[PRACTICE NOTE] Dr. Roswell and Her Other Life: Resetting Pharma's Experiential Benchmark
Institutions rarely choose their own benchmark. They inherit it from whoever sits closest to them, which is usually a competitor who shares the same constraints, the same vocabulary and the same explanations for why certain things take as long as they do. In pharma that habit produces an internal standard that can look respectable from the inside and unremarkable from the outside. The customer, meanwhile, has been running an entirely different comparison.
Institutions tend to measure themselves against their nearest neighbours
Pharma benchmarks its customer experience against pharma. The physician does not. The standard she applies when a manufacturer's portal asks her to re-enter a patient's insurance details for the third time was set by an industry that has never heard of her therapeutic area. Most of the surprise in this work lives in the distance between those two benchmarks.
The internal comparison is honest, and it is the only one an organization can easily instrument. A company can improve on share of voice, reach, recall and portal adoption while losing ground against the standard the physician is actually holding.
Dr. Roswell is a composite rather than a real physician
Dr. Roswell is a composite. She is not a client, not a research subject and not a disguised version of anyone in particular. She carries patterns I have seen repeat across field debriefs, access escalations and customer research inside large commercial organizations, and she carries none of the identifying detail of any one of them. Building her as a composite is deliberate, because the argument here is structural rather than anecdotal.
A single physician's frustration can be set aside as an outlier, and often is. A pattern assembled from many of them behaves differently, because it points at the system that produced it. Her specialty matters less than her situation, which is a chronic condition with a converging clinical landscape and four manufacturers competing for the same patient. What matters most about her is the second life she returns to when the clinic closes.
The twenty three hours when she is not a prescriber
She spends a fraction of her day acting as a prescriber. The remaining twenty three hours she spends as a consumer, and in those hours she is indistinguishable from anyone else buying groceries, applying for a mortgage or working through one of the many other jobs that daily life requires. Companies in that part of her world have spent years removing effort from her path, often without her noticing the removal. None of them asked her to be patient with them while they worked it out.
Those companies set her reference point without intending to. Customer experience outliers of that kind reset the standards of business regardless of industry, and they do it continuously rather than in campaigns. She is not consciously weighing a manufacturer against a retailer, which is precisely why the comparison is so difficult to argue with.
Expectations do not reset at the clinic door
In the book I argued that elevated standards travel with the customer rather than with the category. Whether the task is applying for a mortgage, grocery shopping or any of the myriad other jobs that must be accomplished in daily life, people now expect and anticipate a similar level of convenience across all of their interactions. Expectations are largely not category specific, because the person carrying them is one person. She keeps no separate and lower standard in reserve for regulated industries.
The regulated nature of her professional interactions may explain why certain steps take time, and it deserves respect as a real constraint. It rarely explains why the same information must be supplied three times, or why nobody can tell her where a request currently sits. Regulation governs what can be said and what must be recorded. Design governs how much of the resulting burden lands on her desk.
Positivity bias turns four manufacturers into one impression
Positivity bias is the tendency for people to lump competing options together into a generic and overly optimistic category of sameness. Under its influence customers often cannot meaningfully separate their perceptions and sentiments about one company from the next. They are left with the impression that all the companies involved in a decision must be generally positive and generally the same. That effect marginalizes, homogenizes and commoditizes value propositions.
For a commercial organization the sting is practical rather than academic. In a category where clinical profiles converge, Dr. Roswell's inability to tell four manufacturers apart is a competitive outcome rather than a perception problem. The experiential layer is often the only remaining place where that impression can be broken, which is why experience as the third leg of the value proposition stops being a philosophical point and becomes a commercial one.
What her other life has taught her to expect
What her other life has taught her to expect can be written down with some precision. The Consumer-Grade Specification holds six structural conditions, namely Recognition, Anticipation, Coherence, Effort, Resolution and Visibility. Felt attributes such as easy, simple and fast are reported outcomes that decompose into those six conditions. Thresholds belong to each organization, so the specification describes the shape of the standard rather than the number attached to it.
Recognition means the system knows who she is and what has already passed between them. In her other life a retailer remembers her address, her last order and the fact that the previous delivery went wrong. In her working day she introduces herself again to each function she touches, because her history sits in systems that were never built to speak to one another. Each reintroduction is small on its own and expensive in aggregate.
Anticipation means the next step arrives before she has to ask for it. A benefit verification that predictably requires three documents still asks her for one, waits, then asks for the second. The pattern is known to everyone inside the process and visible to nobody at the point where she stands.
Coherence means the answer holds across channels and across people. She may hear one thing from a field colleague, another from a support line and a third from a status page, each of them accurate within its own frame. Coherence tends to break where accountability divides rather than where competence fails.
