KOL Influencers

One of the most important role that MSLs perform for their companies is cultivation solid relationships with thought leaders or key opinion leaders (KOLs). Naturally, the MSL will spend tremendous effort and time to understand what is important to a given KOL, and where the MSL will bring value.

Decision makers who are at the KOL level often has a team or a staff, with highly influential members. Overlooking and especially mislabeling influencers can hinder your ability to develop a productive relationship over the long term, and be deadly to your success. Let me give you a personal example that got me thinking about the paying attention to influencers in when MSL’ing.

Recently I decided to work with a financial planner to create a wealth plan for our family. We have a little one (“should we start saving for his college now?”), we’d just paid off our mortgage, and we want expertise to guide us with wealth strategy. My husband admits he can be better educated about investment options, but has little time and even less interest. I’m the proactive, “let’s make this happen and we’ll find the time” type. I found a planner and set up an appointment.

The planner was nice and friendly. He ran through the basic “I want to learn more about you” questions, not unlike the kind of questions that a MSL meeting a KOL for the first time would ask. In this case, however, it was more like the MSL sitting down with the KOL and a study coordinator who had contacted the MSL for the meeting, based on the KOL’s need.

After the first 15 or 20 minutes, however, I observed that the planner seemed to focus primarily on my husband. The planner assumed that my husband was the key decision maker in financial matters. He interpreted my husband’s appearance of “hard to read” (ever meet a KOL who’s hard to read?) as “playing hard to get”. He peppered my husband with questions. After the first hour, I was close to kicking him out. Eventually he realized that I was the influencer who was also the key decision maker in what financial decisions get implemented in our family. We’ve met this person one more time and I’m ready to fired him. It didn’t matter that he was nice and friendly: he didn’t understand basic relationship dynamics and failed to provide the type of value we expected. He lost a good opportunity for a long-term business relationship because we’re relatively young.

MSLs who perform clinical research facilitation roles can relate. How many times have you met with a KOL and found that the KOL may have had a general desire to engage in clinical research collaboration with your company, but a staff member (maybe the study nurse or senior study coordinator) in the KOL’s team was the one who ultimately executed the decisions that affect the success or failure of a clinical study? This influencer kept the enrollment on track, reminded the KOL’s team about patients who qualify, or screened patients for eligibility and referring patients accordingly.

I knew a study coordinator in a national cancer institute who told me that the studies that succeed with her KOLs came from MSLs who spent time to interact with her, and communicated what she needed to know. Studies that lagged were with MSLs who were either ignorant of her role in the institution KOLs’ research process, or discounting her as “just a study coordinator, not a KOL, not my job”. We think about influencers and immediately look to KOLs and KOL peers in an institution, department, or clinic. However, key influencers exist within a KOL’s team as well, and may not be immediately recognizable.


Influencers may be a particular member of the KOL’s team who perform an administrative or organizing role, and be easily overlooked. If you find yourself brushing off a KOL’s staff member because “she’s not a KOL” or “he’s just the nurse or clinical coordinator” (worse yet – “this is really the reps’ focus, not mine”), ask yourself, “What if I’m wrong?”

There are many influencers around KOLs who don’t have to be KOLs. Influencers do not have to be a decision maker to have impact on the execution of a decision that affects the outcome of your efforts. As yourself how something gets done with KOLs’ projects, and who are the ones making sure this gets done. Some KOLs are like celebrities who are the “face” of their brand, but have teams of people who do the hard work behind the scenes.

Some influencers have an equal or even greater role in making the decision than the decision maker, especially if the influencer deals with issues that the decision maker does not want to deal with. Clinical research is a great example of this: success with a trial often resides in the “back-end” behind the scenes work with enrollment, not just the “front-end” face time with the KOL.