Welcome to MSL talk with Tom Caravella, a podcast specifically designed for MSL and all things field medical. Hey, guys. Welcome to the podcast. I'm excited. I have 2 guests today. I have Gina Cooper, regional medical affairs director at CRINETICS, and Carsten Schnottwinkel, senior MSL at AstraZeneca. And we're gonna talk about the struggle for KOL access and FaceTime, which I know you guys are gonna love.
This is like a topic I've been dying to talk about for a while because we haven't talked about it in a minute, and it's so important and so relevant. Before we get to that, I just wanna give you guys a quick reminder that there's still time to sign up for AI and Medical Affairs. It's a conference coming up January 28th 29th through Momentum Events. Go to my LinkedIn. You'll see all the information in there, or go to aimedicalaffairs.com. It's in Philadelphia. I'll be there.
I hope to see you guys. It's gonna be a great event. And, guys, let's get into this. So this topic came up actually, I was at a conference, and someone mentioned this to me. And then I reached out to Gina, and I was like, hey, Gina. What do you think? You wanna do this? And she's like, yeah. Let's do this. And then she called Carson, and Carson's like, yeah. I wanna do it. So you guys excited? You ready to go? Yes. Absolutely. Good stuff. Well, let's jump into it.
So, Gina, what what would you say are some of the biggest challenges MSLs face today in securing, access to KOLs compared to, like, let's say, you know, pre pandemic times? So there's several. I mean, the KOLs, I think, have shifted their scheduling. So you see a lot of times, like, where they used to have administrative hours in their offices, those are now taken at home. So to have an availability to have an appointment, that shifted things.
Virtual congress attendance means you don't get that face to face interaction, and you don't always have those opportunities. And I think just as physicians get busier and busier and busier with their scheduling, it means there's less time to meet with anyone outside of their organization. Carson, anything to add? Yeah. I I couldn't really, like, agree more.
I I think there's also, like, a competing number of digital resources available to KOLs that, you know, somehow competes, like, with the value that MSLs also, like, provide. And that also, like, puts additional, you know, time on their agenda to just, like, catch up with what, is happening. And as we all were, like, fed due to the pandemic, our workload was virtual engagements and being on the road face to face interactions. I think physicians also, like, face, similar evolvements.
You know, they have now also telemedicine available. So, again, the workload in particular with those folks, like, in the community has been exploded. And so that definitely, like, reduces some of the the time that we have to talk to them. Yeah. And that was, like, my next question. Like, was that is that really the the issue? Like, how has this shift to virtual engagement impacted the way MSLs interact with key opinion leaders, And what is is that just an expectation from certain KOLs?
Gina, what do you think? I mean, the virtual, in a way, it's helpful. Right? Because it's there's no travel involved, and you can fit it into your schedule a lot easier. Mhmm. And so but it you just lose that person to person relationship building that you have that organically kind of builds when you actually get to meet someone face to face. Yeah. Do you think that the virtual engagement piece is gonna replace traditional face to face meetings with with that MSOs are accustomed to?
Is there a threat, do you think, for that, Carsten? I I hope so not. I I think we all value we're social animals. Right? And I think we we definitely, like, appreciate those kind of face to face interaction. And so what I think will happen is that we live, like, in that hybrid model world where face to face is still, like, critical for relationship building, reading the room, seeing where the KOL is, like, coming from.
But virtual is definitely, like, a very effective, tool for quick touch points, making, like, sure that we don't, like, lose those kind of interactions. So a hybrid is probably, like, what I see in the future. I agree. I think that's definitely here to stay. I think it's it works on both sides fairly well, and it wasn't it wasn't, in a way, a nice shift because it didn't really exist previously, at least not to the extent that it's available now, and it'll continue into the future.
I mean, that's what I'm hearing across the board. Every you know, most of the conversations that I'm having, whether it's with clients or on this podcast, has everybody is, I think, in agreement that the hybrid scenario is pretty much here to stay. The big question is, how do you get more FaceTime? That's really the big question. So, and I'm curious as to, how do you see MSLs adapting their strategies in maintaining relationships with their KOLs when there is limited FaceTime?
What are what are what are some of the things you see people doing? Yeah. I can take a quick shot on that. I I think more so than before, it is important that we are making those in person meetings count, that we really concise in our messaging, that we really are concise on our values that we provide so that our KRLs appreciate the time that we spent together, so to speak.
