[PRACTICE NOTE] Refocusing Leadership DNA in Pharma

The beliefs a company truly values and the behaviors it exhibits are largely a function of the leadership tone set at the highest levels. That holds in every industry, and it holds with unusual force in pharma, where the distance between a scientific promise and a patient outcome runs through dozens of handoffs. Leaders rarely touch those handoffs directly. What they do touch is the question of whether anyone is expected to own the whole of them.

Pharma has no shortage of leaders who believe in the customer. The belief tends to live in sentiment rather than in structure, which is why it rarely survives a quarter that comes in light. Commitment that is built into how leaders are evaluated, how capital is allocated and what the board reviews behaves differently.

The gap between those two conditions shows up in how differently leaders and customers describe the same engagement. Deloitte 2025 research found only 28 percent of HCPs believe pharma's engagement strategies meet their needs, against 82 percent of life sciences executives who say they are satisfied with those same strategies. A spread of that size may not be an information problem. Executives are reading accurate reports about activity while providers are describing their experience of the system.

Leadership acumen is not a charismatic gift or a title

Exceptional leadership of this kind is not an innate trait that only a few charismatic leaders possess, nor does it belong to anyone holding a Chief Customer Officer or Chief Experience Officer title. What leaders at every level need is a belief that exceptional customer experiences can change the basis of competition in their favor. That belief can be learned, and it can be tested against how a leader spends time, attention and money.

In the book this work sits in the first of four layers, Leadership DNA, ahead of Organizational, Operational and Commercial DNA. The sequence matters more than the taxonomy. Leadership DNA is the layer that determines whether a commitment to the customer survives contact with a quarterly target. Without it the other three layers remain optional. That is the quiet reason so many pharma customer experience programs fail while every initiative inside them performs as designed.

Reframe the theory of the firm around relationship value

The theory of the firm was developed by economists to explain why firms exist and why they organize themselves as they do. Most early conceptions emphasized efficiency, minimized transaction costs and other mass production era factors. Reframing it means recalibrating value drivers and growth vectors around customer relationship value, goodwill, reciprocity and trust. In pharma this is the move from a firm that exists to discover and promote medicines. The reframed firm exists to see those medicines reach and stay with patients.

A firm organized around discovery and promotion funds reach, frequency and share of voice. A firm organized around reaching and staying with patients funds the removal of friction between a decision and a therapy. Both can be reported as growth, and only one of them accumulates something that compounds.

Treat each customer relationship as a quantifiable asset

"Our customers are our most important asset" is one of the most repeated platitudes in business. Treating it as substance means each customer relationship becomes an intangible but quantifiable unit of value on a virtual balance sheet. That brings visibility to which relationships are appreciating, which are depreciating and which are worth further investment. Some of that accounting may be imperfect, and it remains more honest than treating relationships as free.

In pharma the relationships in question are a prescriber's confidence and a patient's willingness to stay on therapy, and both are routinely spent without being counted. A difficult prior authorization draws down prescriber confidence, and a confusing copay conversation draws down patient willingness. Neither withdrawal appears anywhere, which is why value leakage can run for years without a line item.

Experience-led growth belongs inside corporate strategy

An experience-led growth strategy has to be a subset of corporate strategy rather than something created in a vacuum. It has to name the experiential battlefields the company chooses to compete on beyond its core products. It also has to act as a revenue driver across every stage of the lifecycle. Treating experience as a post purchase concern caps what it can return. Strategies written outside those three conditions often produce activity that is admired internally and invisible commercially.

In pharma that means choosing which of the three paths the company intends to be visibly better at, and funding it. The Path to Prescribe, the Path to Fulfill and the Path to Adhere behave differently and fail differently. Most organizations hold strong opinions about the first and carry almost no stated ambition about the other two. Choosing one of them as a battlefield is a strategy decision rather than a program.

Employees read their leaders for what is acceptable

Modeling customer-centric behaviors has less to do with declarations than with what the organization sees leaders repeat. Three practices carry most of the weight.

A cadence of communications brings the customer perspective into management systems rather than leaving it to an annual offsite. Consistency of intent matters because variable experiences across channels produce customer and employee dissonance in equal measure. The third practice is celebration, so that Customer Excellence is visibly rewarded rather than quietly assumed.

