Hey, guys. Welcome to the podcast. My guest today is Mary Winkels. She is the global director of medical affairs training and capability at Vertex Pharmaceuticals. And we talk about the MSL secret weapon for insightful engagement. And this is such an awesome conversation. You guys are gonna love it. I wanna thank you all once again for your support of my new book, Job Search Mastery, How to Win Your Dream Jobs. Or for any job seekers out there, Check it out. It's available on Amazon.
And as always, thank you for your support of this show. Welcome to MSL Talk with Tom Caravella, a podcast specifically designed for MSLs and all things field medical. Hey, Mary. Welcome to the podcast. How are you? Hi, Tom. Great. Thanks for having me. Yeah, guys. I am excited. So I know Mary a long time. Right? It's been a long time. Yeah. Yeah. We've been talking about this for a long time. Well So I'm really happy it's finally Yeah. I I I've been like harassing, you know, Mary's brilliant.
She's just a wealth of knowledge and information, and I've been harassing her for a long time. So we finally made it here. So before we get into this topic, why don't you do a quick intro and tell everybody who you are and where you're from and all that good stuff? Yeah. Yeah. Thanks. I'm sure. So I am at Vertex Pharmaceuticals, and I lead the global training and capabilities development function there.
I came there a few years ago to build that function up as Vertex is in the process of growing themselves. But, you know, I came into industry, I think, you probably know the way most people do is I came from clinical practice. So I was in clinical practice as a clinical pharmacist doing formulary management, developing guidelines, had my clinical practice with patients with diabetes, anticoagulation, and I got to know some of the commercial folks who would call on me and some MSLs.
And one of the MSLs, who I think is the best I've ever known, they just really helped me see how joining industry was an extension of what I was already doing, you know, really helping to examine drug therapy, drug profiles, the benefits, and, help extend that beyond the clinics in my patient, the patients in my clinic and, you know, the insurance company I was working for to be able to extend it into a whole region and be able to help folks, assess
the benefits of drugs, understand them better, and make the best choices for their patients. So I really came in as a payer liaison, outcomes liaison, working, with health care decision makers, which was really very good role, very interesting to to look at that type of data, and then became an MSL, MSL trainer, had global roles doing field medical excellence excellence and, and then building a capabilities function.
So it's it's been really just a very nice career, a lot of interesting people, and I feel like I'm learning all the time. And I hope I'll learn something from you today, Tom. I hope so. Well, I know that the audience is gonna learn a ton from you. That much, I know, and I'm really excited to jump into this topic. Before we get started, this episode is sponsored by MSL Mastery, if you guys are unfamiliar.
And as Mary talks about her transition into industry, I know there's a lot of people that listen to the show that are trying to come from clinical practice or from a research, background, and they're trying to break into their 1st MSL role, check out our aspire MSL program, which is a step by step guide on how to land your 1st MSL position. You go to MSL mastery.com for more details. We'd love for you to join us. Mary and I talked about this topic.
We're calling it the MSL secret weapon for insightful engagement. And you're probably all wondering Tom, what does that even mean? So, Mary, the first question I'm gonna have for you is or maybe you could just tell everyone, what is the secret weapon? Yeah. And we kinda kinda came to this through a series of conversations, like you said. But we talked about, you know, curiosity and, you know, where curiosity may have killed the cat, as some people say.
But it turns out that it's really a secret weapon to turning average engagements into insightful ones. Because we know MSLs have a lot of tools in their arsenal. I mean, they're scientific experts. They have the ability to build rapport and relationships, and the really good ones have good emotional intelligence. But being curious and specifically constructing really powerful questions really just supercharges engagements, and that's that's, I think, what we wanted to talk about.
We could all use some more wonderful engagements out there. Yeah. And I think that there are I the reason I think this is such an important topic and it's so helpful is because I think that MSLs are trained a certain way. Mhmm. And I'm sure they have certain questions that they're used to answer, you know, getting answered and asking. And, but curiosity's, an approach. When you take a curious approach and when you're a curious person, I think the questions come naturally.
Then if you feel like you're just asking so much of required questions, I want to ask you, like, where is the skill gap here? Is it that people MSLs, are not are just not asking enough questions? They're not asking the right questions. Are they or they're just not being curious in their approach? Yeah. And and curiosity, like you said, it's a mindset. Right?