And I think the other aspect that we also really have to keep in mind is eventually, like, to collaborate with our cross functional partners. Right? It's not just like MSL struggling with time in front of the KOLs, but also like our, you know, commercial nonsales or sales parts. And so maybe there's also, like, an opportunity to maximize on KOLs availability and minimize, like, multiple calls to keep them, like, engaged and not really, like, annoyed. I can't agree more on that.
I think, you know, it it doesn't matter if you're a small company or a medium size or large company. There are a lot of pharma employees, and oftentimes, there's very few of the really targeted KOLs that we're going after. And so, you know, they if they're constantly getting bombarded by messaging from the same company, they don't care as much about your role. They just want a bit more streamlined communication and working with your cross functional partners. Where is their synergy?
Where are you compliantly allowed to engage together? And also sharing the information in you know, appropriately. So what can you share back cross functionally so that they don't need someone doesn't need to go seek the exact same information out? On the back end, we can certainly streamline that process so that when someone is in front of the customer, that it's, again, valuable to their time. And we're at this time where there's a lot available to MSLs.
There's all these digital tools and platforms that kinda help the process. So how does that play a role in an MSL's ability to maintain or improve a relationship with KOLs? It's it's a great tool in your toolbox. Absolutely. You've got to vet the information to understand that it's accurate and up to date. Like, for example, if someone had retired, you're gonna wanna know that. You you need to Google as well or find some search engine of your choice. It's great to have access to all of those.
It can be a bit overwhelming of picking and choosing which one you're gonna use, and I think you'll find that there's not one tool that's gonna I perfectly identify or give you the available information for all of your KOLs. Like, if someone is very active on Instagram, like, maybe your tool doesn't identify that, but you can certainly go find that information.
So they're helpful, but you still have to do quite a bit of desk research, I think, to actually have a good solid profile for each of your KOLs. Carson, did you you have anything to add? I saw you were. Yeah. I I I totally agree. And I think we're living, like, in a world where we are bombarded with several resource streams. And to Gina's point, I definitely would like to emphasize, it is important to, like, read in between the lines and what information to use and whatnot.
Mhmm. I also would like to add, it it's not necessarily always like a a tool that we use in terms of preparation, in terms of getting to, understand where our chaos speaks next and whatnot. But I think it's also something where we as an MSL or medical affairs can potentially be more proactive and see within the compliant realm, obviously, how can we leverage digital channels to reach out to our KOLs and potentially also obtain some insights.
So maybe just like something in the future that we can leverage more and more, to just really become more effective. Yeah. And not to throw in a shameless plug, but I've actually had a few conversations on this podcast about some of the AI tools and digital tool tools and social listening that can be really effective. Social listening podcast was awesome. I learned a lot, just in in that technique and ability to use that to to help with access and, developing stronger relationships with KOLs.
But getting back to the concept of this more virtual engagement situation, how have KPIs changed or shifted in a world that we see a lot more virtual engagement? Of course, it I think it it fluctuates company to company. There's not a universal standard for KPIs across pharma. Some organizations don't give, virtual engagements the same weight Mhmm. As an in person engagement.
And while it's true that you can fit in more virtual engagements in a calendar, The same amount of work goes into preparing for those documenting, you know, recording the interaction afterwards. And there's also other, you know, obligations that you have on your calendar. So it's, certainly, it's organization specific, but, Kirsten, anything? You know, KPIs have always been a point of discussion and always will be. I think we probably would all agree on that.
And I think it comes down what is more important, what we learn from them, and how do we interpret them. You know, one of my early mentors said that to me, if you cannot measure it, you cannot improve it. And that actually resonates with, with me very well because I feel like we always look out for how can we provide more value.
And so I think the discussion should really be around not really how many interactions you had, how many face to face versus virtual, but more so we're like, what is that? So what behind it? Right? Looking, like, at maybe the impact that some of our conversations had rather the number of interactions and whatnot. So I think it it's still, like, something that we probably have to really figure out. But to your point, Gina, I think it depends also, like, from organization to organization.
Yeah. I know it's still, you know, it's still a source subject. You know? When you when you mention the m word metrics or KPIs, it becomes like there's no standard, and and all companies do it different. Like you said, Gina, like, it's it really varies across the board, but I know that it is it has been difficult, and it is a bit of a sticking point.
