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Diana is a medical science liaison (MSL) covering seven states in the US Midwest region. Before COVID-19, she travelled extensively to meet healthcare providers (HCPs) for office visits, at conferences, and over meals. Owing to limited airplane connectivity, she often drove close to 300 miles (about 5 hours) to reach HCPs in neighboring states. To make the most of her travels she spent an entire week on the road, scheduling several HCP visits in a single trip. In March 2020, she was meeting several HCPs in Iowa. That was the last of her in-person interactions with HCPs before lockdowns started and operations came to a screeching halt.

The turning point for MSL-HCP interactions

In the wake of those early stay-at-home orders, many HCPs cancelled meetings with MSLs. In a survey conducted by The MSL Society in March 2020, 28.4% of MSLs reported that the HCPs they supported were not open to engaging with them due to COVID-19.1 This was partly due to growing safety concerns associated with in-person interactions and partly due to the increasing burden of patient care COVID-19 was placing on physicians.

Diana says, “Initially, HCPs rescheduled appointments for the subsequent months. At that time nobody anticipated how long lockdowns would last.” During this time MSLs shifted their focus to cross-functional communication within their organization. They doubled down on creating or updating slide decks, field resources, and training materials for sales representatives and junior MSLs. However, MSLs may have retained their “in-person mindset” through these activities, as though in preparation for HCP interactions to soon resume just the way they were before the pandemic. Gradually, the magnitude of the pandemic became apparent. “My organization encouraged MSLs to engage HCPs virtually even before COVID-19 hit.”, Diana recalls. “But it never really took off. Every time I brought it up in the past, HCPs suggested I just drop by their office the next time I was in the area.” As the lockdowns continued for weeks and then months, HCPs were forced to reconsider their stance. A survey of HCPs in June 2020 showed that only 4% of respondents were averse to engaging virtually with MSLs.2 Although organizations may have toyed with the idea of virtual engagements before, COVID-19 mandated an unprecedented urgency to the digital transition.

The challenges of interacting in a virtual world

“There were a lot of growing pains initially”, laughs Diana. “One of the biggest problems for us was the lack of a robust virtual platform. As soon as COVID-19 started, we realized that the platform we had been using would be inadequate. For about a month we were scrambling to put together something new.” Thereafter, HCPs had to be trained on the use of the new virtual platforms that often had varying limitations on audience size and level of interaction. The virtual platforms also had to be compliant with the hospital network security systems of HCPs. All of this placed an additional burden on HCPs to master the use of more than one virtual platform. The duration and quality of MSL-HCP interactions in the virtual world changed drastically. While in-person interactions previously lasted anywhere between an hour to 4 hours, virtual meetings were much shorter. Close to 70% of MSLs surveyed indicated that their virtual engagements were only between 5 to 30 minutes in length.1 “HCPs who used to be harder to reach are now more willing to have frequent but shorter meetings each month, as opposed to once every few months”, Diana remarks. This was corroborated by a survey of US-based key opinion leaders, wherein nearly 73% of HCPs said they preferred communicating with MSLs at least once a month even during the pandemic.2 With shorter more frequent meetings, it has become critical for MSLs to strike the right balance between their own goals and HCP needs and to reinvent their content strategy and delivery to suit this framework.

Conference coverage is an important aspect of MSL duties. Prior to the pandemic, conferences facilitated connections between HCPs and MSLs. Last year most conferences were either cancelled or moved to a virtual environment. While nurturing existing relationships has been challenging, building new relationships has proved to be especially difficult in these times. Previously, MSLs could approach several thought leaders at conferences and forge new relationships within a short time. Such organic interactions became near impossible in a virtual setting. Although virtual interactions allow flexibility in scheduling, cut traveling time, and reduce expenses, they present some unique challenges. The learning curve for various virtual platforms demands considerable investment of time and effort from MSLs and HCPs. MSLs find it harder to develop rapport and build trust during virtual interactions. The shorter meeting duration makes it challenging to convey important information effectively, and content delivery needs to be tailored to maximize impact. Finally, organizations remain unsure about the best parameters to assess MSL performance in the virtual setting.

Every obstacle is an opportunity

The main objective of MSLs is to disseminate information related to a therapeutic area and gather insights on patient care from HCPs. Irrespective of the setting, scientific prowess and emotional intelligence remain important skills for MSLs to gauge physician engagement and deliver content tailored to their audience’s needs.

Generic engagement techniques are ineffective in the virtual world. The only way MSLs can provide value to HCPs is by first understanding what they value. One way to go about this is to leverage data generated using customer relationship management (CRM) systems like Veeva and Salesforce.3 Field-based insights can thus be used to create personalized content and engagement strategies for individual HCPs. Since virtual meetings are shorter than in-person visits, it is crucial to condense information and convey key data in the most effective manner. MSLs need to become scientific storytellers. They need to personalize both the content and its delivery. By crafting a succinct scientific story, pacing it right, and using powerful visuals, MSLs can elevate their digital interactions with HCPs. Medical communications teams supporting MSLs for content creation must align on the what HCPs expect from digital interactions and facilitate this story-telling experience through tailored content.

Insights for the future

COVID-19 has had profound effects on the healthcare industry, including on MSL-HCP interactions. It accelerated digitization and forced interactions into a virtual environment. Will these effects prove to be long-lasting? Most experts believe that a more hybrid approach will emerge in the post-COVID world. The time and cost benefits and growing familiarity of digital platforms will ensure that virtual interactions are here to stay. However, they will not completely replace in-person interactions which are crucial for relationship-building.

So what lessons can we carry into the new normal? HCPs indicated that the top three attributes they valued in MSLs were honesty, depth of knowledge, and clear and succinct communication.4 Knowledge exchange remains the ultimate goal for MSL-HCP interactions in both the real and virtual world. Creative solutions that streamline or enhance virtual interactions will boost insight gathering and knowledge transfer. The new normal is ripe with opportunities for reimagined medical communication strategies and tactics that can redefine the MSL-HCP relationship and set it on strong ground for whatever the future may hold.

Find out how Cactus Life Sciences can support your MSL teams with targeted medical communications strategies and tactics and engaging content decks suitably adapted for the digital format. Learn more about our Medical Communications services.


  1. COVID-19 Survey Medical Science Liaison Activities – MSL Society
  2. KOLs reveal how they prefer to engage with MSLs during the COVID-19 pandemic – THE MSL
  3. Survey of Utilization of CRM platforms by MSLs: How can we leverage data to provide personalized engagements with KOL? – THE MSL
  4. MSLs in the age of COVID: KOL perceptions of MSL virtual engagements – THE MSL

This commissioned piece was written by Raeesa Gupte with inputs from the Cactus Life Sciences team.

About the author

Cactus Life Sciences
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Cactus Life Sciences is a medical communication company that provides scientific strategy and content across the healthcare continuum, anywhere in the world ─ with a focus on science, innovation, and efficiency. We work alongside leading healthcare companies to establish the optimal role of medicines and encourage positive behaviors (physician and patient) that improve patient outcomes.