July 29, 2025 • 37 mins
In this episode, Tom Caravela, Sonika Garcia, and Suzi Fraze explore the intersection of medical anthropology and medical affairs. They discuss cultural competence versus cultural fluency, highlighting the impact of cultural contexts on scientific outcomes and communication. Through case studies, they examine cultural influences on medical decision-making and the risks of ignoring these aspects. The episode underscores the role of Medical Science Liaisons (MSLs) in recognizing cultural nuances and the need for emotional intelligence and cultural training. They also discuss frameworks for behavioral change and the importance of diverse patient perspectives.
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Episode Transcript
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(00:01):
Hey, guys.
Welcome to the podcast.
So excited.
This is a topic I have not ventured.
Actually, I didn't even know what this was.
So my buddy, Susie Fraes, who was in our AspireMSL program, who's just become a dear friend,
approached me about this topic, and I was like,medical anthropology sounds great.
(00:22):
Don't know what it is.
So this episode is called culture, context, andcare, the role of medical anthropology in
medical affairs.
And I have Susie with me, and I have SunikaGarcia.
Guys, I'm gonna let you introduce yourselves.
Sometimes I do the intros.
I'm gonna let you guys introduce yourselves.
So, Sunika, why don't you go first?
(00:43):
Sure.
Thanks, Tom.
So excited to be here.
So I'm Sunika Garcia.
I work for Havas Health, specifically in themedical anthropology department.
So my background is in public health andbehavioral science.
All that really means I'm interested in what Ido on a day to day basis is to understand why
human beings do what they do.
And I say human beings because I don'tnecessarily mean only doctors and patients.
(01:05):
Just stripping all that away, the human.
I look at the way that culture, symbolism, allof that really affects the way that we think
and make decisions.
So, yeah, I'm excited to get into thisconversation.
Awesome.
Awesome.
Susie.
I'm so also excited to be here, and I also workfor Havas.
I am in the medical affairs area, currently amedical writer, and I listened to a medical
(01:31):
anthropology presentation here at Havas becauseI had never heard of medical anthropology
either, and it excited me.
It got my wheels spinning.
And, ultimately, I think that this is thefuture of medical affairs.
Awesome.
I can't wait to share this with you.
But before we do, I do have to remind you guysto sign up for Fierce Pharma Week, which is
(01:54):
happening.
It's coming up quick, so definitely register.
It's coming up September, and that's at thePhiladelphia Convention Center or the
Pennsylvania Conventional Center in Philly.
And it is it previously Mass East.
It's a much bigger event now because it alsoincludes, PR communications, pharma marketing,
(02:15):
business development, and licensing.
And when you go register, put in the code m s ltalk, t a l k, no spaces, and you'll get 25%
off registration.
So you just go to Fierce Pharma Week.
It'll take you to the Fierce Pharma site,register, and I'll be there.
(02:35):
It's gonna be awesome, and I look forward toseeing you guys.
So let's jump into this.
First question's gonna be an obvious one, and,hopefully, like, I'm gonna be, like, the number
one person interested in hearing the answerbecause I don't really know what this is.
But what is medical anthropology, and how doesit intersect with the goals of medical affairs?
Yeah.
I can take that.
(02:56):
So medical anthropology is a discipline withinthe larger discipline of behavioral science or
social science if, you know, if anyone's morefamiliar with those term that terminology.
But it's really the study of how people makesense of health, illness, care across various
cultures, various contexts.
For medical affairs, I mean, I look at it as asecret weapon to medical affairs and and doing
(03:22):
medical affairs right.
So it helps us really move beyond, clinicaldata to understand how patients actually live,
how doctors actually make decisions, emphasison the word actually, and how science becomes
action or how science doesn't become action.
Got
it.
(03:42):
I would just add a little bit.
Sunika absolutely said everything that I wouldhave said in addition.
So medical affairs, you know, we are all aboutunderstanding patient and provider
perspectives, improving their health outcomes,and communicating science in a way that really
resonates.
So medical anthropology adds that depth byhelping teams see beyond the clinical data into
(04:05):
real world behaviors, cultural barriers, andhealth equity issues.
I get it.
I love it.
I'm learning.
I'm learning things.
I hope you guys are too.
Alright.
So, Sunika, what's the difference betweencultural competence and cultural fluency, and
why does it matter in medical affairs?
Yeah.
(04:25):
It's such a great point.
I mean, I'm I'm sure a lot of the listenersit's such a great question.
I'm sure a lot of the listeners have heard ofcultural competency.
Many businesses do cultural competencytraining, hospital systems.
But there is a very important distinction, andI think it's some that, you know, people
haven't really thought of in that way.
So cultural competency is really about knowingthe basics of the culture that's impacting
(04:48):
decision making.
So fluency is is about speaking the language.
And I don't mean the language, like, the actuallanguage that someone's speaking, but the
language of culture.
So it's a difference between I'm checking a boxand I'm truly connecting with someone.
I think when we think about medical affairs,fluency lets us engage with that nuance.
(05:10):
It helps us build trust faster, and it reallyavoids missteps, that even the best data can't
fix.
We can have the best data.
We can communicate that data.
But if it's not with cultural fluency in mind,you're not gonna change behavior.
So then why is understanding cultural contextcritical for translating science into
(05:34):
meaningful behavioral outcomes?
Yeah.
I mean, I think, right, like, again, companiesput billions of dollars behind these,
treatments, research.
We have the data, but we get frustrated whendata isn't actually changing behavior.
It's not changing prescribing patterns.
It's not getting a patient to take treatment.
(05:55):
And that's because science doesn't live in avacuum.
I mean, nothing really lives in a vacuum.
Right?
So it lives within the beliefs, the fears, theroutines, the self identity of people, without
thinking about cultural context and, like,executing it through cultural cultural fluency.
We're honestly just broadcasting.
(06:17):
You know?
We're, we're not making that meaningfulconnection.
However, with cultural context, we'retranslating that really important science into
action that actually sticks and an emphasis onactually sticks because this is about long term
behavior change too.
I'm sure you can get a doctor to write yourmedication for the next five patients, but if
(06:40):
they're not doing it long term, it reallydoesn't matter.
Yeah.
Mhmm.
So yeah.
Yeah.
Wanna talk about, like, culture in practice.
So, Susie, I wanna hear from you.
So how can understanding cultural beliefs andbehaviors impact the way we approach scientific
(07:01):
communication or education?
Well, understanding cultural beliefs andbehaviors can be a total game changer in how we
communicate science or educate our patients andproviders.
And this is because culture really shapes howpeople interpret their symptoms, how they trust
the health care system, how they make decisionsabout their care.
(07:22):
And if you ignore these beliefs, as Sunikasaid, you can have the best data.
Even the most evidence based messages can fallflat or be misunderstood.
And so with KOLs, this anthropology reminds usthat they're not just scientific authorities,
but they're also cultural brokers.
So we need to understand how they operatewithin the networks of influence.
(07:43):
They carry reputational risk, and they havestrong values that are tied to patient care.
And if you understand those layers, it reallyhelps you build trust and see it.
It can show that you are thoughtful and alignedpartner, not just another MSL with a slide
deck.
Awesome.
It it's so true.
I I I think what's really interesting, and I Ialways go back to this, but we need to not take
(08:08):
the approach of here's what we want to say, butwe need to think about here's what they need to
hear.
But, you know, really putting the person on theother end of the communication at the center.
And I don't mean that you know, like, ofcourse, we you know, pharma companies, they
they do.
They try to, but it's always what's importantabout our treatment that we need to say.
