I Sure Hope So!

Have you ever said that when asked how your next appointment is going to go? Or perhaps you say it silently entering a physician’s office who has a reputation for dining on MSLs! Hope is not a childhood wish. Hope is nothing to be ashamed of. Hope is a good thing. Of course, you’ll frequently hear (perhaps from your manager) the book title, “Hope is not a strategy!” And hope will not replace a strategy. However, it is a fundamental human emotion of optimism. It indicates a desire and a belief. However, it is often disparaged, so it is likely better as a private emotion rather than an answer to your manager. Someone once said, those who live with hope live differently than those without. Hope, like faith in yourself, is that quiet emotion that steadies us, gives us confidence, and becomes our inner emotional friend during difficult times. Those of you who were gymnasts as a child, how did you do that first successful backflip? Those of you who learned another language for your vacation or mission trip, how did you decide to just have the courage to say it in that language? Yes, these kinds of activities are built on skills, they are also built on our inner emotional life. It’s OK to hope and have faith in yourself. As I tell scientific presenters who are nervous before a big speech, “You know what you are going to say, they don’t. They want you to do well for their sake, and frankly after the first two sentences it is in the hands of a greater power than you!” Have hope and live differently.

Engaging the distracted decision-maker

I went to a funeral recently—a full house, standing room only. The eulogist took the podium silently, looked down at his notes, looked up at us, even scanned the crowd right to left and back again, down to his notes, then looked up and continued the story he started in silence.

His silent ascent to the podium and the silence continuing could not have been more than a minute or two, but it seemed longer—more reverent, more inclusive. And guess what? The crowd was completely silent. We were ready to hear what he had to say.

You can employ this too.

When I’m with a decision maker—an important person—and they’re looking at their screen, their phone, off in the distance, I simply say, “I’m OK, do you need to answer that?” or “Need to get that email off?” Or I put out a blank piece of 8.5x11 paper and I start drawing on it… usually geometric shapes, a Venn diagram, etc.

I do so slowly. This catches their attention and both of us are now looking down at the paper, and I have a collaborator instead of a judge or an impassive physician staring at PowerPoint slides.

The Venn diagram is a good one because the three interlocking circles create that middle circle. That middle circle need not have a name or anything on it. It often houses the future success or the critical question or the thing that we are researching. And of course, our distracted doctor is now looking at our material—our on-the-spot made material—not the company’s brochures (yet).

Use pauses to make sure that you are giving your physician time to take it all in, to think, and to respond. Coaches use W.A.I.T. as their professional mantra: Why Am I Talking?! You can too.

Slow your speech, allow for pauses, note overt and subtle physician interest (leaning forward, asking questions, brighter eyes, head nodding, guttural sounds, etc.). Like in The Princess Bride, “You let me in, prepare to be engaged!”

Lead with Wisdom, Not Just Data

Recently, a Maryland toddler fell from the 15th story of an apartment building and survived with a broken leg and some internal injuries. An MIT physicist and mechanical engineering professor, Anette Hosoi, said, “It’s not the fall, it’s the landing.” She then went on to speak about terminal velocity, mass acceleration, and other factors.

Her first quote though about the fall and the landing is the one that sticks. She said it first instead of all the data first. And in plain language that everyone can understand.

Later in a tip for parents in high rise apartments, Katie Donnelly, a pediatric emergency medicine physician at Children’s National Hospital in Washington, cautioned, “Screens keep bugs out, not keep kids in.” The details of why and how can come later; the wisdom is in the first sentence about screens.

An idea for us all, especially when presenting complicated material, is to find a way to make things very clear to any person at any level of education.

Dr. Rudolf Dreikurs cautioned us not to worry about being “perfect” but rather concern yourself with being “useful.”

Oh, and some interesting ideas here: Joshua Abzug, a pediatric orthopedist at the University of Maryland Medical Center, noted that the child landed in bushes with strong branches, which absorbed the energy. Had the child landed in a soft spot, the injuries could have been much worse, perhaps even fatal.

And one more tidbit: Hosoi mentioned that if a rabbit was dropped from an airplane (do not attempt this at home!), it has a 50/50 chance of survival based on its weight… as long as it isn’t a BIG rabbit!

The point to all of this: make your distinction short and clear and full of wisdom… then pile on the facts, if necessary!

