[PRACTICE NOTE] Resequencing Organizational DNA in Pharma

Companies rarely fail their customers in the places they have studied most carefully. They fail at the handoffs, where no single function has been asked to carry an outcome all the way through. A pharmaceutical commercial organization makes this easy to see, because it is often well designed at the center of each function and largely silent at the joins.

Benefit verification, prior authorization, affordability, specialty pharmacy coordination, onboarding and first fill each sit partly inside a function and wholly inside none. The failures cluster precisely in the spaces no organization chart describes. That pattern is a design gap rather than a character gap, and the people working inside it deserve respect.

In most companies the clearest evidence of the gap is the small customer facing team that keeps rescuing those joins. Heroics are a subsidy, because they let an organization deliver promises its routine processes cannot reliably support. The cost is absorbed through discretionary effort, where nobody records it and nobody budgets for it.

Chapter eight of my book calls the remedy resequencing organizational DNA, and its objective is easy to state and hard to install. Customer outcomes have to become a shared accountability rather than the private burden of a few committed people. This layer sits directly after Leadership DNA, which decides whether a customer commitment survives contact with a quarterly target.

Becoming the kind of company that helps requires a shift in organizational orientation rather than a shift in effort. The aim is an enterprise structurally predisposed to help, instead of one that places that responsibility on the shoulders of a few individuals. Getting there demands attention to the under-appreciated soft factors inside organizations.

Institutional mindsets, beliefs, mental models and behaviors form the collective consciousness of a company. They drive how it thinks, how it functions and how it interprets its place in the world. Instilling shared accountability is a cultural change with a philosophical dimension and a practical one, and it tends to prove more enduring than routine cost takeout or technology led transformation.

Mental models decide what an organization believes is possible

Corporate mental models are the cognitive frameworks through which organizations make sense of the world. They work behind the scenes, quietly guiding corporate behavior long after anyone remembers choosing them. Two practices sit underneath the first bold move, which is to reimagine the art of the possible.

The first is to decode what customer experience outliers actually do, rather than what they claim in an annual report. Customers now carry the same standards into every interaction regardless of category, so the outlier in another industry is already setting the expectation in this one. The second practice is to ask why not us, as a counterpunch to the mental block that says it will not work here.

In pharma that block takes a specific and respectable sounding form, which is that regulation prevents it. Regulation here governs claims rather than burden, and almost none of the friction a patient meets between a prescription and a first dose is legally required. I have watched capable teams retire a sound idea on a regulatory objection that nobody had actually tested.

Benchmarking against peers guarantees the wrong standard

Admiring outliers from a distance changes nothing. The second move is to seek outside perspectives, which means creating thought partnerships that bring an organization angles it does not have on its own. Peer sounding boards let a company test and de-risk an idea before it commits capital or reputation to it.

My own schooling came at the Ritz-Carlton, a two time recipient of the Malcolm Baldrige National Quality Award. One condition of that award is that the recipient codify its methodologies and make them available to others, which is how an outsider can study a standard rather than admire it. Very little of what I learned there was proprietary, and almost none of it was expensive.

Pharma's instinct is to benchmark against pharma, which guarantees that the standard it meets is the one its patients are not applying. A company can be comfortably above the industry median and still sit well below what a patient considers ordinary. That gap rarely shows up in a competitive review, because the comparison set was chosen before the question was asked.

Principles turn good intentions into something teachable

The third move is to codify the obligation to customers. Company specific customer excellence principles turn the good intentions of customer centricity into something that can be understood, trained, implemented and sustained. These principles have to embody the specific experiential factors a company chooses as its basis of competition, tailored to its own context, because borrowed language rarely survives first contact with a real operating decision.

The Ritz-Carlton expresses personalization in its Service Values with a single line an employee can act on. I am empowered to create unique, memorable, and personal experiences for our guests. Notice what that sentence does. It names the behavior, grants the authority and leaves no room to pass the obligation along to somebody else. The line is also short enough to recall under pressure, which is the only test a principle really has to pass.

Pharma has an advantage here that it rarely uses. The obligation to patients is already the stated reason the company exists, so the principles do not have to be invented from nothing. They have to be translated out of mission language and into behavior language that a colleague can apply inside a single interaction.