And I think what I'm hearing is that, I think in this environment where KOLs are so busy that they've become a bit selective in who they wanna see and how. So how can an MSL stand out to a KOL, and get more whether it's virtual, FaceTime, or face to face FaceTime? Yeah. I think that is an excellent question, Tom. And I think there are there are numerous factors that one should potentially, like, take into consideration.
I think out most, I would probably highlight make it a value based partnership. And the emphasis we like on partnership, it's not really so much how much can I get out of this meeting and bombarding that keyword question after question to just, like, hit coming back to our previous, conversation to hit my metrics? It's more so, I think, an emphasis on what can I do to make my KOLs life easier, better? You know, maybe reduce, like, the the time burden, be concise in my messaging.
In concise in messaging, something that, my organization also, like, focuses a lot on is that scientific storytelling. It depends really how you convey that message more so like what the content is that resonates quite often with those KOLs. The other aspect is, like, being curious. Right? If there's, like, a question, try to better understand, where that KOLs were, like, coming from and make the KOLs maybe challenge or barrier the center question like in the room. Less is more.
We all know that, and it's better to underpromise and overdeliver than we're like the other way around. And to your point about conciseness, the one thing that we know that they don't want is a data dump, and avoiding that at all costs because there is a way to demonstrate your scientific acumen in a clear concise way and then that particularly with storytelling, that lends itself to dialogue and a conversation.
And that back and forth is where you have such a great opportunity to demonstrate your knowledge and share that. And I think that's when you become a trusted partner. And then, you know, any request that they have, any ask that they have, like, following up on that, you know, sometimes you can get an answer right away, and sometimes it just may take a little bit more time.
But having that ongoing dialogue so that they're up to date about it and they know that someone's working on it, follow through, you know, has a huge impact in building a relationship there. Good stuff. That's import I mean, that this is that that was kind of the I feel like that was kind of the meat of of what we wanted to get to.
But as you're talking, I think one of the things that I've noticed is in talking to a lot of MSLs is some struggle with the ability to develop relationships with certain KOLs because there's so much virtual engagement. So what advice do you have for MSLs that are trying to develop and maintain relationships, but most of their engagement or a lot of their engagement's virtual? Do your homework on them. You know, do your best to understand what they're interested in.
What do they spend their time on? You know, any small things that you can kinda weave into a conversation to show that you're not just looking at them for their opinion. Right? Like, you're trying to get to know them. You are genuinely taking interest. The curiosity that Carsten said, like, is so so so important within those interactions.
And I think, you know, if if it tends to come across that you're just trying to get information to bring back to your company and not really having a a true conversation with them, like, they're not they're just not gonna wanna engage on an ongoing basis. But being prepared and and being, you know, understanding of where they're at. I call it like pre call planning. Right? Do your due diligence. Do your homework as as you eloquently said. I also feel like virtual is still better than none.
Right? If the first opportunities are always just, you know, hanging in front of my computer and talking to them, that's an entry point. And then maybe over time, you build, like, that kind of relationship. Maybe there's is an opportunity of a local conference, or other opportunities. And then as we had mentioned already early in our conversation, make that face to face conversation count.
I think even more due diligence will, eventually lead you to more impact that you can, you know, have on that KOL. And how how does KOL access differ geographically? Like, are there certain states that are are easier or more MSL friendly than others? There seems to be some regional variance with it. I think I mean, what you'll find is that there's just certain institutions that either have a no c policy for industry individuals.
Like, they really truly don't want to part have any type of dynamic and so be it. That's their institutional policy. You know, during the pandemic, what we saw was, like, there was certainly a huge variance of who had an open door policy and who said absolutely not. And some of that I think is still kinda carried through where, you know, there's certain places that seem to only wanna do virtual engagements now.
And then I think other areas are a bit more open and and love seeing a friendly face again. I would add if if somebody really listening to that podcast would say, okay. Here's the holy grail of choosing, like, the right territory. I would say, unfortunately, there isn't. I I I think there are certain regional differences, but they're also nuanced. I think east and west coast are usually heavily dense with, high impact academic centers.