The power of names

I was recently reminded of the power of names. Taking the time to remember someone’s name can instantly build rapport and trust. Do what you can to memorise them. It makes a bigger difference than you might think.

Watch this video to learn more!

Answer the Question You Wish They’d Asked

In all my presentations, I interview someone “Larry King Style.” which includes questions about their leadership journey from grade school to the present. We do not prepare the interview, I often know nothing about them. The interviews are much better that way, spontaneous, personal, from the heart and the head. Most of my interviewees say “Yes” when asked either in advance or on the spot. It is often the most popular part of the program (in addition to my infinite wisdom of course!).

A recent interview was with a CEO of a major southern hospital. He was terrific, popular, wise, experienced, and a giving person. He did something I’ve never seen before: he prepared! He had a fist full of notes, typed, labeled “the interview”! He didn’t refer to the notes very much, but I knew he was ready for whatever question came from me.

The great part of this particular interview was my questions were just the diving board, he decided how to dive! I’d ask a question, and he gave an answer and then he went on to what he most wanted the physicians in attendance to know, regardless of my question! He seemed to know that this was his moment with these 15 doctors, and he wanted them to know what he wanted them to know.

It was quite different from my other 900+ interviews over the years, and he taught me an important lesson…if you want to make an impact prepare what you want regardless of what happens. Robert Macnamara from the Kennedy and Johnson administrations said words to the effect of the media, “Answer the question you wished they had asked!”

So no matter if it is a ten-minute update or a spontaneous conversation, you always have time to prepare.

"The reason I say that is..."

Communication Tip: Use "The reason I say that is..."

Why? Because it gives people more time to hear, process, and actually consider what you’re saying—especially when sharing a new or challenging idea.

It’s a simple shift that encourages curiosity instead of resistance.

“You killed my father, prepare to die.”

“You killed my father, prepare to die.” Remember that line from the movie The Princess Bride? Mandy Patinkin was the actor. He is also an accomplished singer as well.

On The David Letterman Show one night, he was publicizing his latest album. Letterman said words to the effect that he knew this was an unusual request, but “would you sing this one?” and pointed to the back of the album cover. Mandy seemed surprised, as did the band. And then they did a drop-dead rendition of “Over the Rainbow” seemingly off the cuff.

Now, few things—very few things—on late night TV are spontaneous and unrehearsed, and I have no inner knowledge of this event. But it kept my interest. The persistent “what is going to happen?” thoughts in my head and the resulting song in a near-perfect “spontaneous” performance…

Moments like this, a do-or-die Masters golf shot, a rocket launch, your child’s first steps, a new Key Opinion Leader (!), are all moments of some anticipation if not suspense.

You can use this technique yourself. It is less of a technique and more of an awareness of the anticipation of the other.

In my next post, I’ll share a striking real-life example—and how you can channel this principle to engage the toughest audiences.

Words That Defuse, Not Divide

I listened to an interview where the head of a grassroots organization had lost funding for the event of the year from his major corporate donor. There were finances, people, and of course, politics involved. It was a heated issue and could have been a heated interview, but I noticed an interesting response on the part of the interviewee. Regardless of the pointed questions, the emotions, the differing facts on both sides, he peppered most of his answers with some form of the word “respect.”

As he did, I noticed I listened more closely instead of trying to figure out who was right and who was wrong. In response to a quoted somewhat curt reply from the donor, he’d say, “I understand that ________ is concerned about ______ and, respectfully, I’d like to add/suggest that another way to look at this is _________.”

In another part, he countered with, “With my greatest respect, I disagree but I personally know this person (donor) is a good man with the best of intentions. I do wish we could come to the table and share a way going forward with respect and honor.”

All his responses were laced with value words: “respect,” “concern,” “honor,” “gratitude,” etc. In doing so, he came across as a reasonable man whose organization was hurt by this corporate decision, a decision made by a corporate “good man that I know personally.”

I came away as a listener who was not in any way involved wondering, do I speak this way when the decisions (and the emotions) get hot?

And one more thing I noticed in this 4-minute interview—the interviewee never used the word “but.” However, the interviewer did!

"and what else?"

Use "...and what else?" to stay curious a little longer and transform your conversations. Watch this video to learn more...