I would say that it's the the gap is it's both a skill and not being not thinking or not asking the right questions, but it all comes from a really well intentioned place. MSLs, you know, they have a natural tendency to wanna be helpful and provide value to the KOL. I mean, their time is so precious, and, you know, for us to get meetings, it's very can be very difficult.
And as a scientific expert, if you you feel like one of the value you can provide is giving a lot of data and information to help them. You know? And so engagements can tend to be a lot of MSL talking and giving a just a reflex. As soon as someone asks a question, you just wanna jump in and give the the information.
But the thing about being curious or at least kind of avoiding that reflex a little bit is that when you can dig a little deeper and maybe understand what the true need is or understand where they're coming from, you're gonna be gaining insights about them, how you can bring future value, but you're also going to be able to answer their question better. So it's I think it's that that reflex that I'm here. I'm an expert. I'm your liaison. I can help you understand our data.
But part of it is understanding them better. Yeah. You mentioned the word for reflex. Mhmm. And and that kinda I'm I'm actually thinking as you're talking about this curiosity thing, I'm curious. See, look at, I'm doing it. I'm actually doing it. I see it. Well, is you hit the nail on the head. I am naturally curious. So is this something teachable is, is this something people are born with or is there, you know, is there a muscle that can be developed here? Like, what's your thought on this?
Some people are genuinely curious people. Some people have to really work at it. I think what, what do you think about it being more innate than, than learned? Yeah. Yeah. I mean, look at children. I think, like, kids are, like, naturally curious. Right? And then scientists, I mean, a lot of us who are scientists are naturally curious. But I do think that to some extent, we lose it because we have so many other priorities. You know? You have to deliver some tangible some tactic.
You have to accomplish deliver some kind of data, and it almost feels like a waste of time maybe to be curious. You know? Or maybe people don't feel like they have the luxury of it. But when people know, like, when when we and you can train it, and and I have done it. I I think we'll probably talk about that. But it's like you know about exercise and and being fit. It's something you have to constantly work at.
But knowing when people begin to approach with a curious mindset and they can see that payoff, that asking that right question can really help open the conversation and find the gap and deepen that understanding, I think that they want to learn how to build that. And, you know, how to build it is I mean, we could talk more in-depth, but first is just really knowing. And when people have had a little practice with it, they wanna do more of it.
And a good way is in your previsit planning, think about 1 or 2 or 3 good questions you could ask, and keep them in your back pocket. You know? If I had a chance to ask Tom this, what do I really wanna know about him? About what his challenges are, where he what guideline he follows, and and why he thinks that one's a good one for his patients. You know? What are things that could really help me understand how he wants to get data, the most important kind of data?
Then I'm a better MSL on my next visit. You know? I might have something I can send them in the meantime. So I do think that that that one thing is thinking about questions you can ask and keeping them, and the other is just avoiding that reflex. You know? If someone asks, what is the percent of this side effect in your clinical trials? We could answer it automatically. That would certainly help them. But being able to just take a second and ask, you know, yeah.
Let me get you that data, but it I'd really love to know why is that side effect of concern for you, that particular one. Does it occur what, you know, what how do you manage it when it occurs in your patients? What have you heard about that side effect from other people, you know, with our product?
And those are insights the company is gonna love, but you also may uncover that the physician's biggest concern is that because it means their patients can't achieve the goal you know, the therapeutic goals or that, you know, their patients are too tenuous for that type of side effect. So kind of avoiding learning to kind of dig in a little and relax in the engagements when you can.
I think those are examples of do those seem like things that would kind of get to our goal of more insightful, totally engagements? Yeah. I mean, I I I think that that's a great way to answer that question and share with everyone how strategic this is. This is definitely a strategy being curious as a strategy. And I feel like just from the stuff that you're presenting right now, is it is, and you had mentioned at one point having a curiosity mindset.
So if you adopt a curiosity mindset and you have this strategy to go in and ask really insightful questions and dig deep and be curious and be more curious without being annoying, there's an emotional intelligence piece to this. That's just like, okay, you have to know when you're pushing the envelope and it's beyond natural conversation and you'll realize that I would imagine.