(08:29):
But shifting that a bit can really make, adifference just layering on to what Susie just
explained.
Awesome.
Sunika, let me ask you.
I'm curious.
Can you share, like, a real world I'd like tohear some real world examples
Mhmm.
Of where cultural context influence a medicaldecision or maybe even a patient outcome.
(08:54):
Yeah.
Man, so, I mean, culture is such a it's such abroad word.
It encompasses so much.
And so before I get into the example, I wannasay that when we talk about culture, we're not
just talking about, you know, rituals andlanguage and things within a certain, religious
group or, you know, racial group.
(09:15):
That it's that is part of it, demographics,geography, but it's also the culture of
medicine and how that differs.
So we think about doctors.
Like, there's a difference between the cultureof oncology versus the culture of dermatology.
So I just wanna expand everyone's thinking aswe're listening to this and what we mean by
culture.
I mean, let's take insulin, for example.
(09:36):
I'm working on GLP one brand.
We were you know, we hear a lot about GLP one.
So in some communities, insulin is seen as, youknow, it's in medication.
It's treatment.
It's gonna help you get your diabetes undercontrol.
But in other communities, insulin is not seenas a treatment.
It's seen as a failure.
And so uptake is delayed even when it'smedically necessary.
(09:57):
You know, why aren't you taking your insulin?
And and if I feel like I failed and that'swhat's being reiterated to me and that's the
what ex that's the mindset that exists in theculture that I live in, it's going to deter
it's gonna actually deter adherence.
I don't even wanna think about it.
I don't wanna approach it.
It's going to be a barrier.
(10:20):
In in certain countries, I mean, Japan, forexample, they do a great job at really
integrating so we think about oncologytreatment.
Right?
I mean, it's it's very, diverse.
There's a lot to it.
Certain, certain clinics in Japan integrate,respect based rituals into cancer care.
(10:41):
I was just reading about this.
And by by doing that, adherence goes up.
The way that people view their cancer carechanges.
So little things, bowing gestures are used bydoctors, implementation of shared spaces, the
understanding, and this is really, across a lotof cultures, especially in Asia, understanding
that family is very much an extension of theperson when it comes to things like consent and
(11:05):
decision making and how you approach you know,in The US, it's a bit different.
Right?
With HIPAA and the way that you approach thepatient versus their family, it's different.
In other areas of the con of the world, Consentis very much not just the patient, but their
entire village, their entire community.
I mean, village from a community standpoint.
Mhmm.
So you think about little things like that.
(11:25):
Another, my last example, again, because I Ithink this one is really important.
When you think about food and and cholesterol,we're working on an LDL brand, and it was so
interesting because what food symbolizes in TheUS, we look at food as a risk factor.
So, you know, manage what you eat because, yourcholesterol could go up, things like that.
In other countries, for cholesterol awareness,they stay away from framing food as a risk
(11:49):
factor.
Instead, they honor that food symbolizes thingslike togetherness and harmony and everything
that's good in the world.
And so, you know, you don't want to frame upmessages in the way to make food the enemy.
Little things like that.
I know I'm getting a bit into communicationtoo, but there's it's it's so much.
There's there's so many ways that culture needsto be considered when we're messaging and we're
(12:10):
talking about, different disease states.
Yeah.
So I'll I'll stop talking.
No.
That's helpful because it it gives us, youknow, real examples.
Like, I kinda, you know, started to kindaunderstand what this is, but now that you put
that into, you know, real world examples, it'sit's a little easier to kinda conceptualize.
(12:34):
But now that makes me think what's the risk ofnot considering culture and context in medical
affairs work, especially as we look, you know,globally.
Yeah.
I mean, man, the risk is so significant.
You risk being, irrelevant.
You risk resistance.
Resistance.
(12:55):
I think worst of all, you risk being clinicallyright but behaviorally invisible.
If someone is not resonating with your messageor culturally, it's completely fallen off, it's
not the way that people interpret certainsymbols or behaviors.
You're you're you're losing the person beforethey're even able to finish reading your entire
(13:18):
message.
In a global setting, that means wastedresources, missed trust, missed impact.
You you really can't, even the best data can'tfix a message that's not resonating.
So, I mean, I think you risk a lot.
Absolutely.
And I think this isn't just respectful.
This is about being effective in yourcommunication.
(13:39):
And these cultural missteps can actually tankengagement.
It can delay uptake.
As we've already said, the best data is gonnaland on deaf ears if you're not approaching it
from a place of true human understanding.
And, ultimately, it damages long termpartnerships.
And that's what meta metafares is about.
It's about creating these real partnershipswith HCPs, with these KOLs, with a goal of
(14:05):
ultimately improving patient lives.
But in order to improve patient lives, we needto engage on a level in which they understand,
that they feel respected, that their culturalnuances are and their assumptions are either
validated or challenged, but they need toactually, be able to be in a place where they
can accept the information that you're givingthem.
(14:27):
Awesome.
And, you know, that makes me think as you saythat, it makes me think about the KOL community
and KOL engagement.
So I'm curious.
How can medical anthropology insights improvestakeholder engagement, particularly with, you
know, not just HCPs, but also patients?
(14:49):
Yeah.
Well and I know a lot of my answers have beenmore patient focused, but it it it it's very
important for both audiences.
So I think what it really what medicalanthropology really brings is it helps MSLs
move beyond the clinical script into the theworld of real human context.
It's not you know, think about a doctor.
It's not just what a doctor believes abouttreatment, but it's why they believe it.
(15:13):
How is the culture of their patient population,clinical restraints.
Right?
I mean, yes, it's a culture of patients, butit's also the culture of the world that the
doctor is living in.
They live in their own little world, you know,in their practice setting, regional, norms that
influence that belief.
So for I'm gonna group I'm gonna talk aboutpatients and doctors together.
(15:34):
What anthropology asks is what's reallyhappening beneath the surface.
Really, from a cognitive mindset standpoint,that's where the real engagement lives.
So we we need to not work on educating ourstakeholders.
We forget that it's our job first to understandtheir lived realities.
(15:54):
So stigmas, cultural values, for patients, forHCPs.
I mean, again, I I mentioned, like, contextwithin their practice, but workflow friction
and institutional culture is huge.
And I I brought up how, you know, there's aculture of dermatology.
There's a culture of oncology.
Be these doctors you know, say you have adoctor who's in their fifties.
(16:15):
They've been practicing for thirty years.
These are entrenched ways of thinking.
They were they're they're anchored to frommedical school.
So it a message about why a treatment has thebest efficacy is simply not going to do the job
alone.
Agreed.
And while in medical affairs, most of ourengagement is with HCPs, ultimately, within
(16:39):
pharma and med affairs, there's a bigger andbigger drive to really be more patient centric
and also promoting patients as partners inshared decision making.
So in order to do that, we need to equip ourphysicians, our HCPs, with the right patient
education that appropriately is tailored totheir patient demographic.
(17:02):
And equipping these HCPs with tools that willhelp them understand context for these patients
that they're speaking to, It really helps themhave better communication, better
conversations.
It really helps the HCP understand theirpatient on a better level.
So in order for us to help HCPs facilitatethose communications, the meta affairs teams
(17:26):
need to really understand the barriers that ourHCPs have.
Yeah.
And to that point, and Susie, like, you know,curious what you think about this.
I mean, I think that we focus and do, like, HCPsegmentation, and we're trying to understand
our HCPs better.
I feel like we tend to rely on the same subsetof HCPs, so, like, the urban, academic, well
resourced, knowing that that's not the patientpopulation that they're seeing.