Introvert or extrovert: it's not who you are, it's how you prepare

Going from office to office, making those cold calls, initiating conversation with a new Key Opinion Leader (KOL), and of course socializing on those ever-fun ride-along days… While these are often the breakfast of champions for the extroverts on the team, they can be a real ache for us introverts. Often misunderstood, the introvert/extrovert labels are simply how we get our energy: introverts charge their batteries while alone and feel them slowly deplete over the course of the day while extroverts charge just by being around others are a bit drained when alone.

Shyness and anxiety have been associated with introversion, but extroverts feel those same emotions. Each person handles it in a different way. Some introverts hang back and wait for the other person to engage them (not always a winning strategy with your manager, or your career!). Extroverts, on the other hand, handle those same emotions with over-talking, silly talking, and yes, just talking! Again, when our job is to seek out the other person, we need not relay our life stories.

Anxiety is often an ambiguous feeling (“I’ve heard there are bears in the area”), whereas fear is more direct (“Look! A bear!”). Nervousness is a focus on the wondering what will or could happen, or am I ready, or do they know how nervous I am?

The cure for all of this is to look outward, to engage, to listen, and then listen a bit more. Introverts are exceptional at listening when they disengage from the fear. Extroverts are great listeners when they focus on the story of the other vs. how it reminds them of themselves!

One psychological technique that can be useful for both is to prepare with the following:

1.   I know this about this KOL and their practice_________.
2.   My hunch is that this KOL may ask me ____________.
3.   I know that I know ____________.
4.   Therefore I (*must) __________.

*Now here is the trick…switch the final #4 from “I must….” to “I can….”

When you can, you have an endless supply of encouraging actions you can take. When we go into a meeting with “I must,” we are usually confining ourselves unnecessarily to a defensive posture with few alternatives.

Don’t concern yourself with whichever personality trait you have. Instead, focus on the target, the KOL who is giving you the time to be useful to them and to the patients under their care.

Be prepared to get the person’s voicemail

Have you ever received a voicemail that sounds like a car commercial on the radio when they have to read the fine print as fast as possible? You have to listen to it three times to get the number right, or you are left wondering which ‘Bob’ is calling you?

Next time you make a call, be prepared to get the person’s voicemail. Decide in advance what to say, the pace you will speak, the information vital to the return call (always give your phone number even if you know they already have it), and the purpose of your call…again in a voice as steady as if you were on NPR.

You don’t need to tell them the time or day, the phone will tell them that. Nor do you need to tell them the weather where you are, they don’t care. Nor do you need to imitate an airline pilot’s announcement, “This is, uhhh, your captain speaking, today we are uhhhh going to Seattle (we know that) and we uhhhh will be flying at 35,000 feet (not necessary) and uhhh given the time I won’t be making any more uhhhh announcements.” At last some good news!

Leave a good impression - clear, crisp, professional, paced, with just enough information. That way they will not only remember to return your call, but won’t be afraid to do so!

Are you nervous? Or excited?

Being apprehensive when approaching a new Key Opinion Leader physician and researcher is understandable. You are walking into their territory, their questions, their time. This apprehension can give way to fear, nervousness, and doubt. It’s natural. If you have been following the series “The Pitt,” you can probably identify with the new medical students and even the residents. What is coming through the door next? Who is next? What decision do I need to make now? Am I ready? Even the attending in charge has some harboring doubts and mistakes are made now and then. A surgeon friend of mine told me that what characterizes the operating thinking of a surgeon is “Regardless of what comes my way today, I know I can fix it.” He went on to say that most surgeons in his experience love surgery because they are excited to fix and heal. “I know I can make this life better.” This is confidence steels them for the unknown, the unexpected.

So, as Medical Science Liaisons, are you nervous or are you excited? Nervous is about you… Excited is about them. Do I want my surgeon nervous or do I want her excited to fix me? One video ad for an east coast hospital had a surgeon greeting his patient early in the morning with “Nervous about today’s operation?” The patient responded, “Actually, yes I am.” The surgeon responded, “Good, ‘cause I’m not!” They both shared a reassuring laugh. Nervous is OK… Just translate it to excited at first blush. You are there for that doctor and her patients, she is not there for you. She wants to see excitement on your face and in your words. This visit is not a final oral grad school exam… It is a conversation of social equals figuring out how to heal others in their care.

