Nick Mowat looks at the parallels between Key External Expert and Key Opinion Leader mapping and his time in medical publishing 
I often explain to clients about my background in medical publishing without expanding on my experiences. While my career in medical publishing provides many valuable insights into the behaviour of prominent physicians and surgeons, focusing on the behaviour of individuals, my current role enables me to look at things on a ‘macro level’. 
Clinical Expert Management prides itself on its objective external expert or key opinion leader mapping abilities. My role in medical publishing was based on largely subjective and personal views. 
So, the contrast to my time in medical publishing is considerable. My role in publishing was to develop commercially viable products: new book ideas, new journal ideas and later in my career, digital products. This meant that I had to maintain a broad knowledge of basic science, clinical/medical science and education. One of the key skills was an understanding of how healthcare differed in different locations and how the patient pathway might also differ. All of these factors played an important role in assessing the commercial viability for a new publication/digital product. The job title ‘Publisher’ is used within publishing companies to show that an individual has a responsibility for the commercial performance for a portfolio of publications. A Publisher therefore has to manage a ‘backlist’ of previously published titles (collaborating with their colleagues in sales and marketing as necessary) as well as maintain the forward momentum of their publishing programme. An important facet of a medical publisher’s responsibility is liaising with the various professional medical societies who may sub-contract the publishing rights to commercial publishers. 
A Publisher’s role therefore means that they have one foot inside the publishing house door while maintaining strong, often personal, links with relevant medical professionals. These may be individuals with a national profile but more often they have a global reputation. The development of credibility, trust and often friendship was crucial. 
In my time in medical publishing it was important to maintain the big picture; being receptive to new information and ideas. There were no data sources to inform publishers, but I suspect that medical publishing has now become a numbers game. One publisher I worked for had a history of publishing high-quality books which would never recoup their investment. Their moto could be translated as “in the service of science” and this is how they saw themselves: partnering with the scientific and medical community. So, the decision to develop a new title was made on a subjective basis based on previous experience. Publishing has now become a more exact science these days and the economic performance of a title (within portfolio) is paramount. 
Fast forward to my role in key external expert, or key opinion leader, mapping and the situation is very different! For example, the terminology is completely altered. Publishers didn’t use terms such as ‘Key Opinion Leader’ or ‘External Expert’, however our clients expect an objective, systematic, robust platform to make decisions. 
The nature of the relationships is also different. I recall being at a large international congress on osteoporosis. We were relaxing at the bar one evening with the editors of the journal while all the time we were surrounded by satellite groups of pharmaceutical employees desperate to get a 5-minute discussion. The relationship between a publisher and their authors/editors is a symbiotic one. They need each other for different reasons. A publisher needs to establish/ maintain these relationships to ensure that they stay current but also to stay commercially viable; a Key External Expert or Key Opinion Leader needs to publish to maintain their career. There is mutual need and trust. Publishing projects rarely bring significant remuneration to the authors/editors so there has to be some other reward. The relationship between Key External Experts and Key Opinion Leaders and pharma is different. In the past it often had a commercial basis with money being exchanged for services of various kinds. In these days where buying influence is prohibited the relationship is perhaps moving much more towards the one, I was used in the past? More like the one I had in publishing. A scientific dialogue without the money underpinning the situation. So, in my career have things have turned full circle? 
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