And for those that are really interested in clinical research, access could be eventually easier. Sometimes it could also be harder if leadership is already engaged where they have their conversation and KRLs then often say, you know, why do I have to talk to you as well if, I already talk to your your leadership? The other aspect is also with community practices.
I think areas where you have, like, a lot of those, more private community settings, it will be in general very hard to access as we also discussed earlier, particularly if they don't really have or only limited clinical research opportunity. So I don't know. You you pick your your favorite or your evil and with challenges also come great opportunities where you can eventually, like, stand out by coming up with a novel, approach.
So for all those folks that are listening to that podcast, don't necessarily be turned down by not being maybe in an area that has, high density of academic centers. I think you can do great also in other areas where that's not the case. Yeah. Yeah. We we sometimes hear from hiring managers when we're looking to fill a position. Hey. This is a tough market. We need an experienced MSL. Like, Boston seems like it's a tough area. You know, New York City can be tough.
So I think that, like anything else, it it's gonna vary, but, there we've seen on our side preference for more experienced MSLs in certain markets. That doesn't surprise me. I mean, I'm in Philadelphia in the Northeast, and it's it can be tough for sure. I think with the experience, it just comes like you you have different tools. You have different ways to approach it and or maybe you have some long standing relationships, or you just understand how these particular institutions work.
And that takes a significant amount of time to really understand what's gonna take to get in. Right? Like, what are the what are the different barriers? And then you get creative of how can you overcome these barriers. And, you know, as long as you can say, hey. Challenge accepted. I'm gonna face this head on. You'll find a way. Yeah. Well and and that's you know, I think that that's the key is is there's a certain level of persistence that I think is important.
I think that persistence and resilience, I think, is really important. I think that that we're we're in a time and a place where I think MSLs, in order to be successful and get FaceTime, need to be proactive. This isn't a defensive game. This is an offensive game. Do you guys agree with that? I for sure. Like, they're you know, you've gotta reach out to them. They're not necessarily gonna come out to you. So for sure. Agreed. What about is there a difference therapeutically?
Would you say that certain disease states may have more challenges in getting access in FaceTime than other areas? I mean, I've worked in a couple different therapeutic areas, and I've certainly seen variances. Like, you know, for example, in rare disease, like, there might not be that many KOLs. Right? And, with that also comes, like they're probably also the researchers. They're the clinicians.
Like, there's an o lot of overlap in roles, and it's not segmented as much and maybe a larger disease area. I think, you know, in oncology, which I know Carson is in, it's I don't there's such a high volume of individuals that it it seems very different, but, like although I haven't been in that for a while, so I'll let you speak to it because maybe it's maybe there are some similarities there. Yeah. From an oncology perspective, and, again, it's probably like just be an end of 1.
But if I compare my access to KOLs and I'm in the GI space and compare that to my lung MSL counterpart, it sounds to me at least that he has a much easier game to play than in my case. But I think it also will, like, comes down on what is the portfolio, the pipeline, the company has that you're working for. Our lung pipeline is impressive to say the least. In GI, we're just, like, picking up. So there's obviously more interest to really have those kind of conversation.
I think it also comes down a little bit on disease prevalence. I think there are definitely, like, more patients out there with lung cancer than they are with liver cancer or or pancreatic cancer. And I think that also somehow plays a role in how many KOL interactions you potentially, like, find. And I just had an interaction with a a KOL who I used to call in, and she she commented of, like, you know, she's very selective in who she's gonna engage with and it comes back to that value. Right?
I think no matter what the disease area is is what value do you bring to the conversation, to them as a clinician, And if you can figure out what the value prop is, they'll they'll still see you. Yeah. Well, what so let me ask you this. What tips or tricks or innovations or creative approaches might you guys recommend for someone who's struggling to get FaceTime or for someone who's just looking to get more face to face time with KOLs in their territory?
Yeah. I would say in general, think about the person on the other end. What is most valuable to them? Anything that helps a KOL be more efficient, perhaps reduce workload, may improve life. That patient's life is is super important to them. And if that is not, like, changed by that interaction with an MSL, then it becomes really very tricky to come up with that kind of value proposition. I think the other aspect you know, MSLs, we're wearing different hats.