What gets celebrated tells employees where discretionary effort can be safely spent. Being this kind of enterprise also means resisting the temptation to chase fleeting management trends and quick fixes. Enduring value comes from structural change, and structural change rarely photographs well in a town hall.

Empowerment turns autonomy into accountability for customer outcomes

When leaders empower employees they entrust them with autonomy and authority, and in return employees feel trusted and accept accountability for customer outcomes. Two components do most of this work, and the first is prioritization, which means putting the customer and the employee on business review and board agendas.

The second is permission, which means granting the institutional permission employees need to uphold brand promises. In pharma, and in my own experience of commercial organizations, the permission question is sharpest in the field. Colleagues there routinely see what is failing a patient and have no sanctioned route to act on it. Field teams in this position are not underperforming, and the structure around them is not built to receive what they know.

Governance is where the commitment becomes verifiable

Governance is the proof that the commitment is real, and it escalates in three steps. The first is to incorporate Customer Excellence into strategic transactions, where diligence usually ignores it entirely. The second is to form a dedicated board committee or sub-committee tasked with championing customer centricity and holding the organization accountable. The third is to integrate customer outcome metrics and narratives into quarterly filings, annual reports and other disclosures.

Each step raises the cost of walking the commitment back, which is largely the point of governance. I have watched organizations complete the first step and treat it as the whole program. The step that changes behavior most reliably is a smaller one. Strategic customer experience metrics belong in executive leadership evaluations, so that leaders are held accountable rather than merely supportive.

Pharma's defensible numbers conceal the gap nobody owns

Every function in a commercial organization can defend its own number, and each defense is accurate. Marketing can defend awareness and recall. Sales can defend reach and frequency. Medical can defend scientific exchange, and market access can defend coverage secured. Patient services can defend enrolled patients supported to service levels.

I have sat through reviews where each of those numbers was sound and the patient's path through them was never discussed. Every leader in the room can defend a number while providers and patients continue to experience delay and abandonment. No individual in that room is failing. The structure is not built to surface the thing none of them owns, which is whether earned value becomes realized therapy.

That question has no functional home, so it often gets treated as a measurement problem rather than an accountability one. A billion dollars of earned value becomes roughly seven hundred million after prescriptions that are never filled. It falls again after early discontinuation, and settles close to four hundred and fifty million in realized value after long term adherence erosion. No competitor takes the difference, and the Realization Rate is the number that would make the loss visible.

Leadership DNA creates the conditions for the layer beneath it to function. Organizational DNA is the next layer, where structure, roles and incentives either carry the commitment or quietly absorb it. Operational DNA and Commercial DNA follow it in turn, and leaders who skip the first layer tend to buy capability they cannot govern.

Heroics are a subsidy the enterprise never books

Capable people prevent most of these gaps from becoming visible failures. Someone calls a payer a second time, reworks a form, or stays late to keep a patient from falling out of a program. Leadership usually sees the resolution without seeing the effort required to produce it, because the system looks like it works when somebody makes it work.

Heroics are a subsidy. They are paid by employees, they go unrecorded in reporting, and they run out when the people paying them leave or tire. The alternative is an enterprise that is structurally predisposed to help, where the right outcome arrives as the default rather than the achievement. Leadership DNA is what decides which of those two enterprises a company becomes.

Key Takeaways

Leadership tone, rather than title or temperament, largely determines whether a customer commitment survives a quarter that comes in light.
Reframing the theory of the firm means funding the distance between a prescription earned and a therapy sustained.
Prescriber confidence and patient willingness behave like assets that appreciate or depreciate, and most organizations spend them without counting them.
An experience-led growth strategy only works when it names a battlefield and receives funding inside corporate strategy.
Governance makes the commitment verifiable, and executive evaluations are where accountability stops being sponsorship.
Heroics can hold a broken path together for some time, and they remain a subsidy rather than a capability.

Diagnostic Questions to Consider

Name the experiential battlefield your company has chosen to compete on beyond its molecules.
Identify where prescriber confidence and patient willingness appear in any document the board reviews.
Describe the sanctioned route a field colleague uses when they see something failing a patient.
State which executive evaluation carries a customer outcome metric with real weight attached to it.
Estimate how much of current performance may depend on effort that nobody reports.

