THE INFLUENCER WE MISSED

I can still remember the feeling in my stomach.

This was during a pharmaceutical launch. We were preparing for a customer focus group, and we believed we had identified the physicians who needed to be there.

Before the event, I asked the representatives whether we had everyone we needed. They told me we did. And technically, they were right.

The physician who would eventually matter most had been identified. His name was on the proposed invitation list. But while several of his colleagues had responded, he apparently had not.

Then the day of the focus group arrived.

I was there when he walked in.

I recognized him immediately. His name had been on the proposed invitation list, but he wasn't on the confirmed RSVP list. And because the applicable compliance procedures required advance confirmation, we couldn't simply add him at the door.

We had to tell him that he couldn't participate.

Talk about butterflies in your stomach.

Several of his colleagues from the same department were already inside. They had responded. They were participating.

He wasn't.

And I knew immediately that this could have consequences.

Afterward, I assured the team that we had completed the appropriate process up front. This wasn't about blaming a representative for missing something. If there was a lesson to be learned, it belonged to all of us—including me.

The question I had asked before the meeting was essentially:

Do we have everyone?

What I should have been asking was:

Has everyone responded?

And if not:

Who hasn't responded—and do we understand the potential consequences of that unresolved response?

That distinction stayed with me.

A process can be completed without the loop actually being closed.

The physician had been identified.

He had been considered for invitation.

But he had not been fully accounted for.

IDENTIFIED ≠ INVITED ≠ RESPONDED ≠ CONFIRMED ≠ ACCOUNTED FOR

Sometimes the most important name on a list is the one without a checkmark beside it.

What happened afterward is where the experience became much more interesting.

Over time, I began noticing signals.

There was customer feedback. There were conversations at conventions. There were physician task forces. There was feedback from staff. There was even competitor chatter suggesting that the physician hadn't been particularly pleased about what had happened.

Then there was something else.

Some of the physicians we had invited had dotted-line reporting relationships to him.

And over time, I observed delayed uptake with him and, to some degree, with physicians connected to him.

Could I prove that what happened that day caused what followed?

No.

And I wouldn't pretend that I could.

But I couldn't ignore the pattern, either.

That became one of the most important lessons I took from the experience.

We had identified customers.

What we had not fully understood was the network of influence surrounding those customers.

Before that experience, a typical planning discussion might focus on identifying the ten customers who mattered most.

Afterward, my thinking changed.

Show me the ten.

Now show me the people around them.

Who influences their thinking?

Whose clinical opinion carries weight with them?

Who participates in the decisions around them?

Who may influence a product decision without appearing on the obvious target list?

In one market, that kind of thinking expanded a relatively small group of primary customers into a much broader network that included roughly thirty additional nurses, pharmacists, and other healthcare professionals who could influence product decision-making directly or indirectly.

The dots had always been there.

Experience taught me to start looking at the lines between them.

That approach required more work up front.

But I eventually came to think of it as slowing down to speed up.

The additional work before a launch wasn't slowing us down. It was helping us understand what could slow us down later.

And once I began approaching markets this way, I never went back to the old way.

The approach proved so reliable that influence mapping became a permanent part of how I thought about launch planning.

A target list tells you who matters.

An influence map helps you understand why.

A useful way to pressure-test the process is:

IDENTIFIED → UNDERSTOOD → INVITED → RESPONDED → CONFIRMED → ACCOUNTED FOR

When something remains unresolved, don't merely ask whether the process was followed.

Ask what the unresolved piece might be telling you.

Thirty-five years in the pharmaceutical industry taught me plenty through successes.

But some of the lessons that stayed with me longest came from people, situations, and moments I wished had gone differently.

That physician was one of them.

I can still remember those butterflies.

And I never looked at a customer list quite the same way again.

Experience often looks like instinct to people who didn't see what it cost to acquire.

That's the craft.