But by taking that approach, you then start to get all this additional information and insights, and that becomes the reward for the strategy. So now you have a strategy, there's a reward to it. And that I think, should motivate MSLs, to wanna adopt this and want to do it because you're getting so much more out of it. Yeah. There's two sides to that insights coin too. Right? So I understand the person I'm meeting with better. You know?
She makes her decisions this way or this is what's most important to her when she selects something for her, patients. But then there's insights I can bring back to the company. I mean, sometimes and, you know, I think everyone will raise their hands if they put in these types of insights like doctor x doesn't isn't impressed with our data. Well, why isn't she? You know? How does a medical director interpret that? Is it because it was the wrong data that you know, the wrong age group?
It was could we do another analysis? Should we include different statistics or different data in our next study? And those are all insights that are very important to the company. You know? Our currency. Right? How many how many times the medical affairs currency, one of the big ones is insights. And just bringing back that why. You know, it's one of the skills on every benchmark study I've seen for MSL skills that's one of the lowest is seeking why.
You know, understanding the beliefs, and the reasons why our experts look at our data or make the treatment decisions they do. And if we wanna expand the way they make their treatment decisions or introduce new data, we have to understand what they want. And and and so we're really that big customer facing aid, you know, group that can do that. Yep. Okay. So MSLs now become curious. Right? So now they've said, okay. I got you. I'm in. You had me at curious. Mhmm. So what next?
What do they do next? I think and you said a really important thing. You have to be emotionally intelligent. So you have to be strategic. You know? Think about and a good medical plan should have this, and MSL should understand that. Like, what are our insights gaps? What are the things we know that we don't know? And we would love to know. And then in those meetings, you know, again, plan some of those strategic questions, but be really intelligent about how you do it.
I have a friend who's a KOL, and he said that someone must have gone through one of these trainings, and he felt like like you said, Tom, it was like an hour long inquisition, you know, to the point where he felt like he wouldn't wanna meet with that MSL again. So you have to be you have to learn how to construct intelligent, powerful questions. And we've talked about that a little bit. And to me, they're open ended, but they also really open up the conversation. You know?
They go they open possibilities and they leave room for that KOL. Who's an expert? You know? Why not find out? You know? How do you you know? How could our data be better for you? You know? That's a really powerful question. The closer you get to why are the more powerful questions. But that's that intelligence piece. Asking why of an expert, asking why if you're new in the relationship is very hard and can can, really be threatening. So learning techniques to ask.
Get to the why without maybe using why. You know? Tell me more about that. You made me really curious, Tom. I I remember, at Mas East, we were talking and I said, you know, I could say, what do you do, which is not particularly powerful because you could give me a simple answer. But when I remember I asked you, I think, how did you decide to get into making podcasts? And it really just we had a really insightful you you were reflecting a lot.
You were sharing a lot about kinda your personal goals, and it was a much better conversation, you know, just with a simple question. Well, it's so funny that we're talking about this because this week's episode. So as you and I are talking, there's an episode that's already out and it's called never split the difference. And it's about a book. It's really a book review.
And in the book, Chris Voss, who's the, who's the author talks of, he was an FBI negotiator, and he talks about, how to ask questions, calibrated questions. He calls it and he, everything. Now this is redundant because we just talked about it, you know, this week, last week, I should say. But what you just said is the basis of calibrated questions. You're focusing your questions on what and how, as opposed to why, because why can be threatening.
Yes. So when you're putting together a pre call plan, a pre visit strategy, whatever you want to call it, and you're putting together questions, you really want those questions to be more like what or how, not why, or tell me more. Exactly. Yeah. Tell me those are all really so and there's a little pyramid. This is based on an article that actually another MSL trainer turned me on to, and she sort of originated this.
And I I took the idea further to do a full program called art of powerful questions, but they sort of show a pyramid. And at the bottom, a question like which. Which guideline do you follow? They they talk about, like, questions being levers. Like, if I'm trying to open something, I want a really long lever because it'll give me more power. So something like which, you might tell me, oh, I follow the American Diabetes Association guideline. That doesn't really tell me much.