Enterprise scale matters more than a central function

The fourth move is to create a framework for sustainability. Rather than isolating principles inside a centralized function, the aim is enterprise scale and enterprise wide consistency, so that experiences feel the same across channels and interactions. Adoption can then be de-risked through co-design, because a customer centric culture has to be created and owned from inside the organization.

Outsiders can facilitate the design process, though the culture itself has to flow from the collective consciousness of the company. Employee led co-design is an activation strategy in its own right, because it produces ownership and therefore accountability. Teams rarely argue with principles they helped write, which quietly changes the answer to the question of who owns customer experience inside a commercial organization.

Designing principles and activating them are different jobs

The fifth move is to document the principles. Codifying them through purposeful and creative documentation removes ambiguity about what a company expects of itself. Zappos publishes an annual Culture Book, HubSpot maintains its Culture Code, and the Ritz-Carlton carries its Gold Standards. The format matters less than the fact that an employee can hold the obligation in their hands and point to it.

Documentation also does something quieter. It makes a commitment auditable, which means a decision that contradicts the commitment shows up as a contradiction rather than passing as a trade off. Most organizations do not need more conviction. They need fewer places to hide a shortcut.

Accountability concentrated in one team is a design flaw

In many companies accountability for customer outcomes is relegated to a small group of employees in customer care, customer experience or customer success roles. Those colleagues carry the weight of customer centricity for an entire organization, and some of them do it remarkably well. That is the condition the sixth move dissolves, because concentrated accountability caps the result at whatever a few people can personally absorb.

Cascading customer excellence promotes knowledge diffusion, so that how customers are treated becomes a shared endeavor rather than one team's remit. In practice that means the market access colleague, the medical liaison and the contact center representative all read the same obligation and recognize their own part in it. The work is less about training volume and more about removing the assumption that somebody else is handling the seam.

Diffusion also protects a company when a dedicated team is reorganized or reduced. A capability held in one place can be removed in a single decision.

No single layer of DNA holds on its own

Leadership DNA determines whether the commitment survives contact with a quarterly target. Organizational DNA determines who owns the seams. Operational DNA determines whether helpfulness is repeatable without an exceptional colleague. Commercial DNA determines whether measures, incentives and investment decisions reward realized value rather than declared intent.

No one of the four holds on its own, and the second is the one most often skipped. A company can appoint a credible leader, rebuild a process and still watch the outcome fall into a seam nobody owns. The organizational layer is what converts a stated intention into an assigned one.

Sequence matters less than coverage. A company that works on all four layers at a modest pace tends to outperform one that perfects a single layer and leaves the rest to goodwill. The seams are where that choice gets tested, which is why the organizational layer deserves more patience than it usually receives.

Key Takeaways

Pharmaceutical commercial organizations are often strongest at the center of each function and weakest at the joins between them.
Customer failures tend to cluster in the seams no organization chart describes, which makes them a design problem rather than a performance problem.
Heroics from a small customer facing team subsidize promises the routine process cannot keep, and the cost is rarely recorded anywhere.
Shared accountability can be installed through mental models, outside perspective, codified principles, documentation and diffusion rather than through a new function.
Organizational DNA is the layer that decides who owns the seams, and it holds only alongside leadership, operational and commercial DNA.

Diagnostic Questions to Consider

Name the single accountable owner for benefit verification, prior authorization and first fill, and note whether that owner exists.
Identify the customer promises your organization keeps only because specific individuals go beyond their role to keep them.
Describe the experiential standards your company has chosen as its basis of competition, in language a colleague could act on tomorrow.
List the outside organizations your commercial leaders learn from, and count how many of them sell medicines.
Assess whether a decision that contradicts your customer principles would be visible as a contradiction or absorbed as a trade off.

Closing Reflection

The soft factors are the ones most often postponed, because they resist a business case and they rarely arrive with a vendor attached. They also tend to outlast the things that do. A company can reorganize twice and reinstall its technology stack and still treat customers exactly as it did before, because the mental models underneath were never examined.

Shared accountability asks something uncomfortable of senior commercial leaders. It asks them to stop congratulating the people who rescue the seams and to start asking why the seams needed rescuing at all. The first instinct is to reward the heroics, which is generous and which quietly guarantees that the design never changes.

Organizational DNA is slow work, and it is the layer that makes everything downstream possible. Once accountability is genuinely shared, an operating model can be rebuilt without needing an exceptional person in every role. That is what a company structurally predisposed to help looks like from the inside.

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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