Winners Believe in the Field
Organizations rarely abandon an asset outright. They reclassify it, and the reclassification quietly does the work nobody wanted to argue for in the open. In pharma that reclassification is happening now to the field organization, with a plausible rationale attached.
The conclusion many companies are drawing is that the field is a legacy asset to be managed down. I have come to the opposite conclusion, and the title of this note is a claim I am prepared to defend. The field is pharma's most expensive channel and also its most brand-defining one, and the companies that win will reassert it rather than reduce it.
The case for managing the field down is rational
That case deserves respect, because most of its premises are true. Access to prescribers has tightened, and Veeva Pulse found that 45% of HCPs are accessible to biopharma, down from 60% eighteen months earlier. Digital and AI channels reach more prescribers at a fraction of the cost of a human conversation. On a cost per interaction basis the comparison rarely flatters the field.
Where the reasoning breaks is in the question it answers. It ranks channels on the cost of moving a message, and any system that only talks can be replaced by a cheaper system that talks. The chosen dimension is the error, not the verdict it produces.
What the field collects cannot be bought
Brand teams nominally own the brand end to end, yet their instruments sit almost entirely in the Path to Prescribe. Prescribing data, market research, message testing, share tracking and promotional response are powerful instruments, and they are also indirect, sampled and lagged. None of them explains why a practice stopped starting new patients three weeks ago.
Field intelligence has a different character altogether. It is observed rather than recalled, account specific rather than sampled, current rather than lagged, and already attached to the moment progression broke. That makes it the most unimpeachable and actionable intelligence a commercial organization has, and the one asset a competitor cannot acquire, because platforms and models can be licensed while earned clinical trust cannot.
The commercial consequence of that trust is measurable. Bain found that about 40% of a doctor's drug recommendations relate to overall experience with a company, and that doctors who rate a company highly are 2.3 to 2.7 times more likely to prescribe its products. Deloitte found that 82% of life sciences executives are satisfied with their customer engagement strategies while only 28% of HCPs say those strategies meet their needs, and that distance is where field force effectiveness is actually decided.
Belief begins with what leaders put on the agenda
Belief in the field is tested by allocation rather than by language, and leaders are read by what they schedule. In my book I argued that nothing signals leadership priority more plainly than making the customer agenda part of business reviews and board meetings. Translated into pharma, the experience of the customer and of the customer-facing colleague belongs in the monthly business review beside share and volume, rather than in an annual engagement survey.
An engagement survey asks colleagues how they feel about the company. A business review asks the organization what it intends to do about what those colleagues have seen. The second builds customer consciousness, the degree to which customer reality is present in decisions before they are made. Leadership DNA is the layer where that difference is either settled or left to drift.
Permission is the difference between seeing and acting
The second condition is institutional permission, granted so colleagues can uphold a brand promise rather than apologize for it. Field colleagues often see what is failing a patient long before any dashboard registers it. They see the prior authorization that will not clear, and the American Medical Association reports that 82% of physicians say prior authorization at least sometimes leads patients to abandon treatment.
Seeing it changes nothing when no sanctioned route exists to act on it. A colleague who raises a barrier and watches it vanish into a mailbox learns, correctly, that raising barriers is not part of the job. Permission is not a cultural gesture, and it is a policy position about what a colleague may decide without looking over a shoulder.
Signal needs somewhere to go
Permission without a route produces frustration rather than progress. The frontline is one of pharma's most underutilized intelligence systems, encountering barriers long before dashboards detect them, which is why voice of the frontline listening belongs in the operating model rather than in a research plan. Most commercial models carry no closed loop that moves an observation from a conversation into a decision and back out as a measured effect.
FieldOS is the operating blueprint that closes that loop, and the loop runs through six stages. Those stages are Capture Signal, Classify Barrier, Assign Owner, Intervene, Measure Progression, Learn and Improve. AI sits at the center supporting every stage rather than occupying one of its own. The diagnostic inside it is the Transfer Coefficient, the proportion of meaningful frontline intelligence that survives the journey from customer observation to consequential organizational action and measured effect.