It could be an opener. But if I, ask you kinda ladder up sometimes to better questions like, what do you like about the American Diabetes guideline? You know, then maybe they'll tell you it's simple, you know, whatever. You know, how do you use it in your practice? I'm moving up towards those more powerful questions, and you could see it's like a lever. With a really short lever, you can't do very much work.
But with a really long lever, you can open up the conversation and open up your understanding of that person. Yeah. And it it's it it does become like you have to almost think of yourself as a reporter. What are the, what are the questions reporters ask? And it's usually the who, what, why, where, and how, but it's the, what and the how are the ones that really open things up? Because if you ask questions, like you said, which, where. They're there. They might give you one word answers.
So you want to try to stick to the really broad based open ended questions. And when we were talking in, so when we were at mass east, you had one of the slides that you had was referred to the art of asking powerful questions, which obviously we just talked about, but was there anything that we missed? Like, think about that program. Is there anything else that you wanna add that we might have missed?
Well, I think part of the the basis of that program was thinking about, you know, my work in medical excellence and how we if you're gonna focus on a skill, you wanna make sure it's going to lead to an important outcome, an an outcome that's important for the business. And so we had designed that program not only to teach I I think it is a really important thing. It's it's a great thing for the MSLs to learn how to do this and to practice it.
But part of that program, what we did is we realized to get a change that would be measurable for the for the company, where we could see that our MSLs were asking better deeper questions, we were getting better insights.
Part of it was also to train the managers on this and then to have the managers follow-up with coaching, observing in the field, and coaching because what managers would tell us is, you know, I I was on a visit and I saw probably 3 or 4 chances for them to ask a deeper question or to get it for an insight and they kinda the MSL didn't kinda go for it. So this gave the managers an opportunity to also know what to look for and to help coach to it. So, and then we could demonstrate to the company.
We did take people out of the field. We did have managers invest this time. But after 6 months, we could see, based on external benchmarking, our MSLs went from the lowest quintile in seeking y to the 2nd highest quintile, you know, with this kind of a focus. So, you know, you ask, could this be taught? You know, it can, and it wasn't just us who did the program saying it made a difference. It was blinded outside observers that that could measure it.
So that was that really, I think, is why this topic has stuck with me so much and for so long. Yeah. It clearly works. It clearly works. You know, and it's all, I don't want to dumb it down and say it's really simple, but I think there is some simplicity to it in the sense that, okay, what's the takeaway from this conversation? It is if you're an MSL and you wanna perform at a higher level and have more insightful engagements, be curious. Mhmm. How do you be curious?
Well, we talked about it already. So I think that it's adopting that mindset first and foremost, and then it's putting together a strategy. Mhmm. But let me ask you this, and let's switch gears a second. We're talking about the importance of curiosity with external stakeholders. Is this something that should be used internally? I think yeah. Absolutely. I do. And, honestly, it works great with with partners and children too, especially if you need that minute to think before you do react.
But, you know, that's why in our our, course, we also included medical directors. So we really need you need to understand, as I was saying, like, part of that, what do medical directors what do our internal partners need from us? How do we best bring value to them? You know? What should we be focusing on?
And those are all really if if you're a field medical leader and and you're interacting with those folks, you really need to come to the table and have that same mindset of how can we do better, how can we help you, how can we partner. And that's being curious about what's going well now, How can we improve what we're doing? You know? All those are really powerful questions.
Well and I think and I I don't I don't wanna get back to the prior episode and and talk, you know, again, get back into this book, never split the difference. But, you know, when what he talks about in the book and what I've noticed in my own life is that asking good questions is just a really good life skill. Like you said, when it comes to a spouse or a partner, kids.
So we're talking about like, I asked you that question, but I kind of already knew the answer, which is, yeah, it's really important. It's important in every area of your life, and I'll take it one step forward further. I think we all need to do a better job and asking questions of ourselves at the end of the day. Maybe you ask yourself, Hey, what went well today? What could I have done better? What do I need to do for tomorrow? What's the plan for tomorrow? What time am I getting up?
What time, you know, if you're not regimented, I know what time I'm getting up because I get to get up at the same time every single day, but maybe, you know, or it's on a weekend. What do I want to get accomplished this weekend? What's going to make me feel good at the end of the day. If I can say that I accomplished these things, these are all questions that I think we are important to ask of ourselves to check-in maybe with ourselves to improve in some area Yeah. Or in all areas.