Following is leading

Followership is an act of leadership, and as an MSL practicing the art of the role, your colleagues will look to you for your reaction when new goals or directions are shared with the team. How do you show up for this role? What will your colleagues see and hear in your response? Are you able to manage your emotions when you have objections to the direction provided? What is your tone when you ask clarifying questions? What does your non-verbal behavior say?

Aligning with and supporting the strategy and direction provided by your leadership team is an act of leadership.
·      What emotions do you experience when new is shared? Are they productive or distracting from the mission?
·      How do you manage yourself? Are you more reactive than reflective? How will others interpret your reaction?
·      Do you recognize your patterns and triggers? Once identified, there is an opportunity to plan your response.

Recognizing and managing your emotions is a critical part of being in a leadership role. Pay attention to your emotions to better understand what triggers them. Plan how you will handle a situation you know may be an emotional trigger, including a response that will help you focus on the goal rather than your emotions. Take a deep breath, hold it, breathe out slowly. It’s necessary to experience emotions but the key is to be mindful of how you react, especially in front of others who look to you as a role model. If you’ve got an eye on a role managing other in the future, this is the time to develop the skills that are required AND people are watching.

No doubt you realize that the goals that are rolled out to MSLs are the result of hours of discussion and negotiation which include many trade-off decisions that will influence how you spend your time. Having this shared purpose brings a team together. Be the person that helps solidify this purpose through leading as a follower.

My inner expertise is curiosity

Meetings and discussions are prime opportunities to make ourselves heard, but often hesitancy, embarrassment, and simple ignorance prevent us from saying anything.

I was recently with a group of men who were discussing a baseball game – their vast knowledge of the game was met with equal amounts of enthusiasm! My ‘sports chat’ however is limited to when I watch the Olympics every four years, and the odd demolition derby or two during the summer. I am quite literally clueless with nothing to contribute. Nothing! So, I sat in silence occasionally nodding my head to show some semblance of, well, anything.

Being an extrovert, one can only do this for so long before breaking so I took a different approach. “You mentioned ______, the first baseman. In your opinion what makes him so special?” At that moment I was desperately hoping the guy was the first baseman! All of a sudden, an entirely new conversation began with me there too. The ‘guys’ all had an opinion… all I had to do was ask a few more questions out of real curiosity (and complete ignorance!) to be able to join in.

My inner expertise is curiosity, not baseball. This same skill allows me to communicate with executives, the homeless, snobs, us commoners, even with those I don’t like a whole lot! Phew, this time I made it out of a sports discussion with my self-esteem intact…and I even found out what a first baseman is supposed to do!

From chameleon to connector: advancing MSL impact through empathy

On Monday, I shared how Medical Science Liaisons (MSLs)—like chameleons—adapt their agenda and style to meet the moment. Today, let’s take that one step further.

Taking our listening to the next level is when we demonstrate empathy. Here we identify and address the emotions expressed by the KOL based on what we see and hear in an authentic manner. This takes practice but when we are empathic, we move away from trying to fix a problem and can see what someone needs or feel what they feel, fueling our understanding of their perspective. Here are some ways to show your empathy:

• “How will this impact you?”
• “I can see why that would upset you.”
• “I appreciate you sharing that with me.”
• “That must have been frustrating.”
• "What do you need from me?"

Embedding these skills into our way of working demonstrates active listening. Here, we correctly identify the emotions behind the KOLs words to get to the underlying issue or challenge. The connection you make when empathetic and actively listen will enhance your relationship and provide better insights and outcomes.

KOLs deal with many pressures throughout the day, and your meeting may follow a tough conversation with a patient or a fight with the insurance company about trying to secure your medication. Adjusting to your environment like a chameleon and reading the emotions of a situation through active listening is an important part of the art of being an impactful MSL. KOLs will engage at a different level when they feel heard and understood.

Consider your last three KOL meetings. How would you rate your listening skills? What one change can you make to take your listening to the next level this week?

Pull ideas from others

Instead of always pushing your perspective, try pulling ideas from others. Ask, listen, and create space for voices to emerge. Watch this video to learn more!

What do chameleons and MSLs have in common?

