This piece is written for the people who submit materials and lecture slides — not for those who review them, but for those whose work gets reviewed. For the ones who carry a sales number, hold the requests of a physician-customer, and are caught between the two every single day. Not to criticize. Only to shine a light, once, on the deepest part of that irritation at being sent back — on a single question: is the reviewer your enemy?
01Sales Targets and Requests You Cannot Refuse
First, let me acknowledge one thing. Your situation is not simple enough to be settled with pretty words. There is the quarter’s number, a budget you must hit, and beyond it your own evaluation and the mood of your team. And in front of you stands a physician you have worked with for years. “Show this data this way.” “Let me speak in these terms.” You cannot easily refuse such requests. If the relationship breaks, the next opportunity may be lost with it.
This pressure is invisible to those who do not know the field. It is easy, from a safe place, to say “follow the rules.” But for someone carrying both the numbers and the human relationships through every day, it is not as light as it sounds. Let us begin by not treating that weight lightly.
02And Yet, Some People Build the Bridge
Having admitted that weight, let me set down another fact beside it. Under the same pressure, there are people who carefully build a bridge between the company’s rules and the customer’s requests. They do not flatly reject the physician’s wishes. They explain why a given expression cannot be used — not in the language of statutes, but in the language of the other person’s own interest: “so that your lecture, Doctor, will not be questioned later.”
Such people may be unwelcome at first, but in time they win the customer’s trust. The customer comes to think, “If this person stops it, there must be a reason.” This, I believe, is one model of a good relationship between a new kind of pharmaceutical company and a physician, in a new era. Regulation need not break a relationship; it can become the foundation of one that lasts. There really are people who embody this.
03Friction Creates an Enemy
On the other hand, there are not a few people who, in respecting the customer’s wishes too much, generate friction with the internal material reviewer. I understand the feeling. You want to satisfy the doctor in front of you, to keep your promise, to make the number. Pushing with that single-minded urgency, the reviewer who stops you slowly begins to look like a wall.
And before you know it, the reviewer becomes a potential enemy. “Not this person again.” “They’ll never let it through.” A single sent-back email quietly turns into a judgment of character. But here, just once, please stop. Is that person really your enemy?
04What the Reviewer Is Actually Carrying
When a reviewer “stops” something, consider what is happening behind it. On your behalf, they are carrying several kinds of risk.
Legal risk
Exaggerated advertising (Article 66 of the Pharmaceuticals and Medical Devices Act), advertising of unapproved products (Article 68) — material that crosses the line puts the whole company within reach of administrative sanction.
The physician’s credibility
A doctor who lectured with improper material can have their credibility damaged later. What is being protected is, in fact, the customer-physician too.
The patient’s risk
Overstated information eventually distorts prescribing decisions and, at the end of the chain, reaches the patient. The reviewer protects the most distant person, in the least visible place.
Your own risk
When it becomes a problem years later, the one in the line of fire may be you, who submitted it. The reviewer is shielding your future self.
Sending material back is the act of carrying these risks “here, now.” Letting it pass is far easier in the moment; it avoids being disliked. To stop it anyway is to have seen, in advance, the price someone will otherwise pay later.
05The Care Inside “Stopping You”
It may sound a little grand, but I will write it anyway. When a reviewer stops a material, what is there is not obstruction but care. In truth, you might even call it love.
If improper material goes out into the world, someone, someday, will surely become the object of hatred — from the regulator, from the public, or from an internal investigation. The reviewer is quietly lowering the probability that this future hatred is ever born. By taking on the role of the disliked one, they reduce, before it happens, the larger hatred that would otherwise arise in society. The one who stops you lets go of being liked now, in order to reduce hatred far away.
06It Looks Like Enmity Because the Time Horizon Differs
So why does the same person look like an ally to one and an enemy to another? In most cases, it is because the length of time each is looking at is different.
| Seen as an enemy | Seen as a collaborator | |
|---|---|---|
| Time horizon | This quarter’s number, next week’s lecture | Trust years from now, the firm’s survival |
| Meaning of a send-back | Obstruction of my work | Prepayment on a future risk |
| The reviewer’s motive | Spite, self-protection, box-ticking | Protecting the company, the physician, the patient |
| How the relationship ends | The conflict hardens | They become a trusted adviser |
On a short horizon, the one who stops you is a nuisance. On a long horizon, the same person becomes the last breakwater protecting you. Enemy or ally is decided, quietly, not by the other person’s character but by the length of time through which you yourself are looking.
07A Few Questions, Just for Reflection
I do not mean to preach. But if there is a moment when the reviewer feels like an enemy, take a single breath amid the busyness and ask yourself:
- This expression I want to push through now — would the me of three years from now be able to look at it with pride?
- Is the reviewer stopping “me,” or the material I am trying to send out?
- If the physician who lectured with this material were criticized later, could I protect that person?
- Have I made the effort to bring the reviewer onto my side — not as an enemy, but as my first reader?
If you stumble even a little on any of these, the enemy may not be the reviewer, but the hurried self.
08In Closing — Toward Love, Not Hatred
To build a bridge between the customer’s requests and the company’s rules is no small thing. I deeply respect the people who do it every day. And I cannot bring myself to blame those who are in the midst of friction now. Everyone is doing their utmost.
But if there is one thing to carry home, let me write this. The material reviewer is not your enemy. With love, they are reducing in advance the hatred and the social risk that someone would otherwise have had to bear. When you can bring that person onto your side, you can also make your relationship with the physician-customer deeper and longer. The relationship between a new kind of pharmaceutical company and a physician, in a new era, will likely be built by the hands of people like that.
- The pressure on the submitting side (sales targets, the physician-customer’s requests) is real and must not be treated lightly. On that footing, those who build a bridge between the rules and the requests become the model of a good relationship for a new era.
- When a reviewer “stops” something, they are carrying — here and now, on your behalf — legal risk, the physician’s credibility, the patient’s risk, and the submitter’s own risk. A send-back is not obstruction but a prepayment on future risk.
- The reviewer looks like an enemy only because the time horizon is short. Seen over the long run, the same person becomes an ally who reduces future hatred and social risk — care (love) rather than enmity.
- Aristotle. Nicomachean Ethics. (On philia — the friendship that wills the good of the other for the other’s own sake.)
- Hirschman, Albert O. Exit, Voice, and Loyalty: Responses to Decline in Firms, Organizations, and States. Cambridge, MA: Harvard University Press, 1970. (Voice rather than exit — the constructiveness of staying and speaking up.)
- Edmondson, Amy C. The Fearless Organization: Creating Psychological Safety in the Workplace for Learning, Innovation, and Growth. Hoboken: Wiley, 2019. (Psychological safety and healthy conflict raise the quality of an organization.)
- Grant, Adam. Give and Take: A Revolutionary Approach to Success. New York: Viking, 2013. (Short-term unpopularity and long-term trust — the giver’s paradox.)
- Schein, Edgar H. Humble Inquiry: The Gentle Art of Asking Instead of Telling. San Francisco: Berrett-Koehler, 2013. (The art of asking — conveying the rules without breaking the customer relationship.)
- Japan Pharmaceutical Manufacturers Association (JPMA). Code of Practice. Tokyo: JPMA. (The shared self-regulatory framework for proper relationships with healthcare professionals.)
- Ministry of Health, Labour and Welfare (Japan). Guidelines for Sales Information Provision Activities for Prescription Drugs. September 2018. (The administrative standard the reviewer stands upon.)