Over the last several years a common challenge for MSL leaders has been finding ways to engage and retain MSLs.  One common approach to the retention issue is to create numerous levels for the MSL role.  Teams may have an MSL, Senior MSL, Principle MSL, Executive MSL, Senior Executive – well you get the idea.  However, over time this very tactic used to retain MSLs starts to create engagement challenges.

These roles were often created to retain high performing MSLs or MSLs with the most seniority.  This seemed like a good way to provide higher income and progression for individuals who did not want to move into headquarter positions or management..  In addition, as the competition for talent increased this position could be used to bring an MSL into the organization who has experience from another organization.

However, over time two issues occur that cause engagement problems.  The first is that for those with the title of “senior” desire additional growth every couple of years.  This approach satisfied the issue for a while but did not fix the underlying problem of a career path that is limited to deciding between field management or relocation to the home office.  Secondly, the differences in expectations between the various levels are not typically clear.  This is especially difficult in a role that already struggles to quantitatively evaluate performance.

This may appear to be an organizational design and retention issue, however, it is really an issue of strategy.

Strategy includes the prioritization of activities and resources allocation within an organization.  By creating levels without creating differentiation, the leader has chosen to invest discretionary resources into a role that does not provide a clearly differentiating value.

There are two rules to adding levels to a field organization:  differentiation and value.  The differentiation rule states that there must be unique responsibilities, knowledge requirements, capabilities, and performance measures for unique roles.  The value rule adds that this differentiation must provide incrementally greater value to your customers and/or the organization in order to earn sustained company investments in the role.

THE MSL Organization:

When MSL organizations add hierarchy into their roles, the underlying belief is that the MSL are gaining experience within their therapeutic area and company, and have become more effective at their position.

• They are able to help others in the organization develop in their roles and are often looked upon as mentors to new MSLs
• They have more time to take on special projects such as training, planning, advisory boards, etc
• They become more efficient responding to common HCP questions.
• They are more familiar with their approved materials and are able to navigate them with greater ease.
• They have established relationships so less time is needed to get an appointment or to network within the territory.

Those designing the organization use this to justify an increased investment in salary, benefits, and other perks.

It may be true that as MSLs gain experience they are able to take on more.  However, the addition of strategy, leading project teams, or coaching others to their field role does not typically meet the threshold for differentiation and value.

THREE WAYS TO DIFFERENTIATE ROLES THAT DRIVE VALUE

Here are three ways to differentiate MSL and senior MSL roles that would provide sustainable incremental value:

Change Territory Size (efficiency):

 While this is not typically what leaders of MSL organizations wish to do, one option is to change the size of the territory based on level.  If a new MSL can effectively work a territory of 30 health care providers, then a senior MSL may be able to handle 50 HCPs while maintaining the same level of quality.  This is not popular, but if it is not even considered possible, then the underlying assumption that seniority leads to increased capacity is false.  This option provides a clear differentiator that is easily understood by others and demonstrates incremental value to the organization.

The strength of this approach is that a manager can shrink or expand the team based on the number of MSLs or Senior MSLs they have available.  A challenge with the approach is that it requires having clear quality standards in place in order to hold accountability to quality while the size of the territory expands.  It also can cause disruptions in territory alignment as individuals are promoted to senior MSLs in different regions.

Different Stakeholders

A second option is to identify a unique set of stakeholders that represent additional value to the company and assign those stakeholders to the senior MSL.  For example, the Senior MSL could be responsible for the top 10 KOL institutions that span across territories.  They would be responsible for working with top KOLs and institutional leadership.  Many companies creating unique field medical teams focused on the payer organizations which requires unique skills.

The skills required for this role are unique, there would be additional training required and their measures of performance would vary versus the MSL role.  By connecting the differentiation to a different stakeholder group, it make the incremental value easier to identify.

Internal Responsibilities:

 The most common approach used today it to give the Senior MSLs internally facing responsibilities.  There may be one person responsible for training, another for participating in brand strategy, and another building tools.  Because they have their territory under control they get invited to participate in these work teams.

The work team option is sustainable if it meets the rules of differentiator and value.  To be differentiated, the responsibilities must be formal.   For example, if the role is structured to be 50% field and 50% projects, there must be clear expectations for both parts of the job.  Both responsibilities should factor into the senior MSLs performance management conversations.

The responsibilities on a work team typically require unique knowledge and skills.  MSLs should be selected and trained for that part of their job.  For example, if a Senior MSL is responsible for training, they should have experience with training strategy, instructional design, facilitation, and learning evaluation.  If a Senior MSL is responsible for tool and system development, they should have experience designing processes, working with technologists, defining user requirements, and running user acceptance testing.  With this option, the incremental value comes from activities not related to the rest of their MSL role.

If internal responsibilities are used as the value differentiation, there should be clear separation with other organizational roles.  What is the difference between the senior MSL assigned to training versus the director of training?  What is the difference between the Senior MSL involved in strategy and the Field Director?

A key decision with this approach is deciding between hiring functional specialists versus assign the responsibility to the senior MSL.  The decision should be based on the complexity of the functional responsibilities, the ability to train MSLs in those functions, and the amount of supporting resources available.

Effective organizational design of the MSL team can be a difficult task.  However, it is important to invest the time upfront in designing each of these roles to increase the level of clarity with the entire organization on what the senior roles are responsible for and how individuals qualify for the position.