(17:49):
And so I think that and really bringing in thevoice of the community and community based
physicians, more rural providers, HCPs infederally qualified health clinics, you know,
things like that, really thinking beyond, okay.
Sure.
We we might be speaking to an HCP in anacademic setting.
However, thinking more zoomed out and largelyon who they're serving, we need to maybe talk
(18:13):
to other HCPs as well that we we don't alwaystake that approach.
Right.
Agreed.
It's it's it's so interesting having thisconversation with you guys because there's
there's a lot of focus and perspective from thepatient side.
I mean, we have a patient advocate and and anurse who who are both obviously very, very
smart and know so much about health care andand and medical affairs.
(18:37):
So this is a really interesting new perspectivefor me and, obviously, for my audience.
So I'm loving it.
So, Susie, how can medical affairs teams betterincorporate patient perspectives, especially
from, like, diverse populations?
(18:59):
So to really oh, sorry.
No.
Go ahead.
To really embed diverse patient perspectivesinto strategy, our medical affairs teams need
to go beyond the advisory boards and thesurveys.
They really need to listen differently, andthat's where the anthropology style thinking
really comes in.
So we tap into qualitative insights,ethnographic research, patient narratives,
(19:23):
community health workers, and even sociallistening.
And these sources really reveal the livedexperience and the culture and the systemic
barriers that exist within our health caresystem, and then partner with cross functional
teams to really translate these insights intoreal action and real change.
And that, you know, creates adaptingeducational content.
(19:45):
It can transform clinical trial design, and itcan really, shape field engagement.
Yeah.
I mean, I I you said cross functional teams,and and part of that cross functional team
needs to be the person who's who's on the endof of receiving the message.
So patients co create with the patients.
(20:06):
Don't just you know, yes.
Research is important.
Do the ethnography.
Do the, the interviews, but don't, rely on,like, you know, an academic expert or even
myself, a behavioral scientist, to then takethat research and analyze it and and make
decisions.
You know?
I should be making decisions with thecommunity, and and, yeah, cocreating with them.
(20:29):
That's really, really key.
Because, ultimately, we interpret thingsthrough our own lens.
We need to learn how to interpret thingsthrough patient lens, through HCP lens, because
we all come with our assumptions, and thatabsolutely impacts how we process interactions.
(20:49):
So to really become aware of your assumptionsand also the assumptions of our health care
providers and ultimately downstream theassumptions of our patients really helps create
tailored messaging, and the tailored messagingis what is going to move the needle for our
patients.
Yeah.
So
then I'm sure there's gaps.
(21:12):
So where do you guys see gaps in pharma andbiotech companies that are trying to address
cultural competencies and contextualunderstanding?
I mean, I could take a stab first.
I mean, I think, ultimately, we just conflateawareness with action.
(21:34):
So pharma checks the boxes with bias trainingor, you know, some sort of cultural competency
training.
And but we but we rarely build the culturalinsight into the core of the strategy, and it
goes back to my cocreating point.
So we need to move beyond the thought of weknow this population exists, and we need to
(21:56):
research them to we have designed this, andthis strategy supports the realities that they
face, whether it's how they define health andwellness, whom they trust, what influences
their decisions.
I mean, I think okay.
Listen.
We're headed in the right direction, but Ithink it's gonna involve a bit more of, like,
(22:17):
we know our target.
We're gonna understand them by the books, andthen we're gonna take that knowledge and create
for them.
We need to really embed ourselves a bit moreand thinking about even what are the symbols in
in which that that exists in their community.
What language are they using to explain, youknow, certain health concepts?
(22:38):
And so I I think it's just it's a bit more.
And, again, like, cultural competency trainingis happening, cultural fluency training,
cultural humility training, those things arenot happening, and I think that that's, that's
a big gap.
Agreed.
So there is a heavy reliance on the surfacelevel diversity metrics, but that doesn't
(23:01):
really dig into the deeper contextualunderstanding of what it is to just be human on
an individual level.
And the strategies get built on assumptions andnot true insights.
And as Sanika said, you know, there's lots oftrainings, and it but it feels like more of a
check the box kind of training where, you know,you maybe can have a conversation that is more
(23:24):
respectful, but are you really understandingthe key drivers of that relationship and things
that will really resonate with the personyou're speaking with.
And this does translate outside of meta affairsand pharma.
It really is the human to human component ofinteraction and how can we really make the
(23:46):
partnerships more effective.
And you are looking at the disconnect betweeninsights and how they're actually used.
And what about what about, like, tools?
Are there tools or frameworks that medicalaffairs teams can use to integrate some of
these philosophies into their clinicalstrategies, medical education, insights?
(24:10):
Yeah.
I mean, I think it's it's it's a lot.
It's we're we're talking about it, but we'renot expecting anyone to know, like, medical
affairs or on the pharma side to understand,you know, how to actually make any of this
happen.
But but consulting with and having programs,training programs, I actually just created a
(24:31):
training program for a company for their MSLs,to like, a behavioral science training.
Right?
Exactly what we're talking about.
Where where what tools can we give them?
What frameworks can we give them?
Medical affairs, MS they're busy.
They you know, we're not expecting you to reada a behavioral science book and and, like,
apply it.
But what are some quick, easy frameworks thatwe can give them to understand their doctors
(24:54):
better?
And so I think it's a multistep.
It's one, helping MSLs in a very digestibleway, and and medical care teams in a very
digestible way understand how do I even gatherthis insight.
Like, what do I do?
Where do I start?
I love thinking about populations from, like, arational, situational, emotional context.
(25:16):
I mean, it's just three easy, like, buckets.
And if you can even just do that, I thinkyou've made a lot of progress.
Helping them insight generate through thoseframe through, like, a framework like I just
mentioned.
And then once you have all this insight, okay.
What do I do with it?
I think there are really great behavior changeframeworks out there.
There are a lot.
I love specifically in the context of talkingin medical affairs.
(25:39):
I love, like, the BJ Fogg model, the CommBmodel.
They're they're easier to to grasp and reallyeffective when it comes to doctors.
So things like, does the doctor or the patienthave the capability, the opportunity, and the
motivation to even do what I'm asking them todo?
Because if one of those things doesn't exist,they're not gonna do it.
And so using all that insight and generating itthrough a behavior change model and I I know it
(26:04):
still might seem like a lot, but but truly,like, it is simplified enough where anyone can
do this, and it makes so much of a difference.
I'm talking to a doctor.
I now can understand that it's really the factthat they don't have time.
They have too much on their desk, and they theythey're in an inertia cycle where they're just
like, you know what?
I don't have time.
(26:24):
I have five minutes with each patient.
You're telling me to do something different?
No.
I'm just trying to survive.
If I'm having a conversation with the doctorand I can pick that up from them, then I
understand that is a institutional context thatis serving as a barrier.
If I'm hearing from my doctor that they'rereferencing maybe a past experience that didn't
go so well when they tried to do thingsdifferently, now I know that emotion's at play,
(26:47):
and that's a harder, barrier to to sort ofovercome.
So even allowing MSLs or helping MSLs pick upthings like this in conversations with doctors
is you're already taking you know, you'realready moving the needle so much.
And let's talk about MSLs, because that's themajority of our audience.
(27:08):
So I wanna I wanna get to, like, the MSL pieceof it.
So, Susie, how can medical science liaisonsplay a role in identifying some of the cultural
nuances when they're interacting with theirHCPs and KOLs?
Yeah.