Progression is the measure of what the field changed
A loop nobody measures becomes an initiative, and initiatives are abandoned in the second budget cycle. Activity measures tell an organization that the field was busy last quarter. Progression measures tell it whether a patient moved, which is the only question the science ever asked.
The stage ladder is deliberately plain. It runs Scripts Written, Filled, Therapy Started, 90-Day, Persistence, organized under the Path to Prescribe, the Path to Fulfill and the Path to Adhere. Measured that way a field organization can show where earned value stops becoming realized value, and the Realization Rate holds the commercial system accountable for the difference.
AI made the field more valuable than ever
The contrarian turn in this argument is that AI strengthens the case for the field rather than dissolving it. AI did not replace the field organization, it made it more valuable than ever. The tenet underneath that claim is uncomfortable for anyone selling a platform as a strategy, because AI will not make a fragmented commercial model customer-centric, it makes whatever operating system exists faster and more scalable.
Most field AI in pharma today is a talking tool. Next best action, message refinement, call preparation and targeting make an organization better at speaking, and a field organization given better talking tools simply talks better. A field organization given a listening system changes outcomes instead. Years ago I told CXM, while building a field experience measure, that "Doctors don't go around asking about loyalty." The listening has to be designed, which is the whole difference between better listening and better pre-call planning.
Heroics are a subsidy worth refusing
There is a cost in all of this that rarely appears in a commercial plan. Field colleagues absorb the failures of a system that was never designed to carry what it promises, working around a missing handoff, chasing a benefits investigation, holding a relationship together across a gap nobody above them can see. Leadership sees the resolution and largely never sees the effort that produced it.
Heroics are a subsidy. The organization books the outcome while the colleague pays for it in discretionary effort, and the subsidy stays invisible precisely because it works. Predisposition means a company is structurally and systematically predisposed to deliver exceptional experiences, which is the opposite of excellence manufactured through frontline heroics.
Believing in the field means declining to keep collecting that subsidy. In practice that means prioritization in the forums where resources move, permission a colleague can act on, a route for what they see, and a measure of what they changed. Those four conditions turn the most expensive channel into the most defensible one.
Key Takeaways
- The field is pharma's most expensive channel and its most brand-defining one, which argues for reassertion rather than reduction.
- Field intelligence is observed rather than recalled, account specific rather than sampled, current rather than lagged, and attached to the moment progression broke.
- Belief in the field means prioritization, permission, a route for signal and a measure of progression rather than language about how much the field matters.
- AI applied to talking makes a field organization a better talker, while AI applied to listening changes where value leaks.
- Heroics are a subsidy that leadership collects without seeing it, and refusing it is what structural belief in the field looks like.
Diagnostic Questions to Consider
- Name the forum where field intelligence changed a resource decision last quarter, and name who owned the outcome.
- Describe what a colleague may decide on a patient's behalf without approval from two levels above them.
- Trace the last ten barriers raised by field colleagues through to an owner, an intervention and a measured effect.
- Separate the AI investments in the commercial plan that help the field speak from those that help the organization listen.
- State the proportion of field performance reported as activity rather than as progression along the stage ladder.
Closing Reflection
The field has been judged for years on a question it was never the right instrument to answer. Asked how cheaply a message can be delivered, it compares poorly against a channel that costs almost nothing to run. Asked what is stopping a patient from starting therapy in a specific practice this week, it has no rival in the commercial system.
That reframe is less about conviction than about instrumentation. A field organization without a loop is an expense that leaders will eventually rationalize. A field organization inside a loop is an intelligence capability that compounds, and no competitor can buy its way into one.
Exceptional science deserves an exceptional commercial system, and the field is where that system keeps its promises or quietly fails to. Winners believe in the field because they have done the arithmetic, not because they are sentimental about it. The belief shows up in agendas, permissions, loops and measures, which is the only form of belief an organization can act on.
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.
