Evolving Medical Affairs' Mindset: Total Strategy

Reimagining Medical Affairs Strategy Through the Lens of 'Total Strategy'

In one of my early experiences as a team leader and direct line manager, I encountered a situation where a member of a different team suggested that my field associates needed to be "more strategic". When I asked them to clarify what they meant, they struggled to articulate their thoughts. Over the years, strategy has become somewhat of a buzzword, often thrown around without genuine understanding, leading to a "you'll know it when you see it" mentality. This ambiguity is partly attributable to the countless books written addressing various singular aspects of “business strategy”.

In the dynamic landscape of healthcare and pharmaceutical industries, the role of Medical Affairs has evolved beyond traditional boundaries, necessitating a more holistic and adaptable approach to strategy. Drawing inspiration from the Dutch philosophy of “Total Football”, my concept of “Total Strategy” emphasizes flexibility, adaptability, and the importance of a multifaceted skill set. Total Strategy advocates for an approach where your mindset is fluid, and adaptability is key, mirroring the versatility seen in Total Football players who seamlessly switch positions as the game demands.

This strategy transcends traditional rigid structures, encouraging leaders and teams to quickly analyse and respond to changing situations with creativity and holistic understanding. The concept of Total Strategy offers a fresh perspective on how Medical Affairs professionals can navigate the complex environment they operate in.

Instead of thinking of strategy as a singular concept, usually associated with higher level company strategy, Medical Affairs leaders need to be able to understand the situation they are in and choose the right strategy. The fundamental principle of what strategy is remains the same across all domains (identifying your problem, understanding your objectives and choosing “where to play and how to win”) but understanding exactly which domain requires your attention at any given time will help you to excel and deliver positive impact at all times.

The Essence of Total Strategy in Medical Affairs

Total Strategy in Medical Affairs is about deliberately applying strategic principles in various domains - from corporate vision to functional tactics, disease area dynamics, product lifecycle management, people leadership, and organisational culture. This approach demands a seamless integration of strategies across these domains to ensure agility and effectiveness. It requires an ability to analyse the situation to understand where key problems lie and which domain(s) of “strategy” to focus on. This is a skill needed at every level and will allow individuals to adjust their mindset and problem-solving skills to address the true problem statement.

Below I highlight some key areas for consideration. Ultimately there will be any number of “strategies” you could work on and understanding which areas need your focus is critical. Being able to switch your mindset between them will allow you to address each problem with the right solution.

1. Corporate / Company Strategy Alignment

Medical Affairs, like any function, must align with the broader corporate strategy, contributing to overall organisational objectives while maintaining its unique voice and expertise. This alignment ensures that Medical Affairs activities are not only scientifically robust but also resonate with the company's vision and goals. Executive leadership will be focused on wider company objectives and making sure to have these in mind will allow an appropriate level of communication when engaging with them.

2. Functional Strategy

Medical Affairs will have its own functional strategy around evidence generation, external engagement, scientific communication etc. Choosing “where to play” and “how to win” in these functional domains will have interdependencies with other parts of the business. Medical affairs plays a leadership role across nearly all phases of development and commercialisation and its role in integrating strategies across functions like clinical development, regulatory compliance, market access, and patient advocacy is crucial. This integration ensures cohesive action plans that leverage cross-functional insights for impactful outcomes. Having a Total Strategy mindset and approach allows for seamless integration across functions.

3. Disease Area and Product Strategy

Medical Affairs professionals need to develop deep disease area expertise and product knowledge. This specialisation allows for strategic planning that anticipates market trends, addresses unmet medical needs, and navigates the product lifecycle from development through post-market surveillance. From here, developing disease area and product specific strategy should be integrated with wider functions, primarily Marketing and Market Access.

4. People and Culture

Medical Affairs, like all functions, must prioritise people development, leadership and team culture. This involves nurturing talent, fostering diversity and inclusion, and developing leaders who can adapt to various roles and challenge. There are specific technical capabilities that are required within Medical Affairs (such as clinical trial management and medical writing) but we should not overlook more general skills such as strategy development, leadership, communication etc. Having a bespoke people strategy is critical to ensure the long-term success of the organisation.

5. Organisational Design

When developing your Medical Affairs strategy, vision and objectives, you need to ensure that the structure is right to support high quality execution. Designing an appropriate medical structure and organogram will be critical in how you execute and operationalise your strategy.

6. Other domains

There are any number of different “domains” of strategy that might apply at an individual, team or company level. Understanding this will enable you to adjust your view point, your approach and your behaviours appropriately. This might be your “transition strategy” when moving into a new role or a “crisis management strategy” in the face of an unexpected emergency. There will also be overlap between domains with corporate strategy influencing functional strategy and disease area strategy being interdependent with  (and so on) which stresses the importance of intellectual and learning agility for Medical Affairs professionals.

A Call for Conversations and Debate

The application of Total Strategy in Medical Affairs is not just a theoretical exercise but a call to action for professionals in this field. It invites robust conversations and debates on how we can collectively enhance our strategic approaches, embrace versatility, and drive meaningful change in healthcare.

By adopting the principles of Total Strategy, Medical Affairs professionals can lead the way in innovation, patient-centricity, and scientific excellence, ultimately leading to positive impact for the company we work in, the people we work with and the patients we serve.

Joshi Life Sciences is a coaching and strategic advisory consultancy for the Life Sciences industry set up by Dr Mayur R. Joshi (LinkedIn Profile).

Joshi Life Sciences specialises in career coaching for aspiring and current Medical Affairs professionals to maximise their potential and enhance their impact. We also advise companies looking to enhance their Medical Affairs functions, scale up their teams, build their organisations and we partner with companies that have shared values and vision.

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