Closing Reflection

The move described here is modest in language and large in consequence. Leaders do not have to become experience designers, and they do have to become the principal advocates for customers inside their own management systems. That advocacy is most useful when it is repetitive, unglamorous and attached to money. A belief expressed once a year at an offsite can be sincere and still change nothing.

Pharma has earned the right to be judged on more than molecules, and the layer that would let it be judged that way is largely unbuilt. The three legs of the value proposition are product, brand and experience, and pharma built two of them well. Leadership DNA is where the third leg gets its budget, its owner and its place on an agenda.

I have come to see this layer as the least technical and the most difficult of the four. Structure can be redrawn, processes can be rebuilt and commercial models can be redesigned, often within a single planning cycle. Changing what leaders reliably ask about takes longer, because it asks them to be measured on something they used to sponsor. The organizations willing to make that trade tend to stop needing heroes.

About the Author

Wayne Simmons is the founder of The Customer Excellence AGENCY and the author of The Customer Excellence Enterprise (Wiley, 2024). He is founding faculty of the MS in Customer Experience Management at Michigan State University's Broad College of Business. He led global customer excellence in Pfizer's first Chief Marketing Organization and in Bayer's Customer Powerhouse.

The Customer Excellence Agency: Advancing the Pursuit of Excellence in Service of Science.

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[PRACTICE NOTE] Your Call Plan Isn’t the Problem. Your Customer Context Is.