Perhaps this is just too obvious a question. Chameleons and Medical Science Liaisons (MSLs) adapt to their environment and their emotions, enhancing communication. As an MSL, part of your art is to adjust for each interaction—including your agenda, approach, and the science you discuss. Sometimes you lead the discussion—but most of your time should be spent listening. The art of being an MSL is knowing when to set your agenda aside and let the KOL take the discussion where they want.

No matter the situation, active listening is the key to success. Remember those insights you’ve been asked to deliver? Actively listening will uncover them. Honing this skill requires practice and consciousness to move to the highest level of active listening in every conversation.

We’re all comfortable reacting to what we hear, providing feedback or answering a question. This is our quick response that doesn’t involve contemplation, just a quick reaction to the point or question posed. Think about this like shutting an open door. Instead, paraphrase what you’ve heard to gain confirmation that you correctly heard and interpreted what they’ve said. Often the KOL will take their thoughts to a deeper level and give you more insights. Asking for clarification will allow you to elucidate additional thoughts by asking questions to probe deeper and illuminate the underlying concerns.

Perhaps these three skills are second nature and tools you use routinely as an MSL. If not, they’re great ways to build rapport with your KOLs and dig deeper into their true insights and experience.

Want to take your listening one step further? On Wednesday, I’ll share practical tips for bringing empathy into your MSL conversations—and why it makes all the difference. Don’t miss it.

“I felt heard, thank you.”

“I felt heard, thank you.” This was the response I had from recent interactions with two different people. I didn’t ask for the response and frankly, I might have passed it off as a simple “thank you.” But the earnestness of their first three words took me by surprise.

It made me wonder how often I may have missed this message before. I also wondered how many times I may have missed helping someone to feel heard, with my focus instead working to “solve for” or advise or placate or quiz. Those people may have felt better heard by their dog, cat, or budgie!

Making someone feel heard doesn’t have to be complex—paraphrasing and empathy are powerful tools for simple communication.

When was the last time you said to yourself, “I felt heard”—or better yet, the last time someone told you, “I felt heard, thank you”?

Make your presentations more powerful and impactful!

When you're giving a presentation, your audience is thinking one thing: "Can you help me solve my problem?"

Get straight to the answer. Be clear, be direct, and focus on what matters most to them.

Watch this quick video to learn how to make your presentations more powerful and impactful!

Doing the right thing: compliance isn't always easy

Have you ever received a request to do something that your gut told you wasn’t the right approach from a compliance perspective? It may have been a déjà vu moment, transporting you back to the numerous policies and SOPs you’ve read that outline the expectations for your role. I view building compliance strength in the same light as going to the gym. Building strength in the gym will help prepare me for challenges such as the distance or elevation of a hike. Building our compliance strength will help us navigate unexpected challenges in the field, which is an important component of the art of being an impactful MSL. Understanding of the “why” behind your company’s policies, procedures, and guidance will strengthen the base knowledge from which you can draw when an unpredictable situation arises and your gut chimes in. At the recent Medical Affairs Professional Society (MAPS) meeting, I attended a workshop led by Adeola D., Pamela Lonzer, and Monchiere Commodore, who reviewed some important reminders and led us through a good discussion:

·        Upholding the integrity of the science we discuss is critical. Fair balance and scientific balance are critical during scientific exchange. Enough said!

·        The “Safe harbor” for non-promotional scientific exchange has guardrails, even with the new SIUU Communications Draft Guidance. Are you confident you know how to work within these guardrails as defined by your company?

·        Minimizing the risks or overstating the benefits of a product during a conversation with an HCP is misbranding (and a false claim). How do you ensure balance in each conversation, every time, even with the KOL’s with whom you have a long relationship?

·        There are clearly compliant and non-compliant ways of working in with commercial, there is a lot of grey in between. How does your company interpret that grey and do you reflect that interpretation in the field?

The workshop included an activity where we identified risks, assessed severity, determined the control, and monitored the outcomes. It was valuable to hear the different perspectives from others on their interpretations and experiences. There was no “group think” at our table! It was a good reminder that grey can be interpreted in different ways and depends on the space you are navigating (i.e. launch, device). Each company has a different risk tolerance which will be reflected in the types of activities that are implemented.

When has your gut chimed in to alert you to assess the compliance of a request?