going into the holiday weekend. I've only got 2 points so far. I really need to pick it up, you know, the the last half of the year. I I need to get 8 points. I really need to start focusing and and locking in specific things.
It's easier for the MSL to track compared to the old traditional method. Well, you know, you have a a a metric worth 30%, which is moving your KOLs along and and getting them to understand our data better and to maybe talk about our data and influence their peers. And and that's worth 30%, and maybe you're halfway there, maybe you're not. I'm not really quite sure how to evaluate this as a manager, what to tell you. Or, you know, you're expected to do a 180 interactions.
You've only had 50 in the first half of the year. Yeah. Well, good luck. July is a hard month. December is a hard month. You know, you you can't really control when people are available. I don't know how you're ever gonna get there. Well, you take some of that out of it. Mhmm. And and by this point system, it's, like, very clearly defined. Here are the things I need to do to get to that point total. So I think that's how it it really benefits the MSO. Yeah. No. I mean, I could totally see it.
I could totally see it. How do you think this benefits leadership? So the MSL managers and HR counterparts, as you mentioned, or even department heads. Yep. Again, so you can easily keep track of where individual MSLs are at through quarterly or midyear points and and Mhmm. More easily track their progress and help them out, where, you know, MSLs need that extra help or and where to put your time as a manager, who needs that assistance, who's not tracking well.
It's much easier to quantify where they're at in their progress. From an HR perspective, this can also be used to differentiate between MSLs. Yeah. We use the example, say, 10 to 12 points meets expectation. Well, maybe that's true for a new MSL or, what we could call an MSL 1 in some companies. But for senior MSLs, MSL twos, executive MSLs, whatever the term is, the more experienced, you know what? Maybe their meet expectations is 15 points.
Mhmm. They have more experience, they're being paid higher salaries, of course, more should be expected from them. You can adjust that bar accordingly to differentiate the different levels of MSLs. I think there's also value in this. It is difficult as you move up the the corporate ladder, up the corporate chain to communicate what these wins, these highlights, these impactful activities are, because we know as we move higher up the chain, numbers become more and more important.
It's easier to look at numbers for a group and understand what's being done. So I think this helps the field medical management explain up the chain and show what's being done because it kinda standardizes all of that subjective qualitative work. That's a good word standard. Because that's I think that's the the the missing piece is standardizing this monumental and unstandardized right now concept. So I I do think it makes sense. Now I like to play devil's advocate.
So what what might be the downside? What what would be reasons why a company or a medical affairs department should not do this or may not wanna do this? So so why even though I've had this idea for 15 years, I've tried to implement it at 4 different companies, and I've not been able to. Oh, jeez. Full transparency, because change is hard. Yeah. No one embraces change until they have to. Mhmm. And this is saying, okay, what's been done since, essentially, 19 seventies with MSL metrics?
Nope. We're gonna do it totally differently. I think that's the primary, issue is that it just takes change and an agreement to change and and to adapt this. I also think there's a risk, the 1st year that this is done regarding calibration. And what I mean by that is, again, let's say the committee sets, as we've been talking about, 10 to 12 points at the end of the year would be a meets expectation. Well, maybe it turns out that bar is too low, and everyone on the team gets 15 plus points.
Mhmm. Well, as previously defined, everyone on the team then should get in and exceeds expectation as a year end rating. Well, HR doesn't like that. Yeah. Senior management doesn't like that. That, honestly, we're talking about more dollars in raises and bonuses and all the rest than than expected. But that might have to be something that is, you know, done and agreed to in that 1st year while the system is calibrated.
Of course, that second year, the bar would be set at, say, 15 points for everybody Right. As it meets expectation.
Of course, the other option is to take a year and to kinda run this as a pilot concurrently with the traditional way of doing metrics and assessments and KPIs to see what those calibrations are, what those values should be at the end of the year, and also to compare the 2 and and see how they, align, see, you know, how the the team members, the MSLs themselves, like the new system before jumping into it fully. And that makes total sense.
Then then you can try out the concept without having it attached to anything that's going to cause any issues. Because I was thinking the same thing. I think the biggest challenge is, like, you know, you're not really gonna know until you know. So you gotta have you have to start somewhere, though. Yeah. So that's that's somewhere. Yeah. Now that's an interesting idea because you're not, you know, you're not really committing to it just yet.
What about what if do you think that there's a way that MSLs can do this on their own right now? So they listen to this podcast, and they're like, I wanna do this. Do you think there's a way that MSLs could gamify their current metrics, their current system, as a way to motivate themselves and encourage themselves to do better? Yep. Absolutely, Tom. It all starts with the generation of these lists and these point values.