March 15, 2026

Why healthcare professionals now judge pharmaceutical engagement against the best experiences in their lives, and what that means for the future of commercial leadership. When commercial performance falters, the reflex inside many pharmaceutical organizations is to adjust the machinery of field execution. Leaders revisit call plans, recalibrate targeting models, and increase the volume of activity in the hope that more precision or more frequency will restore momentum. For decades this system has been treated as the central instrument of commercial performance, determining which physicians are prioritized, how frequently representatives engage, and how resources are deployed across territories. Yet the growing gap between commercial effort and commercial impact suggests a deeper issue. T he problem is rarely the design of the call plan itself. It is the context in which healthcare professionals now operate. Physicians are navigating increasingly complex clinical, administrative, and informational environments, and that evolving reality now shapes prescribing behavior far more than the cadence of promotional interactions. What many organizations are experiencing is a widening Customer Context Gap. Commercial systems were designed for a time when prescribing decisions could be influenced primarily through promotional interaction and product information. Today physicians operate inside a far more complex reality shaped by administrative burden, reimbursement constraints, digital information overload, and growing expectations for seamless support across the entire care journey. In this environment the physician’s decision is influenced not only by clinical evidence but also by how easily a therapy fits into the practical realities of care delivery. When commercial models remain anchored in promotional activity while the customer’s context has fundamentally changed, even the most disciplined call plan struggles to deliver the outcomes it was designed to produce. Closing this gap requires a different way of thinking about commercial performance. The question is no longer how to optimize promotional activity but how to align the organization around the real journeys through which physicians help patients receive therapy. Prescribing decisions unfold within complex sequences of clinical evaluation, reimbursement navigation, patient readiness, and ongoing support. When commercial strategy is designed around these journeys rather than isolated interactions, the role of the field force begins to evolve. Representatives are no longer positioned primarily as messengers of information but as partners in removing barriers that slow care. Organizations that recognize this shift begin redesigning their commercial systems accordingly, aligning field engagement, digital support, access programs, and patient services around the same goal: helping healthcare professionals help patients move from clinical intent to successful treatment. From Promotional Activity to Customer Journeys The pharmaceutical industry has historically organized commercial activity around the moment of promotion. Call plans, targeting models, and message sequencing were designed to influence prescribing behavior primarily through informational engagement with healthcare professionals. While this model brought structure and scale to commercial operations, it reflects an earlier era in which the path from clinical awareness to prescribing action was comparatively linear. Today the journey is far more complex. Physicians must navigate an intricate landscape of clinical evidence, treatment guidelines, payer requirements, prior authorization processes, patient affordability concerns, and adherence challenges. Prescribing a therapy is no longer a single decision point. It is the beginning of a chain of events that determines whether a patient ultimately receives and remains on treatment. This is why the commercial conversation must expand beyond the traditional moment of prescription to encompass three interconnected journeys. The first is the Path-to-Prescribe , where scientific evidence, clinical education, and confidence in the therapy shape the physician’s willingness to recommend treatment. The second is the Path-to-Fulfill, where access, affordability, patient readiness, and operational support determine whether that recommendation ultimately becomes therapy in the patient’s hands. The third is the Path-to-Adhere , where ongoing patient support, monitoring, and engagement determine whether patients remain on therapy long enough to realize the intended clinical benefit. Science drives the Path to Prescribe, where evidence, clinical education, and confidence in the therapy shape the physician’s willingness to recommend treatment. Experience shapes the Path to Fulfill, where access, affordability, and patient readiness determine whether that recommendation becomes therapy in the patient’s hands. Sustained outcomes depend on the Path to Adhere, where ongoing support, monitoring, and engagement ensure patients remain on therapy long enough to realize its intended clinical benefit. When commercial organizations focus almost exclusively on the first while leaving the latter journeys fragmented and burdened, a significant portion of therapeutic value is lost between intention and impact. In many therapeutic areas, the result appears in the persistent gap between prescriptions written, prescriptions filled, and therapies sustained—gaps that reflect not a failure of science but a failure of system design. Recognizing these three journeys shifts the unit of focus from promotional activity to the real-world pathways through which care is delivered. It reframes the role of the field force, the purpose of digital engagement, and the design of patient support programs around a single objective: reducing the friction that stands between clinical intent, treatment initiation, and sustained patient outcomes. Customer Context Is the New Commercial Variable For much of the pharmaceutical industry’s history, commercial performance was largely explained by a familiar set of variables. Product efficacy, clinical differentiation, promotional reach, and sales force execution determined the trajectory of most brands. When performance lagged, leaders adjusted those levers by refining segmentation, optimizing targeting, and recalibrating call plans. Today those traditional levers still matter, but they no longer explain commercial outcomes on their own. A far more powerful variable has entered the equation: customer context. HCPs now operate within an environment defined not only by clinical complexity and administrative burden but also by rising expectations shaped by their experiences outside healthcare. Physicians are also consumers. In their personal lives they interact daily with companies such as Apple, Amazon, Tesla, and Netflix that anticipate their needs, remove friction, and simplify complex processes through thoughtful design. These experiences quietly reset the benchmark for competence, responsiveness, and respect for their time. When those same physicians step into their clinical roles, they do not shed those expectations. They carry them with them. The contrast between the seamless orchestration of their consumer experiences and the fragmented systems surrounding many healthcare interactions becomes difficult to ignore. What once felt acceptable now feels unnecessarily burdensome. This dynamic represents the Consumer-Grade Imperative. Healthcare professionals