So I I see MSLs as being in a really primeposition to understand these cultural nuances
(27:34):
because their interactions they're on the frontlines with these HCPs in the HCPs local
environment, so they can pick up on thosesubtle cues.
And I think there's an you know, the assumptionthat, well, they're just you know, they're in
clinical inertia.
You know?
What what they're doing is just easier to keepdoing.
But to really understand what is perpetuatingthat clinical inertia rather than just saying,
(27:58):
well, they don't wanna change because x.
Well, that's based on the MSL's assumption.
So dig into what are the perceived barriers ofeach individual HCP.
And, again, it comes down to tailoredmessaging.
You know, understand what is this HCP'sperceived barrier.
And then instead of coming at them with talkingabout a, b, c, what's more tailored to their
(28:21):
individual need is x, y, z, and now you knowthat.
So it really you understand what matters tothem.
You understand what barriers they are facing onan individual level and what what might be
challenging them to really, change theirclinical behavior.
It helps you ask the right questions.
It helps you, give them better answers.
(28:45):
You know, it really uncovers their priorities.
And sometimes these priorities are maybe evenassumptions that the HCP themselves don't even
know that they have until you ask them thequestion.
Say, okay.
You know, you seem like you really want to doyou know, you wanna keep doing this.
Can you tell me why?
And can you tell me why you know, what youwould need to hear to maybe have some changed
(29:07):
behavior?
So it really helps you enable the conversationwhere you can really extract the information
that you need to hear to help this HCP reallyunderstand assumptions.
And then that, like, that makes me think of,like, how should companies go about training
(29:28):
their medical affairs professionals and MSLteams on all of this that we're talking about?
Well, the great thing is, for the MSL role inparticular, having emotional intelligence is
really a key factor.
So I feel like a lot of hiring managers arealready trying to find people who are
(29:51):
emotionally intelligent because you can't justhave the science.
You have to have the people skills.
And medical anthropology gets down to the root,the base level of human on human reaction or
interaction.
So it you already have folks who are set up forthis, but to really help them challenge their
(30:13):
unconscious biases, help them really dig downinto the root behavior, the things that will
ultimately drive communication and drivebehavior change.
Yep.
Awesome.
Totally agree.
Cool.
Alright.
So let's let's see.
(30:33):
What time do we have?
Alright.
We still have some time.
I this is, like, one of those conversations Ithink we we we may have needed, like, a full
hour to talk about this because there's so muchto to kind of uncover.
But I'm like, exercising self control becauseI'm like, okay.
Do not go on and on.
But because there's so much to talk about.
(30:54):
And I I'm like, alright.
Let's keep it short.
But, yeah, I mean, there's there's so much tounpack.
And just to layer on to what Susie just said, Ithink when it comes to training, making sure
that you're delivering information in a verybite sized, digestible way.
If you need to do trainings in different parts,do it.
Because, like, you know, again, MSLs arehumans.
(31:16):
They're only able to digest, you know, certainnumber of information.
It's a lot, but they're not used to this kindof information necessarily.
So I would say in addition to everything Susiementioned, make sure that it's digestible in,
you know, separate trainings.
Got it.
And to kind of shift away from, okay.
I need to get through this deck.
I need to talk to this new KOL, and I need toget through this deck.
(31:38):
Maybe your first metric, the first thing thatyou do with engagement, the what success can
look like is understanding that HCP on theirindividual level, looking at them through their
own lens.
So understanding those assumptions,understanding where they are coming from, that
(32:00):
might be the best first step.
And and it's not even getting through yourdeck.
It's, you know, understanding this person on ahuman level.
Yep.
You know, and as we're as we're talking aboutMSLs, there's so there's always the topic of
insights and how important insights are.
(32:22):
So for MSLs and and field medical teams, howshould they take cultural insights and
communicate them back to the organization tohelp influence strategy, and and the future
kind of direction of the organization?
(32:43):
I mean, I think it's, it's really about lookingat this as less of an add on and more of, like,
an actual integrated strategic operating lens.
So okay.
So an MSL is is gathering insight, and thenthey have to share it back to to their
organization.
I mean, I think, keeping that conversation,that communication regular, and not you know,
(33:07):
once a year, we're having these conversations.
It needs to feel more embedded into the day today.
So that way, not only that it becomes more,like, second nature, but that everyone in the
organization is sort of speaking the samelanguage and understanding it to the same,
capacity.
Because I I don't I would you know, in thefuture, and I we're heading in that direction.
(33:30):
I would love to see behavioral science andmedical anthropology really, like, stepping
more into this integrated role where everyonehas this sort of department in their
organization because they see that importance.
Right?
It's not just about understanding culture anddelivering that insight back.
It's not designing through it.
And so for medical affairs, I think that meansa shift from, you know, as I mentioned before,
(33:54):
like, a scientific storyteller to reallytranslating the context in which someone is
existing.
And when you are delivering that thatinformation back to your organization, if the
organization is thinking this way too, then itit's it's received, more effectively.
People are able to know what to do with thatinformation.
A lot of times our biggest barrier is that wetalk about these things.
(34:16):
We deliver this information, and then peopleare like, well, I don't really know what to do
with it.
And I'm confused, and it's not talked aboutenough, and so I'm just gonna do nothing.
And it's totally understandable.
Like, that makes sense.
Right?
It's sort of like just, a bit of paralysis on Idon't know where to go from here.
I'm not expert.
So I think just embedding it in a way thatmakes it more digestible and understandable for
(34:36):
everyone in every role because I don't thinkthere's any role in a pharma organization, in
medical affairs organization that cannotbenefit from this way of thinking.
So, yeah, I think it's just investing in newtypes of insight gathering, the way that we're
communicating that insight gathering back toour organizations.
And, yeah, again, just just having this be moreembedded into overall strategy.
(34:59):
Got
it.
And I I actually see medical anthropology asthe missing piece in medical affairs right now.
You know, we strive for these relationships.
You know, that that's ultimately what we want.
We want these relationships.
And I truly think that teens that embracemedical anthropology will surpass.
(35:26):
I think they will create new metrics becauseright now, metrics are kind of a touchy subject
in MedAffairs.
You know, MedAffairs is constantly trying toprove their value.
And, you know, we know our value, but, youknow, it's not based on sales.
It's based on, you know, different, moresubjective metrics.
And for teams that are really creating thisdeeper connection with KOLs are going to see
(35:53):
the needle move, and those are going to reshapemetrics.
It's going to reshape how we interact withindividual HCPs.
And, ultimately, in an era that's defined bygenerative AI, the existing questions about
future work, medical anthropology can reallyreorient us, and it brings us back to what is
(36:14):
deeply and profoundly human.
And it brings that personal level back, andit's where meaningful change begins and where
better out patient outcomes can actually takeroot.
And I do believe that the teams that do notengage in medical anthropology will be left
behind compared to teams that do embracemedical anthropology.
(36:37):
Boom.
There it is right there, folks.
Awesome.
Well, thank you, guys.
That was awesome.
And medical anthropology, who knew?
Now I know.
I mean, it's amazing.
And real quick shout out.
So, guys, if you see me drinking out of thismug, and if you can't see it, if you're not
looking at YouTube, I have this mug, and itsays my name on one side, and it says published
(36:58):
author on the other.
And Susie gave me this after I launched mybook.
So thank you, Susie.
I use it every day.
I'm using it right now.
I love that.
It's a great book too.
Yeah.
Quick shout out.
If anybody's looking for a job and you haven'tbought my book, first of all, shame on you.
Second of all, job search mastery, how to winyour dream job.
Get it on Amazon.
