MSL-KOL Engagement

The Evolving Role of Field Medical: How MSLs Are Defining Pharma’s Third Pillar

For years, Field Medical teams quietly powered pharma and biotech companies serving as the trusted face, eyes, and ears of Medical Affairs. MSLs built relationships, asked insightful questions, shared science with integrity, and bridged the gap between internal teams and healthcare professionals (HCPs).

But the game has changed. The customer and the marketplace are evolving in such a way that status quo of the past no longer works.

Field Medical is now engaging across the entire product lifecycle, sometimes as early as proof of concept, to inform decisions that shape the Target Product Profile (TPP). At the same time, the ecosystem around them is expanding. Today’s MSLs must navigate a broader range of external stakeholders while delivering value in a complex, fast-moving scientific landscape.

Importantly, Field Medical doesn’t set the medical strategy. That responsibility often lives with the brand and headquarters Medical Affairs, which defines a strategy aligned to but distinct from Commercial. The role of field medical is to execute that strategy with clarity and purpose, using tools and frameworks that turn vision into action.

This evolution is twofold: Field Medical teams have redefined the scope on how they engage refining and expanding the who, what, why, how, and when of scientific exchange. And they’re also raising expectations internally, demanding stronger strategic plans from HQ: clear scientific narratives, aligned objectives, and a defined sense of purpose in the field that requires a different set of skills.

Field Medical isn’t just stepping up. It’s pushing the organization forward.

Borrowing Commercial Discipline Without the Commercial Baggage

Commercial teams have long operated with rigorous structure: customer engagement models, account planning tools, coaching frameworks, and defined call objectives that ladder up to brand strategy.

Now, Field Medical is adopting similar discipline but with a distinctly medical lens. Where Commercial seeks share, Medical seeks insight. The intent isn’t promotional; it’s educational and patient outcomes driven. The goal isn’t messaging consistency, it’s scientific clarity and credibility.

To support this, Medical Affairs is implementing structured frameworks (often called Medical Engagement Frameworks or Scientific Engagement Strategies). These are Medical’s adaptation of the Customer Engagement Model (CEM), reframed to reflect the scientific, non-promotional nature of medical field work. They provide structure without stigma.

And they’re working. These frameworks help field medical demonstrate the quality and outcomes of engagements not just quantity. Instead of reporting, “I met with Dr. Smith three times,” field medical teams can now say, “Here’s how my interactions with Dr. Smith influenced research adoption and helped shape our trial strategy.” That’s the kind of impact leadership wants to see.

Account and Engagement Planning: Making Scientific Exchange Count

Each strategic account, health System, integrated delivery network and other organization is its own ecosystem. It has its distinct priorities, decision-makers, and internal dynamics. Without structure, field teams risk missing key opportunities or duplicating efforts.

That’s where joint account planning comes in. When developed and executed effectively, account planning tools give both Field Medical and Commercial a holistic view: who the key decision makers are, where knowledge gaps exist, what unmet medical needs exist, and which engagements matter most to meet the needs of the organization and the patients they serve, along with our business needs.

Strategic engagement plans take it further. They push MSLs to ask:

• What’s my objective for this meeting?
• What do I need to learn?
• How can I deepen my understanding of this customer’s beliefs, ideas, and thoughts?
• How can I tailor appropriate scientific dialogue to be most applicable to this customer’s world?
• How can I stimulate new thinking based on current and future trends for us and for customers?

This clarity leads to more purposeful, more productive interactions and builds credibility with HCPs or Key Opinion Leaders (KOLs) who value focused, relevant scientific discussions.

Medical Insights: The Currency of Field Medical

However, plans are only as powerful as the insights they generate. Medical insights are the currency of Field Medical — the most valuable output of every HCP interaction. They transform conversations into intelligence that shapes strategy, refines the scientific narrative, and uncovers new opportunities for patient impact.

Capturing them requires curiosity and empathy. MSLs must create space for HCPs to share their beliefs, ideas, information, and thoughts (BITs) — the raw material of insights. When gathered with intent and skill, BITs become more than notes in a database. They become strategic assets that flow back to headquarters and guide better decisions.

In today’s environment, insight gathering is a core competency and a strategic imperative. Organizations that build disciplined processes around insight capture and use are the ones turning field conversations into lasting competitive advantage.

Coaching: The Differentiator, Not the Report

Here’s the truth: MSLs are highly educated. But terminal degrees don’t guarantee strategic thinking or advanced engagement skills. Historically, many have been left to figure it out on their own.

That’s changing.

Coaching, not reporting, is the real catalyst for field growth. When done well, coaching helps MSLs elevate how they engage, how they listen, how they deliver the science, and how they align with strategy.

Field coaching reports (FCRs) can help guide those conversations and track progress over time, particularly in engagement behaviors. But it’s the coaching itself (the dialogue, the behavioral feedback, the moment-to-moment development) that unlocks real performance.

This coaching is especially vital in the context of Medical Engagement Frameworks or Scientific Engagement Strategies. These approaches define what “great” looks like in the field, but coaching helps MSLs get there. It turns strategy into action, and action into impact.

Take a simple example: An MSL may know every data point of a study, but if they share it in a way that’s disconnected from the HCP’s interest, or misaligned with the scientific narrative, the value is lost. Coaching reframes the delivery. Over time, this leads to better conversations, stronger relationships, and more strategic execution in the field.

Busting the Myth: Yes, MSLs Need Coaching

The idea that coaching is remedial or unnecessary is outdated.

The myth extends beyond MSLs themselves to Field Medical leaders, who often blur the lines by labeling everything they do—training, mentoring, managing, or leading—as “coaching.” True coaching is distinct. It’s developmental. It sharpens essential soft skills such as self-awareness, storytelling, presence, and active listening, while strengthening the connection between field activity and strategic purpose.

Organizations that invest in developing Field Medical leaders, equipping them with the mindset and capability to make coaching their default approach, are not just seeing better conversations, they’re reporting

• Deeper KOL relationships
• More useful insights flowing back to HQ
• Clearer alignment between field execution and corporate goals

In short: Coaching is no longer a “nice to have.” When leaders embrace it as their primary lever, it becomes a competitive advantage.

Why It Matters: The Third Pillar

Field Medical is the “tip of the spear” when proving that Medical Affairs deserves a seat alongside R&D and Commercial as the third strategic pillar of the organization.  Not by becoming more like Commercial but by becoming more disciplined in how it delivers scientific value.

Structure doesn’t undermine the science. It sharpens it. With the right frameworks, coaching, and mindset, no scientific exchange is wasted. No insight is lost. And no field conversation happens without purpose.

In fact, organizations that embrace this evolution are seeing results. The 2023 biopharma consensus report on Field Medical impact found that companies using structured engagement tools and feedback systems showed stronger alignment between field insights and strategic decision-making. It’s not just about doing more. It’s about doing the right things, better.

Looking Ahead: The Strategic MSL

The future of Medical Affairs will require a stronger strategic mindset at every level. Headquarters Medical Affairs must elevate how it enables and aligns the field, providing clearer narratives, sharper objectives, and more robust frameworks for scientific exchange. At the same time, MSLs will continue to evolve: still scientists, but also relationship architects, insight gatherers, and strategic partners who help shape what’s next.

The companies that embrace this dual shift — strategic clarity from HQ and strategic execution in the field — will thrive. The ones that cling to outdated models or same old, same old… They’ll be left behind.

Field Medical is no longer a lone wolf function. It’s a force multiplier. With the right tools, mindset, and support, today’s MSLs can make every interaction count and reshape what value looks like in pharma.