And I I think we quite often also have to think outside the box. If we are just, like, trying to maintain the status quo, we'll probably not really be very successful. And quite often I say, you know, MSL is just a title and not like a restriction to maybe that that entrepreneurial thinking that it's still like within you. And there's not only precision medicine that is like a buzzword and and changes like the treatment landscape. But with that comes also like that precision engagement.
Gina had mentioned it earlier on, do your due diligence. Try to really figure out what is the value that you can provide to the KOL. Make it really, like, concise. A lot of other aspects that you have brought up, doing this podcast already is definitely, like, setting you up for for success, like, in the future. And don't rush it. Sometimes it's not really that immediate win that shows, like, the value the asset that you will be for the organization.
But come up with a strategic territory plan and lay it out, like, for a year. Maybe if you can't out for, like, for the next year as well, and you will see that, you made big strides in in your career. And jumping on the territory plan and having a really good one laid out, like, identify who can help you within your organization. Right? What other relationships can you leverage? What other MSLs can you leverage? Like, make friends with MSLs in your territory.
You'll be surprised at how many times you can help one another out. And, also, in the due diligence, like, listen to the social social listening podcast and the AI ones too to, like, find some great tools and tips. But, you know, it's there's been an evolution, I think, in in social media where physicians are engaging a lot more. Right? And they're actually really I think their goal is education.
They're trying to raise awareness to issues or to diseases or conditions, like and, you know, meet them where they're at and understand, like, what they're talking about, what they're watching, engage with that. Like, what do they think of it?
And, you know, obviously, scour their their websites, but you may find that the institutions also have a pretty strong social media presence and, you know, what's being said, what's new, what's innovative, like, what can you connect on that someone's interested in? I totally agree. And and I hate to go back in time, but when I was a rep a 1000000 years ago, it it really was the same kind of scenario is every office, every KOL, every practice, there's that that there's the backdoor.
There's the secret code. There's, you know, what's most important to that KOL? What's gonna peak their interest? What do they find valuable? What's what's important to them? And like you said, Gina, by asking other people, other MSLs, cross functional counterparts, sales reps, TLLs, market access people, anybody that has the same, you know, list of KOLs that they're calling on, they could be really, really valuable to pick their brain and find out what's been working for them.
What are the hot buttons? And what could you incorporate into your regular, you know, practice and your engagement strategy? So I just think that sometimes the most obvious thing almost gets forgotten a little bit. But, again, this becomes this becomes an offensive game. You have to be offensive to do that. You have to be the one to reach out. You can't expect people to call you up and say, hey. Here's the answers to the test. You have to ask for it.
So I I mentioned the word valuable, and I can't finish this conversation without talking about value. So can you guys share what MSLs or how MSLs can demonstrate value to KOLs in order to develop that relationship and get them the access that they need in you know, really for the long term. I'll go back to the follow through. Right? If, like, say you're supporting, an investigator initiated trial. Right? Like, you know, there's a lot of markers along the way.
Like, how much are you, you know, within con how much can you assist? But, like, continuing to assist to making sure that the communication is there. If they ask for something, you follow through. You you are responsive to them. You're also, you know, anticipating some of their needs as best you can. Right? And that comes with the long term relationship. And then offering that up, like, I think those are those are good starting points for sure.
Yep. You can have a list of objectives, but if you're not, like, defining and then coming up and maybe also agreeing on next steps, there is no follow-up. There is no relationship building. So I think you emphasize a very critical aspect. And I think along that line, in order to help you become more successful, it also starts with you. Maybe reflect and do a quick debrief after every KOL interactions. Have I done my due diligence? Have I defined next steps? Have I really followed up?
Because those ultimately, aspects that KOLs definitely appreciated and helped them to also be more successful in their life. Awesome. Well, thank you both. This was an amazing conversation. It went fast too. That was, like, the fastest 30 minutes of my life. I wanna thank you both. This was, like, really helpful and insightful. I actually feel like I need to go back and listen to it again. But but thank you guys for for coming on and for joining me. Thank you so much, Tom, for the invite.
Yeah. Yeah. This was fun. Having me, Tom. Good stuff. And, guys, thank you as always for listening to the show, for sharing it with others. Really appreciate you. Don't forget, you can find these on Apple, Spotify. Check us out on YouTube, and, and follow me on LinkedIn. But thank you as always for your support, and we will see you next time. Thanks, guys. Thank you. Thank you so much for listening to the show.
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