Guys, Sunika, Susie, you guys were amazing.
(37:20):
This was such an awesome conversation, and, Ilearned a lot.
And I hope everybody else did too.
And if you did, share it with others.
And as always, appreciate your support of theshow.
Love you guys, and we'll see you next time.
Bye.
Thank you.
Thank you.
Hey, guys.
Welcome to the podcast.
So excited.
This is a topic I have not ventured.
Actually, I didn't even know what this was.
So my buddy, Susie Fraes, who was in our AspireMSL program, who's just become a dear friend,
approached me about this topic, and I was like,medical anthropology sounds great.
(00:22):
Don't know what it is.
So this episode is called culture, context, andcare, the role of medical anthropology in
medical affairs.
And I have Susie with me, and I have SunikaGarcia.
Guys, I'm gonna let you introduce yourselves.
Sometimes I do the intros.
I'm gonna let you guys introduce yourselves.
So, Sunika, why don't you go first?
(00:43):
Sure.
Thanks, Tom.
So excited to be here.
So I'm Sunika Garcia.
I work for Havas Health, specifically in themedical anthropology department.
So my background is in public health andbehavioral science.
All that really means I'm interested in what Ido on a day to day basis is to understand why
human beings do what they do.
And I say human beings because I don'tnecessarily mean only doctors and patients.
(01:05):
Just stripping all that away, the human.
I look at the way that culture, symbolism, allof that really affects the way that we think
and make decisions.
So, yeah, I'm excited to get into thisconversation.
Awesome.
Awesome.
Susie.
I'm so also excited to be here, and I also workfor Havas.
I am in the medical affairs area, currently amedical writer, and I listened to a medical
(01:31):
anthropology presentation here at Havas becauseI had never heard of medical anthropology
either, and it excited me.
It got my wheels spinning.
And, ultimately, I think that this is thefuture of medical affairs.
Awesome.
I can't wait to share this with you.
But before we do, I do have to remind you guysto sign up for Fierce Pharma Week, which is
(01:54):
happening.
It's coming up quick, so definitely register.
It's coming up September, and that's at thePhiladelphia Convention Center or the
Pennsylvania Conventional Center in Philly.
And it is it previously Mass East.
It's a much bigger event now because it alsoincludes, PR communications, pharma marketing,
(02:15):
business development, and licensing.
And when you go register, put in the code m s ltalk, t a l k, no spaces, and you'll get 25%
off registration.
So you just go to Fierce Pharma Week.
It'll take you to the Fierce Pharma site,register, and I'll be there.
(02:35):
It's gonna be awesome, and I look forward toseeing you guys.
So let's jump into this.
First question's gonna be an obvious one, and,hopefully, like, I'm gonna be, like, the number
one person interested in hearing the answerbecause I don't really know what this is.
But what is medical anthropology, and how doesit intersect with the goals of medical affairs?
Yeah.
I can take that.
(02:56):
So medical anthropology is a discipline withinthe larger discipline of behavioral science or
social science if, you know, if anyone's morefamiliar with those term that terminology.
But it's really the study of how people makesense of health, illness, care across various
cultures, various contexts.
For medical affairs, I mean, I look at it as asecret weapon to medical affairs and and doing
(03:22):
medical affairs right.
So it helps us really move beyond, clinicaldata to understand how patients actually live,
how doctors actually make decisions, emphasison the word actually, and how science becomes
action or how science doesn't become action.
Got
it.
(03:42):
I would just add a little bit.
Sunika absolutely said everything that I wouldhave said in addition.
So medical affairs, you know, we are all aboutunderstanding patient and provider
perspectives, improving their health outcomes,and communicating science in a way that really
resonates.
So medical anthropology adds that depth byhelping teams see beyond the clinical data into
(04:05):
real world behaviors, cultural barriers, andhealth equity issues.
I get it.
I love it.
I'm learning.
I'm learning things.
I hope you guys are too.
Alright.
So, Sunika, what's the difference betweencultural competence and cultural fluency, and
why does it matter in medical affairs?
Yeah.
(04:25):
It's such a great point.
I mean, I'm I'm sure a lot of the listenersit's such a great question.
I'm sure a lot of the listeners have heard ofcultural competency.
Many businesses do cultural competencytraining, hospital systems.
But there is a very important distinction, andI think it's some that, you know, people
haven't really thought of in that way.
So cultural competency is really about knowingthe basics of the culture that's impacting
(04:48):
decision making.
So fluency is is about speaking the language.
And I don't mean the language, like, the actuallanguage that someone's speaking, but the
language of culture.
So it's a difference between I'm checking a boxand I'm truly connecting with someone.
I think when we think about medical affairs,fluency lets us engage with that nuance.
(05:10):
It helps us build trust faster, and it reallyavoids missteps, that even the best data can't
fix.
We can have the best data.
We can communicate that data.
But if it's not with cultural fluency in mind,you're not gonna change behavior.
So then why is understanding cultural contextcritical for translating science into
(05:34):
meaningful behavioral outcomes?
Yeah.
I mean, I think, right, like, again, companiesput billions of dollars behind these,
treatments, research.
We have the data, but we get frustrated whendata isn't actually changing behavior.
It's not changing prescribing patterns.
It's not getting a patient to take treatment.
(05:55):
And that's because science doesn't live in avacuum.
I mean, nothing really lives in a vacuum.
Right?
So it lives within the beliefs, the fears, theroutines, the self identity of people, without
thinking about cultural context and, like,executing it through cultural cultural fluency.
We're honestly just broadcasting.
(06:17):
You know?
We're, we're not making that meaningfulconnection.
However, with cultural context, we'retranslating that really important science into
action that actually sticks and an emphasis onactually sticks because this is about long term
behavior change too.
I'm sure you can get a doctor to write yourmedication for the next five patients, but if
(06:40):
they're not doing it long term, it reallydoesn't matter.
Yeah.
Mhmm.
So yeah.
Yeah.
Wanna talk about, like, culture in practice.
So, Susie, I wanna hear from you.
So how can understanding cultural beliefs andbehaviors impact the way we approach scientific
(07:01):
communication or education?
Well, understanding cultural beliefs andbehaviors can be a total game changer in how we
communicate science or educate our patients andproviders.
And this is because culture really shapes howpeople interpret their symptoms, how they trust
the health care system, how they make decisionsabout their care.
(07:22):
And if you ignore these beliefs, as Sunikasaid, you can have the best data.
Even the most evidence based messages can fallflat or be misunderstood.
And so with KOLs, this anthropology reminds usthat they're not just scientific authorities,
but they're also cultural brokers.
So we need to understand how they operatewithin the networks of influence.
(07:43):
They carry reputational risk, and they havestrong values that are tied to patient care.
And if you understand those layers, it reallyhelps you build trust and see it.
It can show that you are thoughtful and alignedpartner, not just another MSL with a slide
deck.
Awesome.
It it's so true.
I I I think what's really interesting, and I Ialways go back to this, but we need to not take
(08:08):
the approach of here's what we want to say, butwe need to think about here's what they need to
hear.
But, you know, really putting the person on theother end of the communication at the center.
And I don't mean that you know, like, ofcourse, we you know, pharma companies, they
they do.
They try to, but it's always what's importantabout our treatment that we need to say.
(08:29):
But shifting that a bit can really make, adifference just layering on to what Susie just
explained.
Awesome.
Sunika, let me ask you.
I'm curious.
Can you share, like, a real world I'd like tohear some real world examples
Mhmm.
Of where cultural context influence a medicaldecision or maybe even a patient outcome.