Yeah. So am I being crazy by saying this? No. I mean, I think just if we wanna keep it on MSL, you know, like you said, after your visit, you could even ask yourself a good how question. How could that visit have gone better? How could I have, you know, uncovered more insights or brought more value?
But I'll tell you a funny anecdote that, when I was doing MSL training, we had a partner that we worked out that, did some, like, rapport and how to read, you know, the the people you're interacting with and and adopt, you know, kind of adjust your style. And he would tell an anecdote that he went to a cocktail party with his wife, and, he didn't know anybody there. And he decided he would apply this just questioning, being very curious.
And he said he went and he he talked with 1 guy, and he just kept asking him questions. What do you do, John? You know? What do you like to do on the weekend? You know? And it turns out he fishes, and he's like, well, how do you decide what to fish for? You know? How do you pick a good lure? And he he kept just asking questions. And when his wife came to get him, like, 45 minutes later, he said the guy he was talking to, even though he'd shared nothing about himself, he said, you know what?
Your husband's a really fascinating man. I really enjoyed our conversation. So just, think about your KOLs. Like, if you're curious about them and you really want to understand them better, it's that other side of the coin. You know? It's you don't wanna make it burdensome for them, but it has that possibility for you to be interested in them. They're gonna appreciate the engagement more than if they were just read a bunch of data. Yeah. You know, there's that expression.
If you wanna be interesting, be interested. Mhmm. You wanna be interesting, be interested. Be interested in the other person. How do you show that you're interested in them? You ask a lot of questions. And it's funny. What do most people love to talk about the most themselves? Right? KOLs are no different. There are people just like we are.
So this curiosity thing, asking powerful questions and opening KOLs up is really just doing the same thing that you explained that that guy did at the party is, you know, but I think one of the things that can help MSLs is to be more natural about it. So in your curiosity, if you can, if you can develop this natural ability to do this natural, meaning it's not coming off as rehearsed or I'm saying programmed to the questions that the company told me to ask you or whatever.
I think that that that authenticity. Yeah. Will resonate. And then that KOL lets their guard down and they say, oh, that's a great question. Boom. Here's the answer, whatever that might be. Mhmm. Yeah. And you like you said, you have to pair it with emotional intelligence, and you have to be strategic. You can't come in with 10 and 12. Keep a couple in your pocket, and if you get a chance, bring them out. You know?
Yeah. I feel like I'm I'm now being led to throw the v word out there and talk about value because, like Mhmm. You know, it's you have to throw the value word out there every once in a while when we're talking about medical affairs. So do you feel like MSLs that get really good at this are also being able to be in line with this value proposition of, you know, how valuable MSLs are. Does this make you more valuable when you learn this skill? Yeah. I I do.
And I and value, it's always the other side is measuring. Right? So it's really always hard to measure. But if you can really get people and and this is where, like you said, the internal partners understanding what you're doing is important. But if they can really begin to see that the observations, what's being reported from the field that's going into insights generation is better, or, you know, they're getting more appropriate responses to the questions that we really need to know.
And that's where field leadership can help is really say, you know, here's 3 things this quarter that are really important. And even, like I say, at team meetings, maybe for 5 minutes on a Friday, does anybody have any powerful questions that have worked really well? Does anybody have any powerful questions they struggle with? You know, like, I was trying to get to it. I couldn't. And have your MSLs coach each other and then really share kind of what you're doing.
Like, you know, these are questions and maybe even offer them up to the medical directors because they they go out and meet with folks. They they should get in the habit of asking these powerful questions as well. But if we could really truly measure it, it would be seeing better, more impactful insights, but that's a whole other podcast, Tom. Hey. Look. We it took us long enough to get this one going. I'm glad that we were finally able to do it. Thank you, Mary. You're awesome.
This was a great conversation. I could talk forever. But in the interest of time, we'll leave it at that. And, you know, curiosity may have killed the cat, but it made one heck of an MSL. Right? Yeah. And a podcast. And a great podcast. Well, thank you guys. As always, appreciate all your support. If you found value in this episode, please share it with others. Thank you for making this one of the fastest growing podcasts in the pharmaceutical industry, and we will see you next time.
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