The Glue That Holds It Together: Craig Granowitz on the Real Role of Medical Affairs

It's rare to find a leader who has run both the commercial engine and Medical Affairs inside the same career. It's rarer still to hear what that view teaches about where Medical Affairs actually sits inside an organization.

Craig Granowitz, M.D., Ph.D. (Chief Medical Officer, Lexicon Pharmaceuticals) started as a sales rep, grew a $2.5 billion commercial business, and then moved deliberately into Medical Affairs, where he built global organizations at Schering-Plough, Merck, Amarin, and Lexicon. In this conversation with Scott Thompson, Craig lays out a working definition of the function: Medical Affairs, in his framing, is not the center of the organization and not its foundation, but the connective function that holds R&D, Commercial, and every major external stakeholder together. From there, the conversation covers the three attributes he looks for in every Medical Affairs hire, how he reads the health of a team from the outside in, and why he believes the more human a leader becomes, the more valuable that leader is in the era of AI. If you are trying to explain what Medical Affairs does and why it matters, start here.

Key Takeaways:

• Medical Affairs is "the common glue," not the center or the foundation. In Granowitz's words: "You're not the center, you're not the floorboards, but you're the common glue, in organizations that are effective."
• Three attributes define a strong Medical Affairs professional: curiosity, tenacity, and courage. Granowitz names them directly: "curiosity, tenacity, and courage. Those to me are the three attributes," and adds, "If you have curiosity, the other two come out of that."
• Assessing a Medical Affairs organization starts with watching how it shows up in the room. Granowitz's method: "The first thing I would do is I'd walk into a cross-functional meeting, or a bunch of cross-functional meetings, and look for consistency and harmony," then he asks, "Are you driven by guidelines and rules, or are you driven by principles?"
• The hardest part of the job is stressing the system without breaking the trust that built it. In Granowitz's words: "It is that dynamic tension of create the trust and the environment of productive communication, but then stress it with pretty audacious goals that are gonna stress that harmony when stuff doesn't happen to your expectation, which is every single time that you then don't have a train wreck. That's the challenge."
• The organizations he built scaled alongside an industry that was scaling too. Granowitz recalls having close to 2,000 people in Medical Affairs worldwide at one point in his career. That growth mirrors the field overall: industry estimates put the global Medical Affairs workforce at around 50,000 in 2000, a figure that has grown past 500,000 today, according to PharmExec.
• The more human you are, the better off you will be in the era of AI. Granowitz puts it directly: "In the era of AI, the more human you are, the better off you're gonna be," because AI "doesn't touch the world. It doesn't touch people." A January 2026 Deloitte study of 1,394 employees backs that instinct: enduring human capabilities, curiosity foremost among them, are what separate high performing teams, regardless of how much AI enters the workflow.

Want to talk through this with our team? We're here to help.

About Our Guest

Craig Granowitz, M.D., Ph.D., is Chief Medical Officer at Lexicon Pharmaceuticals. He has held senior leadership roles on both the commercial and medical sides of the pharmaceutical industry, starting as a sales rep and rising through marketing and general management to lead a $2.5 billion business before moving into Medical Affairs, where he built global organizations at Schering-Plough, Merck, Amarin, and Lexicon.

Connect with Craig on LinkedIn: https://www.linkedin.com/in/craig-granowitz-a43878101/

FAQ

What does Craig Granowitz mean when he calls Medical Affairs "the common glue"?
He means Medical Affairs is not the center of the organization or its foundation, but the function that connects R&D, Commercial, and every major external stakeholder around a consistent scientific story.

What are the three attributes Craig Granowitz looks for in Medical Affairs professionals?
Curiosity, tenacity, and courage, with curiosity as the root attribute that drives the other two.

How can you tell if a Medical Affairs organization is healthy?
Start by watching cross-functional meetings. Consistency, harmony, and whether Medical has an equal seat at the table are the signals worth watching for.

What is the hardest leadership challenge in Medical Affairs, according to Granowitz?
Building trust and a productive working environment while simultaneously setting ambitious goals, without losing the harmony that trust created.

Will AI replace the human side of Medical Affairs leadership?
No. Granowitz argues the opposite: as AI takes over more routine, fact-based work, the leaders who stay closely connected to real people and real problems become more valuable, not less.

About OnPoint: The Medical Excellence Podcast

OnPoint: The Medical Excellence Podcast delivers insightful conversations on the most pressing issues facing top Medical Affairs professionals. Listen to stay ahead of industry trends and be inspired by leaders shaping the future of Medical Affairs.

Find more episodes on our OnPoint YouTube channel.