(08:54):
Yeah.
Man, so, I mean, culture is such a it's such abroad word.
It encompasses so much.
And so before I get into the example, I wannasay that when we talk about culture, we're not
just talking about, you know, rituals andlanguage and things within a certain, religious
group or, you know, racial group.
(09:15):
That it's that is part of it, demographics,geography, but it's also the culture of
medicine and how that differs.
So we think about doctors.
Like, there's a difference between the cultureof oncology versus the culture of dermatology.
So I just wanna expand everyone's thinking aswe're listening to this and what we mean by
culture.
I mean, let's take insulin, for example.
(09:36):
I'm working on GLP one brand.
We were you know, we hear a lot about GLP one.
So in some communities, insulin is seen as, youknow, it's in medication.
It's treatment.
It's gonna help you get your diabetes undercontrol.
But in other communities, insulin is not seenas a treatment.
It's seen as a failure.
And so uptake is delayed even when it'smedically necessary.
(09:57):
You know, why aren't you taking your insulin?
And and if I feel like I failed and that'swhat's being reiterated to me and that's the
what ex that's the mindset that exists in theculture that I live in, it's going to deter
it's gonna actually deter adherence.
I don't even wanna think about it.
I don't wanna approach it.
It's going to be a barrier.
(10:20):
In in certain countries, I mean, Japan, forexample, they do a great job at really
integrating so we think about oncologytreatment.
Right?
I mean, it's it's very, diverse.
There's a lot to it.
Certain, certain clinics in Japan integrate,respect based rituals into cancer care.
(10:41):
I was just reading about this.
And by by doing that, adherence goes up.
The way that people view their cancer carechanges.
So little things, bowing gestures are used bydoctors, implementation of shared spaces, the
understanding, and this is really, across a lotof cultures, especially in Asia, understanding
that family is very much an extension of theperson when it comes to things like consent and
(11:05):
decision making and how you approach you know,in The US, it's a bit different.
Right?
With HIPAA and the way that you approach thepatient versus their family, it's different.
In other areas of the con of the world, Consentis very much not just the patient, but their
entire village, their entire community.
I mean, village from a community standpoint.
Mhmm.
So you think about little things like that.
(11:25):
Another, my last example, again, because I Ithink this one is really important.
When you think about food and and cholesterol,we're working on an LDL brand, and it was so
interesting because what food symbolizes in TheUS, we look at food as a risk factor.
So, you know, manage what you eat because, yourcholesterol could go up, things like that.
In other countries, for cholesterol awareness,they stay away from framing food as a risk
(11:49):
factor.
Instead, they honor that food symbolizes thingslike togetherness and harmony and everything
that's good in the world.
And so, you know, you don't want to frame upmessages in the way to make food the enemy.
Little things like that.
I know I'm getting a bit into communicationtoo, but there's it's it's so much.
There's there's so many ways that culture needsto be considered when we're messaging and we're
(12:10):
talking about, different disease states.
Yeah.
So I'll I'll stop talking.
No.
That's helpful because it it gives us, youknow, real examples.
Like, I kinda, you know, started to kindaunderstand what this is, but now that you put
that into, you know, real world examples, it'sit's a little easier to kinda conceptualize.
(12:34):
But now that makes me think what's the risk ofnot considering culture and context in medical
affairs work, especially as we look, you know,globally.
Yeah.
I mean, man, the risk is so significant.
You risk being, irrelevant.
You risk resistance.
Resistance.
(12:55):
I think worst of all, you risk being clinicallyright but behaviorally invisible.
If someone is not resonating with your messageor culturally, it's completely fallen off, it's
not the way that people interpret certainsymbols or behaviors.
You're you're you're losing the person beforethey're even able to finish reading your entire
(13:18):
message.
In a global setting, that means wastedresources, missed trust, missed impact.
You you really can't, even the best data can'tfix a message that's not resonating.
So, I mean, I think you risk a lot.
Absolutely.
And I think this isn't just respectful.
This is about being effective in yourcommunication.
(13:39):
And these cultural missteps can actually tankengagement.
It can delay uptake.
As we've already said, the best data is gonnaland on deaf ears if you're not approaching it
from a place of true human understanding.
And, ultimately, it damages long termpartnerships.
And that's what meta metafares is about.
It's about creating these real partnershipswith HCPs, with these KOLs, with a goal of
(14:05):
ultimately improving patient lives.
But in order to improve patient lives, we needto engage on a level in which they understand,
that they feel respected, that their culturalnuances are and their assumptions are either
validated or challenged, but they need toactually, be able to be in a place where they
can accept the information that you're givingthem.
(14:27):
Awesome.
And, you know, that makes me think as you saythat, it makes me think about the KOL community
and KOL engagement.
So I'm curious.
How can medical anthropology insights improvestakeholder engagement, particularly with, you
know, not just HCPs, but also patients?
(14:49):
Yeah.
Well and I know a lot of my answers have beenmore patient focused, but it it it it's very
important for both audiences.
So I think what it really what medicalanthropology really brings is it helps MSLs
move beyond the clinical script into the theworld of real human context.
It's not you know, think about a doctor.
It's not just what a doctor believes abouttreatment, but it's why they believe it.
(15:13):
How is the culture of their patient population,clinical restraints.
Right?
I mean, yes, it's a culture of patients, butit's also the culture of the world that the
doctor is living in.
They live in their own little world, you know,in their practice setting, regional, norms that
influence that belief.
So for I'm gonna group I'm gonna talk aboutpatients and doctors together.
(15:34):
What anthropology asks is what's reallyhappening beneath the surface.
Really, from a cognitive mindset standpoint,that's where the real engagement lives.
So we we need to not work on educating ourstakeholders.
We forget that it's our job first to understandtheir lived realities.
(15:54):
So stigmas, cultural values, for patients, forHCPs.
I mean, again, I I mentioned, like, contextwithin their practice, but workflow friction
and institutional culture is huge.
And I I brought up how, you know, there's aculture of dermatology.
There's a culture of oncology.
Be these doctors you know, say you have adoctor who's in their fifties.
(16:15):
They've been practicing for thirty years.
These are entrenched ways of thinking.
They were they're they're anchored to frommedical school.
So it a message about why a treatment has thebest efficacy is simply not going to do the job
alone.
Agreed.
And while in medical affairs, most of ourengagement is with HCPs, ultimately, within
(16:39):
pharma and med affairs, there's a bigger andbigger drive to really be more patient centric
and also promoting patients as partners inshared decision making.
So in order to do that, we need to equip ourphysicians, our HCPs, with the right patient
education that appropriately is tailored totheir patient demographic.
(17:02):
And equipping these HCPs with tools that willhelp them understand context for these patients
that they're speaking to, It really helps themhave better communication, better
conversations.
It really helps the HCP understand theirpatient on a better level.
So in order for us to help HCPs facilitatethose communications, the meta affairs teams
(17:26):
need to really understand the barriers that ourHCPs have.
Yeah.
And to that point, and Susie, like, you know,curious what you think about this.
I mean, I think that we focus and do, like, HCPsegmentation, and we're trying to understand
our HCPs better.
I feel like we tend to rely on the same subsetof HCPs, so, like, the urban, academic, well
resourced, knowing that that's not the patientpopulation that they're seeing.
(17:49):
And so I think that and really bringing in thevoice of the community and community based
physicians, more rural providers, HCPs infederally qualified health clinics, you know,
things like that, really thinking beyond, okay.
Sure.
We we might be speaking to an HCP in anacademic setting.
