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Convergence Models

Inside-out Convergence: Can Office and Field Join Forces?

  • Ines Vogel
  • Simon Weber
  • Wednesday, 22. January 2025

The age-old divide between office strategists and field operatives has always been a source of tension. Could these two worlds finally merge into one? In part four of our series about convergence models, we explore the concept of inside-out convergence.

Every office has its myths, those shared truths that employees nod to with a knowing smile. These range from when to grab lunch to who’s forever loading the dishwasher in the coffee kitchen (spoiler: it’s always the same poor soul). Yet myths also seep into work itself, shaping perceptions of roles and relationships. Take the classic opposition between office-based and field-based medical teams.

In this folklore, in-house Medical Affairs people are the cool-headed strategists, masterminding plans from behind their desks. Field Medical Affairs, on the other hand, are the maverick road warriors: independent, hands-on, and customer oriented. The former crunch data and charts; the latter wield relevant discourse and instinct. One plans; the other develops (and improvises) an intelligent discussion. One knows the business and strategy; the other knows the customer. Both know their data. And, inevitably, each assumes the other is clueless about their reality.

Against this backdrop, the idea of merging these two tribes seems almost revolutionary. Yet some pharmaceutical companies are giving it a try. The goal: to save money, dissolve old conflicts, and create a harmonized Medical Affairs strategy. But is it possible? What are the promises and pitfalls of inside-out convergence?

Consider this scenario: Four Medical Science Liaisons (MSLs) manage a market, dividing regions geographically. Under typical circumstances, they would report to a MSL Lead working under or hand in hand with a medical director. However, in this case, both positions have been eliminated. Instead, the MSLs take on additional internal responsibilities—strategy development, alignment with global —while gaining more influence and prestige as Regional Medical Directors. This hybrid role amplifies their authority in the market, positioning them as highly relevant partners to doctors and gives access to national and even regional/global strategy crafting.

This approach addresses a persistent challenge in the pharmaceutical industry: field staff often criticize global or national strategies for failing to meet the specific needs of local doctors. Hybrid roles like regional medical directors (or customer network managers in the commercial field) are brought to life in the hope of empowering teams to craft localized strategies that better reflect regional realities and market demands.

A Cross-Industry Dream of Harmony

Developments in other industries may bolster the confidence of proponents of inside-out convergence. In mechanical engineering, cross-functional teams of engineers, sales, and service staff work together at client sites, ensuring seamless machine setup and ongoing support.

The role of the Inside Sales Managers in software and computing has also emerged: a professional who manages the entire customer relationship—from sales to support—remotely and as part of the office-based staff.

Convergence Models, Part 3

Expertise Convergence: Are Generalists the Better Sales Representatives?

Behind these approaches lies the same aspiration, the same persistent dream: can we finally dismantle the spatial and mental divide between office and field staff? Could we put an end to the endless tug-of-war, recycling the same tired arguments? Isn’t it time to imagine a new era of harmonious collaboration—one where internal and external teams learn from each other, work in unison, and ultimately achieve the best outcomes for the company?

Dreams, unfortunately, have a knack for being overly naive, too tidy for the messy complexities of reality. In the harsh glare of daily office life, their flaws and misconceptions become all too clear. What if internal and external roles aren’t meant to be reconciled at all? What if this tension, far from being a flaw, is essential for the company’s success?

A Delicate Balance of Interests

Perhaps we need to better understand the nature of these conflicts. Contrary to office folklore, this isn’t about personalities or the supposedly irreconcilable character traits of office strategists versus field operatives. The real culprit is sociological. Businesses thrive on dividing labor, separating those who face the market from those who strategize behind the scenes. It’s a practical setup: only one team must deal with unpredictable customers, leaving everyone else to work undisturbed.

But this arrangement has its downsides. Most market information reaches the office filtered through the field staff—a dynamic ripe for mistrust. Are the road warriors painting a rosier picture than reality to make their lives easier? Then there’s the deeper issue: conflicting priorities and local rationales. Field staff, above all, want to preserve their relationships with doctors. For instance, they might push to include many doctors from their region in a study, even if these practitioners lack substantial experience. From the company’s broader perspective, however, it makes more sense to prioritize centers and practitioners with significant influence in the medical community.

Here’s the twist: both sides have excellent arguments, and both are technically correct. It’s not personal (and nobody should take it personally). It’s a role-playing game scripted into the job descriptions. Like lawyers, prosecutors, or expert witnesses, each actor champions their case. Eventually, there’s a compromise—or an executive ruling from the managerial high court. This structured process is how companies weigh conflicting objectives and make balanced decisions. Sure, it’s frustrating, even maddening at times. But look closely, and you’ll find that only by dividing labor along the lines of an organizational tension each rivalling objective will be stretched to an optimum rather than muddled in a lazy compromise.

Convergence Models, Part 1

The End of the Division of Labor in Pharmaceutical Field Services?

New Forms of Collaboration and Confrontation

What happens when inside-out convergence removes the traditional checks and balances of departmental structure? Consider the case of four Regional Medical Directors who operate without an in-house counterpart. This autonomy can spark creative solutions but also carries the risk of overreach, leading to a loss of focus. Do these directors need to juggle two roles—local advocate and corporate strategist? And what guidelines or support can help them navigate this dual responsibility?

Companies exploring inside-out convergence must tread carefully to address these challenges. They need to establish functional equivalents to the traditional safety nets of clearly defined job descriptions and established conflict-resolution rituals. Whether through precise role definitions or robust processes, new structures must ensure that the field service perspective is balanced, scrutinized, and integrated into the broader strategy.

For managers and organizational designers, these challenges underscore a key aspect of their work. They may view themselves as peacemakers, reuniting teams and reconciling differences. And indeed, everyone—whether a daring field representative or a strategic office worker—longs for harmony. Yet the true task of management is to ensure something far more critical: productive conflict. And be ware: when four regional Medical Directors need to decide on national educational formats, on the ‘one national voice’ to global or on study entries for their key regional university hospitals you might encounter conflict again. Organizing ultimately means choosing where you want tensions to surface within your organization.

Authors

Ines Vogel

specializes in stakeholder management within health care: from strategy development to facilitating medical discourse.

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Simon Weber

Simon Weber

consults pharma companies developing aligned strategies and organizational structures to execute them in an ever changing healthcare ecosystem.

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