And whether an MSL does that on their own or the couple teammates who might want to also, you know, participate in this, or if the whole team does it, with the manager, assisting in, you know, kinda as an informal exercise. It all starts with generating these lists. And then in terms of self motivation, there's all kinds of ways to look at it. Alright. In the month of February, I gained 2 points. Well, in the month of March, I wanna beat that. I wanna aim for 3 points.
Or in the Q1, I got x number. Next quarter, I wanna beat that. So there's a personal saying that personal record as it were, per quarter. You might compete against teammates who had the best quarter, who had the most points in the quarter, or look at it and say July, alright, over the 1st 6 months of the year. Who had the single best month of points? And, you know, maybe there's a little, incentive prize for that Starbucks card, whatever it might be.
Yeah. You know, who had the who set the record in a a single month for points. All kinds of ways to look at it. I think the again, the the best thing to the MSL, though, is that it can more clearly, more easily track how they are progressing through the year compared to a large complex 6 or 7 weighted items on a, you know, big business plan. Am I attaining my goals? Am I on track by the end of the year or not?
And I think that is the biggest, benefit to the MSL as they gamify this and and work through this. Am I on track or am I not? And I can tell very easily. And if I'm not, what things can I do from some quick wins, rack up some quick points? Because, again, they're all impactful. They're all important for the company. They all bring value. It's just a matter of how much value. Right. No. I think it's awesome. It's, it's so cool. And and I like that, you know, that word impact.
I think that that is that's a key word is how can you be more impactful? What types of activities you're gonna focus on for greater impact? And then you get you get higher points for greater impact. So, what about you know, I know, obviously, you're you're you've seen a lot and you have your finger on the pulse of what it takes to be successful. What do you think MSLs need to do to find success in 2024? Well, we are in difficult times.
And I think the single biggest thing that MSLs can do or MSL functions in companies is diversify, diversify, diversify. And I know that goes counter to what seems to be happening in field medical affairs, which is actually sub specialization. Right? Smaller, more focused teams on specific aspects of medical affairs. I'm kinda saying the opposite, diversify. 2023 has been a brutal year for company layoffs. This year, number of companies, how unexpected.
I, myself, I was hit back in August, with an unexpected layout, 60% of our company. You look at just in December, announcements of acquisitions, Ceravell by AbbVie, Corona by BMS. We'll find out the impact of those in January, February, March about consolidation and more layoffs. Right? It is always necessary for the MSL function to show its value to the company. Because, again, we can't do it in terms of sales dollar, sales volume, like the commercial side.
It's even more true now, I think, with all of these layouts. So my advice by diversifying, get your fingers into as many pies as you can, or even better, think of the octopus. Get your tentacles wrapped into as many different departments and functions as you possibly can to show how you are supporting them, to show the value you are bringing.
It gives the opportunity to network for exposure, and if you, as an MSL, you feel like, well, my management, my field medical management chain doesn't support this. What you can do as an individual is volunteer for projects, for assignments, take on as much as you can possibly handle while still getting your day job done, but do, again, increase that exposure with headquarters to show your value.
If you wanna volunteer for an assignment, but you're not comfortable doing it, ask if you can be a co lead to learn from a more experienced MSL so the next time you can be the lead. But get into as many things as you can to show that value because layoffs are a part of this business more so now than it seems like even previously, acquisitions, you name it. We have to show the value, and I think the best way to do that is to show value across multiple domains and functions as possible.
Amazing advice, Bart. You're the man. Thank you. This was this was a great conversation. Guys, I told you you wouldn't be disappointed. And what I love about this is the creativity, the ingenuity. We haven't really talked we haven't had this type of twist on this subject. So I love bringing new ideas. I hope it was helpful for all of you guys. And, Bart, I wanna thank you. You're amazing. I appreciate you, brother.
Well, thank you, Tom. I would ask, you know, if there are any companies out there, MSL managers, who are already doing this, please reach out to me. I wanna hear how you got the company to agree. I wanna hear how it's going. How do the MSLs like it? How do you think it compares to traditional ways of doing assessments? I'm not aware of any that are, but, you know You never know. I don't know what I don't know. So if it's happening, please let one of us know. Yeah. Reach out to me too.
We'll we'll we'll do a podcast on it, and and maybe, Bart, we'll have you come back, and maybe we can have a discussion, like, a little bit of a panel discussion on how like, a part 2, you know, how that comp this concept was implemented and and how it's finding success. I think it'd be really cool if somebody's doing it. Reach out. Absolutely. Yes. Let's find out. Well, thank you, Tom. This has been fantastic. Yeah, Bart. Appreciate it. For joining me.
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