However, thinking more zoomed out and largelyon who they're serving, we need to maybe talk
(18:13):
to other HCPs as well that we we don't alwaystake that approach.
Right.
Agreed.
It's it's it's so interesting having thisconversation with you guys because there's
there's a lot of focus and perspective from thepatient side.
I mean, we have a patient advocate and and anurse who who are both obviously very, very
smart and know so much about health care andand and medical affairs.
(18:37):
So this is a really interesting new perspectivefor me and, obviously, for my audience.
So I'm loving it.
So, Susie, how can medical affairs teams betterincorporate patient perspectives, especially
from, like, diverse populations?
(18:59):
So to really oh, sorry.
No.
Go ahead.
To really embed diverse patient perspectivesinto strategy, our medical affairs teams need
to go beyond the advisory boards and thesurveys.
They really need to listen differently, andthat's where the anthropology style thinking
really comes in.
So we tap into qualitative insights,ethnographic research, patient narratives,
(19:23):
community health workers, and even sociallistening.
And these sources really reveal the livedexperience and the culture and the systemic
barriers that exist within our health caresystem, and then partner with cross functional
teams to really translate these insights intoreal action and real change.
And that, you know, creates adaptingeducational content.
(19:45):
It can transform clinical trial design, and itcan really, shape field engagement.
Yeah.
I mean, I I you said cross functional teams,and and part of that cross functional team
needs to be the person who's who's on the endof of receiving the message.
So patients co create with the patients.
(20:06):
Don't just you know, yes.
Research is important.
Do the ethnography.
Do the, the interviews, but don't, rely on,like, you know, an academic expert or even
myself, a behavioral scientist, to then takethat research and analyze it and and make
decisions.
You know?
I should be making decisions with thecommunity, and and, yeah, cocreating with them.
(20:29):
That's really, really key.
Because, ultimately, we interpret thingsthrough our own lens.
We need to learn how to interpret thingsthrough patient lens, through HCP lens, because
we all come with our assumptions, and thatabsolutely impacts how we process interactions.
(20:49):
So to really become aware of your assumptionsand also the assumptions of our health care
providers and ultimately downstream theassumptions of our patients really helps create
tailored messaging, and the tailored messagingis what is going to move the needle for our
patients.
Yeah.
So
then I'm sure there's gaps.
(21:12):
So where do you guys see gaps in pharma andbiotech companies that are trying to address
cultural competencies and contextualunderstanding?
I mean, I could take a stab first.
I mean, I think, ultimately, we just conflateawareness with action.
(21:34):
So pharma checks the boxes with bias trainingor, you know, some sort of cultural competency
training.
And but we but we rarely build the culturalinsight into the core of the strategy, and it
goes back to my cocreating point.
So we need to move beyond the thought of weknow this population exists, and we need to
(21:56):
research them to we have designed this, andthis strategy supports the realities that they
face, whether it's how they define health andwellness, whom they trust, what influences
their decisions.
I mean, I think okay.
Listen.
We're headed in the right direction, but Ithink it's gonna involve a bit more of, like,
(22:17):
we know our target.
We're gonna understand them by the books, andthen we're gonna take that knowledge and create
for them.
We need to really embed ourselves a bit moreand thinking about even what are the symbols in
in which that that exists in their community.
What language are they using to explain, youknow, certain health concepts?
(22:38):
And so I I think it's just it's a bit more.
And, again, like, cultural competency trainingis happening, cultural fluency training,
cultural humility training, those things arenot happening, and I think that that's, that's
a big gap.
Agreed.
So there is a heavy reliance on the surfacelevel diversity metrics, but that doesn't
(23:01):
really dig into the deeper contextualunderstanding of what it is to just be human on
an individual level.
And the strategies get built on assumptions andnot true insights.
And as Sanika said, you know, there's lots oftrainings, and it but it feels like more of a
check the box kind of training where, you know,you maybe can have a conversation that is more
(23:24):
respectful, but are you really understandingthe key drivers of that relationship and things
that will really resonate with the personyou're speaking with.
And this does translate outside of meta affairsand pharma.
It really is the human to human component ofinteraction and how can we really make the
(23:46):
partnerships more effective.
And you are looking at the disconnect betweeninsights and how they're actually used.
And what about what about, like, tools?
Are there tools or frameworks that medicalaffairs teams can use to integrate some of
these philosophies into their clinicalstrategies, medical education, insights?
(24:10):
Yeah.
I mean, I think it's it's it's a lot.
It's we're we're talking about it, but we'renot expecting anyone to know, like, medical
affairs or on the pharma side to understand,you know, how to actually make any of this
happen.
But but consulting with and having programs,training programs, I actually just created a
(24:31):
training program for a company for their MSLs,to like, a behavioral science training.
Right?
Exactly what we're talking about.
Where where what tools can we give them?
What frameworks can we give them?
Medical affairs, MS they're busy.
They you know, we're not expecting you to reada a behavioral science book and and, like,
apply it.
But what are some quick, easy frameworks thatwe can give them to understand their doctors
(24:54):
better?
And so I think it's a multistep.
It's one, helping MSLs in a very digestibleway, and and medical care teams in a very
digestible way understand how do I even gatherthis insight.
Like, what do I do?
Where do I start?
I love thinking about populations from, like, arational, situational, emotional context.
(25:16):
I mean, it's just three easy, like, buckets.
And if you can even just do that, I thinkyou've made a lot of progress.
Helping them insight generate through thoseframe through, like, a framework like I just
mentioned.
And then once you have all this insight, okay.
What do I do with it?
I think there are really great behavior changeframeworks out there.
There are a lot.
I love specifically in the context of talkingin medical affairs.
(25:39):
I love, like, the BJ Fogg model, the CommBmodel.
They're they're easier to to grasp and reallyeffective when it comes to doctors.
So things like, does the doctor or the patienthave the capability, the opportunity, and the
motivation to even do what I'm asking them todo?
Because if one of those things doesn't exist,they're not gonna do it.
And so using all that insight and generating itthrough a behavior change model and I I know it
(26:04):
still might seem like a lot, but but truly,like, it is simplified enough where anyone can
do this, and it makes so much of a difference.
I'm talking to a doctor.
I now can understand that it's really the factthat they don't have time.
They have too much on their desk, and they theythey're in an inertia cycle where they're just
like, you know what?
I don't have time.
(26:24):
I have five minutes with each patient.
You're telling me to do something different?
No.
I'm just trying to survive.
If I'm having a conversation with the doctorand I can pick that up from them, then I
understand that is a institutional context thatis serving as a barrier.
If I'm hearing from my doctor that they'rereferencing maybe a past experience that didn't
go so well when they tried to do thingsdifferently, now I know that emotion's at play,
(26:47):
and that's a harder, barrier to to sort ofovercome.
So even allowing MSLs or helping MSLs pick upthings like this in conversations with doctors
is you're already taking you know, you'realready moving the needle so much.
And let's talk about MSLs, because that's themajority of our audience.
(27:08):
So I wanna I wanna get to, like, the MSL pieceof it.
So, Susie, how can medical science liaisonsplay a role in identifying some of the cultural
nuances when they're interacting with theirHCPs and KOLs?
Yeah.
So I I see MSLs as being in a really primeposition to understand these cultural nuances
(27:34):
because their interactions they're on the frontlines with these HCPs in the HCPs local
environment, so they can pick up on thosesubtle cues.
And I think there's an you know, the assumptionthat, well, they're just you know, they're in
clinical inertia.
You know?
What what they're doing is just easier to keepdoing.