Effort means the volume of work the system transfers to her in order to complete its own process. Her other life has taught her that low effort signals respect rather than mere convenience. Every form, every call back and every re-keyed field is effort she absorbs on behalf of a patient who is waiting. Accumulated effort of that kind becomes experiential friction, and accumulated friction becomes commercial drag.
Resolution means something actually ends. A request that is acknowledged, routed and then quietly left open consumes more of her trust than an outright refusal would, because a refusal at least closes the loop. In her consumer life a case number implies an owner and a conclusion. In her working day it may imply only that the request has been recorded somewhere.
Visibility means she can see where things stand without asking anyone. Without that view she manufactures visibility herself through follow up calls, chased messages and staff time she does not have. Lack of visibility is one of the quieter hurdles inside the commercial drag she carries through the week.
Nobody designed the composite of her working day
Everyone she deals with is competent. The field colleague knows the therapeutic area, the support agent knows the benefit design, the medical information specialist knows the data and the brand team knows the market. Nobody designed the composite of their work, which is the only thing Dr. Roswell ever actually experiences.
The gap is a design gap rather than a character gap, and that distinction carries most of the diagnostic weight here. Her working day is assembled from parts that were each optimized in isolation, by functions that were measured in isolation, against targets that were set in isolation. Experience was left to default while brand and product were deliberately designed. The default is what she meets, which makes customer experience in pharma a question of composition rather than of attitude.
The asymmetry between her account and the industry's confidence
The most useful reading of this gap comes from the distance between what customers report and what their suppliers believe. Deloitte found that only 28 percent of HCPs believe pharma's engagement strategies meet their needs, while 82 percent of life sciences executives say they are satisfied with those same strategies. Both groups may be answering honestly about genuinely different things. Executives are describing the strategy as designed, and physicians are describing the composite as delivered.
An asymmetry of that size is rarely a measurement artifact. It tends to indicate that the instruments inside the commercial system report on activity rather than on progression. What an organization chooses to measure about customer experience governs most of what it is able to see.
Where the work sits inside the commercial system
Work of this kind rarely belongs to a campaign or to a single function. It sits with Customer Excellence as the fourth domain of commercial excellence, alongside launch excellence, marketing excellence and sales excellence. The fourth governs whether earned value survives the journey from a clinical decision to a patient on therapy.
In practice that means designing against the six conditions across the Path to Prescribe, the Path to Fulfill and the Path to Adhere rather than inside any one of them. It means treating her effort as an economic variable with a Realization Rate attached rather than as a service complaint to be absorbed. Consumer-Grade Pharma is a capability to be designed in rather than a conviction to be held. Companies that become structurally predisposed to deliver it stop relying on individual heroics to hold the experience together.
None of this asks an organization to abandon what it already does well. It asks that HCP engagement strategy be judged against the standard the physician brought with her rather than the one the category has grown used to. Her other life is already the benchmark, whether or not anyone inside the building has agreed to it.
Key Takeaways
- Pharma benchmarks its customer experience against pharma, while the physician benchmarks it against every company that has ever removed effort from her path.
- Expectations travel with the person rather than with the category, so they do not reset at the clinic door.
- Positivity bias leaves customers unable to separate one company from the next, which marginalizes, homogenizes and commoditizes otherwise distinct value propositions.
- The Consumer-Grade Specification holds six conditions, namely Recognition, Anticipation, Coherence, Effort, Resolution and Visibility, and each one takes a concrete form in a working clinical day.
- The gap she experiences is a design gap, because competent people are each doing good work inside scopes that nobody ever composed.
- Experiential friction accumulates into commercial drag, which makes her effort an economic variable rather than a service complaint.
Diagnostic Questions to Consider
- Name the benchmark your organization actually uses when it judges its own physician experience, and say whether any company outside pharma appears in it.
- Count how many times a single physician supplies the same information to your organization across one complete access request.
- Identify who owns the composite of a physician's working day with you, as distinct from who owns each separate part of it.
- State which of the six conditions your current measurement can report on today, and which of them it cannot see at all.
- Explain what would have to change if physician effort were treated as an economic variable with a Realization Rate attached to it.
Closing Reflection
Dr. Roswell will probably never file a complaint. She will route the next patient toward whichever path costs her the least, and from the outside the decision will look entirely clinical. That is the quiet form competitive loss takes in a converging category, and it rarely announces itself anywhere a dashboard would pick it up.
The composite she experiences can be designed, which is the more hopeful half of the diagnosis. Her other life proves the six conditions are achievable, because they were achieved by companies operating under serious constraints of their own. Pharma's constraints are real, and they govern less of her experience than most organizations assume. What remains is a design question, and design questions can be given owners.
I have come to read the distance between her two lives as the most honest measure available of how much work the commercial system is doing for the science it carries. Closing that distance does not require a new conviction about customers, because the conviction has been there all along. It requires someone to own the composite, and a standard specific enough to build against.
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.