increasingly evaluate pharmaceutical engagement not against other pharmaceutical companies but against the best experiences they encounter anywhere in their lives. In this environment even a clinically superior therapy can struggle if the surrounding system makes it difficult to initiate treatment, navigate reimbursement, or support patient adherence. Customer context therefore becomes the new commercial variable. It determines whether scientific differentiation translates into practical adoption. It shapes whether prescribing intent becomes therapy initiation and whether therapy initiation becomes sustained patient outcomes. Call plans were designed to manage activity. Customer context requires organizations to manage journeys. The Field Force in the Era of Customer Context Recognizing customer context as the defining commercial variable inevitably reshapes how the role of the field force is understood. For decades the pharmaceutical sales representative has been positioned primarily as the carrier of scientific information. Call plans optimized the frequency and sequencing of these interactions to ensure that physicians received consistent messaging. That role does not disappear, but the environment surrounding it has changed profoundly. Physicians today are navigating administrative burden, payer complexity, digital information overload, and increasing time pressure. In this environment they are not simply seeking more information. They are seeking clarity, simplicity, and support that helps them navigate the complexity surrounding treatment decisions. This shift transforms the representative from a messenger of information into something far more valuable: a partner in removing friction from the care journey. Conversations move beyond repeating clinical claims toward understanding the practical barriers that physicians and their teams face as they attempt to initiate and sustain therapy for patients. The most effective field forces are therefore supported by commercial systems designed around journeys rather than activities. Representatives are equipped not only with scientific messaging but with the insight and coordination required to address obstacles across prescribing, reimbursement, and patient support. Field engagement becomes a catalyst for problem solving rather than simply a vehicle for promotion. From Call Plans to Customer-Aligned Commercial Systems If customer context has become the defining commercial variable, then the systems designed to support the field must evolve accordingly. The traditional call plan was built to manage activity. It provided structure for how frequently physicians were engaged, how territories were covered, and how resources were deployed. Yet activity alone does not determine whether therapies ultimately reach patients. What determines impact is whether the commercial system surrounding the physician reduces or increases the burden of delivering care. A customer-aligned commercial system begins with the journeys through which physicians help patients move from diagnosis to treatment and beyond. Marketing clarifies the scientific story. Sales provides trusted relationships and real-time understanding of physician needs. Access teams simplify reimbursement pathways. Patient support programs reduce administrative burden. Digital engagement reinforces and extends human interaction. The result is a commercial system that operates less like disconnected functions and more like an integrated network designed to help physicians help patients. This is the essence of Customer Excellence. It aligns the entire commercial enterprise around the real-world context in which care is delivered. The problem was never the call plan. The problem was the context. Key Takeaways Commercial performance in pharma organizations has traditionally been managed through field execution mechanics, yet the effectiveness of those mechanics increasingly depends on how well they reflect the real-world context in which physicians operate. Customer context has become the most pivotal commercial variable as administrative burden, payer complexity, and consumer-grade expectations reshape how prescribing decisions are made. HCPs now evaluate pharmaceutical engagement against the best experiences they encounter anywhere in their lives, raising the standard for clarity, responsiveness, and ease. Optimizing promotional activity alone is no longer sufficient. Commercial success depends on reducing friction across the journeys physicians navigate as they move patients from diagnosis to treatment. Customer Excellence represents the structural response, aligning marketing, sales, access, digital engagement, and patient support around the real journeys of care delivery . Diagnostic Questions to Consider Are we optimizing the activity of our field force, or designing commercial systems that support the real journeys physicians navigate to help patients receive therapy? How well do we understand the administrative, reimbursement, and operational barriers physicians encounter after they decide to prescribe a therapy? Do our commercial systems reduce the burden placed on physicians and their staff , or unintentionally add to the complexity of care delivery? Are we benchmarking our engagement against other pharma companies , or against the best experiences physicians encounter in their lives as consumers? Have our investments in digital platforms simplified the physician’s experience, or multiplied the number of disconnected interactions they must manage? Are we still managing performance through activity metrics alone , or beginning to understand the context that ultimately determines whether therapies reach patients? Closing Reflection The pharma and life sciences industry has spent decades refining the mechanics of field execution. Call plans, segmentation models, and targeting systems brought structure and discipline to commercial organizations. Yet the environment surrounding physicians has evolved far more rapidly than the systems built to support them. Healthcare professionals now operate in a world defined by consumer-grade expectations for clarity, responsiveness, and ease. When the experience of engaging with a pharmaceutical company fails to reflect those expectations, the contrast becomes impossible to ignore. Organizations that recognize this shift will redesign their commercial systems around the realities of modern care delivery. They will move beyond managing activity and toward understanding the context in which physicians help patients receive treatment. In doing so they will close the gap between scientific innovation and real-world impact. Your breakthrough science deserves experiences worthy of it. Together, we turn customer excellence into real-world impact. About the Author Wayne Simmons is a hands-on commercial excellence architect and founder of The Customer Excellence Agency, where he partners with pharmaceutical and life sciences leaders to turn customer-centric ambition into durable commercial advantage. He previously served as Global Customer Excellence Lead within Pfizer’s Chief Marketing Organization and has held leadership roles with Bayer Pharmaceuticals and The Ritz-Carlton Leadership Center. Wayne writes The Customer-Centric Marketer newsletter and is the author of The Customer Excellence Enterprise: A Playbook for Creating Customers for Life. The Customer Excellence Agency: Advancing the Pursuit of Excellence in Service of Science.

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