But to really understand what is perpetuatingthat clinical inertia rather than just saying,
(27:58):
well, they don't wanna change because x.
Well, that's based on the MSL's assumption.
So dig into what are the perceived barriers ofeach individual HCP.
And, again, it comes down to tailoredmessaging.
You know, understand what is this HCP'sperceived barrier.
And then instead of coming at them with talkingabout a, b, c, what's more tailored to their
(28:21):
individual need is x, y, z, and now you knowthat.
So it really you understand what matters tothem.
You understand what barriers they are facing onan individual level and what what might be
challenging them to really, change theirclinical behavior.
It helps you ask the right questions.
It helps you, give them better answers.
(28:45):
You know, it really uncovers their priorities.
And sometimes these priorities are maybe evenassumptions that the HCP themselves don't even
know that they have until you ask them thequestion.
Say, okay.
You know, you seem like you really want to doyou know, you wanna keep doing this.
Can you tell me why?
And can you tell me why you know, what youwould need to hear to maybe have some changed
(29:07):
behavior?
So it really helps you enable the conversationwhere you can really extract the information
that you need to hear to help this HCP reallyunderstand assumptions.
And then that, like, that makes me think of,like, how should companies go about training
(29:28):
their medical affairs professionals and MSLteams on all of this that we're talking about?
Well, the great thing is, for the MSL role inparticular, having emotional intelligence is
really a key factor.
So I feel like a lot of hiring managers arealready trying to find people who are
(29:51):
emotionally intelligent because you can't justhave the science.
You have to have the people skills.
And medical anthropology gets down to the root,the base level of human on human reaction or
interaction.
So it you already have folks who are set up forthis, but to really help them challenge their
(30:13):
unconscious biases, help them really dig downinto the root behavior, the things that will
ultimately drive communication and drivebehavior change.
Yep.
Awesome.
Totally agree.
Cool.
Alright.
So let's let's see.
(30:33):
What time do we have?
Alright.
We still have some time.
I this is, like, one of those conversations Ithink we we we may have needed, like, a full
hour to talk about this because there's so muchto to kind of uncover.
But I'm like, exercising self control becauseI'm like, okay.
Do not go on and on.
But because there's so much to talk about.
(30:54):
And I I'm like, alright.
Let's keep it short.
But, yeah, I mean, there's there's so much tounpack.
And just to layer on to what Susie just said, Ithink when it comes to training, making sure
that you're delivering information in a verybite sized, digestible way.
If you need to do trainings in different parts,do it.
Because, like, you know, again, MSLs arehumans.
(31:16):
They're only able to digest, you know, certainnumber of information.
It's a lot, but they're not used to this kindof information necessarily.
So I would say in addition to everything Susiementioned, make sure that it's digestible in,
you know, separate trainings.
Got it.
And to kind of shift away from, okay.
I need to get through this deck.
I need to talk to this new KOL, and I need toget through this deck.
(31:38):
Maybe your first metric, the first thing thatyou do with engagement, the what success can
look like is understanding that HCP on theirindividual level, looking at them through their
own lens.
So understanding those assumptions,understanding where they are coming from, that
(32:00):
might be the best first step.
And and it's not even getting through yourdeck.
It's, you know, understanding this person on ahuman level.
Yep.
You know, and as we're as we're talking aboutMSLs, there's so there's always the topic of
insights and how important insights are.
(32:22):
So for MSLs and and field medical teams, howshould they take cultural insights and
communicate them back to the organization tohelp influence strategy, and and the future
kind of direction of the organization?
(32:43):
I mean, I think it's, it's really about lookingat this as less of an add on and more of, like,
an actual integrated strategic operating lens.
So okay.
So an MSL is is gathering insight, and thenthey have to share it back to to their
organization.
I mean, I think, keeping that conversation,that communication regular, and not you know,
(33:07):
once a year, we're having these conversations.
It needs to feel more embedded into the day today.
So that way, not only that it becomes more,like, second nature, but that everyone in the
organization is sort of speaking the samelanguage and understanding it to the same,
capacity.
Because I I don't I would you know, in thefuture, and I we're heading in that direction.
(33:30):
I would love to see behavioral science andmedical anthropology really, like, stepping
more into this integrated role where everyonehas this sort of department in their
organization because they see that importance.
Right?
It's not just about understanding culture anddelivering that insight back.
It's not designing through it.
And so for medical affairs, I think that meansa shift from, you know, as I mentioned before,
(33:54):
like, a scientific storyteller to reallytranslating the context in which someone is
existing.
And when you are delivering that thatinformation back to your organization, if the
organization is thinking this way too, then itit's it's received, more effectively.
People are able to know what to do with thatinformation.
A lot of times our biggest barrier is that wetalk about these things.
(34:16):
We deliver this information, and then peopleare like, well, I don't really know what to do
with it.
And I'm confused, and it's not talked aboutenough, and so I'm just gonna do nothing.
And it's totally understandable.
Like, that makes sense.
Right?
It's sort of like just, a bit of paralysis on Idon't know where to go from here.
I'm not expert.
So I think just embedding it in a way thatmakes it more digestible and understandable for
(34:36):
everyone in every role because I don't thinkthere's any role in a pharma organization, in
medical affairs organization that cannotbenefit from this way of thinking.
So, yeah, I think it's just investing in newtypes of insight gathering, the way that we're
communicating that insight gathering back toour organizations.
And, yeah, again, just just having this be moreembedded into overall strategy.
(34:59):
Got
it.
And I I actually see medical anthropology asthe missing piece in medical affairs right now.
You know, we strive for these relationships.
You know, that that's ultimately what we want.
We want these relationships.
And I truly think that teens that embracemedical anthropology will surpass.
(35:26):
I think they will create new metrics becauseright now, metrics are kind of a touchy subject
in MedAffairs.
You know, MedAffairs is constantly trying toprove their value.
And, you know, we know our value, but, youknow, it's not based on sales.
It's based on, you know, different, moresubjective metrics.
And for teams that are really creating thisdeeper connection with KOLs are going to see
(35:53):
the needle move, and those are going to reshapemetrics.
It's going to reshape how we interact withindividual HCPs.
And, ultimately, in an era that's defined bygenerative AI, the existing questions about
future work, medical anthropology can reallyreorient us, and it brings us back to what is
(36:14):
deeply and profoundly human.
And it brings that personal level back, andit's where meaningful change begins and where
better out patient outcomes can actually takeroot.
And I do believe that the teams that do notengage in medical anthropology will be left
behind compared to teams that do embracemedical anthropology.
(36:37):
Boom.
There it is right there, folks.
Awesome.
Well, thank you, guys.
That was awesome.
And medical anthropology, who knew?
Now I know.
I mean, it's amazing.
And real quick shout out.
So, guys, if you see me drinking out of thismug, and if you can't see it, if you're not
looking at YouTube, I have this mug, and itsays my name on one side, and it says published
(36:58):
author on the other.
And Susie gave me this after I launched mybook.
So thank you, Susie.
I use it every day.
I'm using it right now.
I love that.
It's a great book too.
Yeah.
Quick shout out.
If anybody's looking for a job and you haven'tbought my book, first of all, shame on you.
Second of all, job search mastery, how to winyour dream job.
Get it on Amazon.
Guys, Sunika, Susie, you guys were amazing.
(37:20):
This was such an awesome conversation, and, Ilearned a lot.
And I hope everybody else did too.
And if you did, share it with others.
And as always, appreciate your support of theshow.
Love you guys, and we'll see you next time.
Bye.
Thank you.
Thank you.
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