Strategic Alignment in Medical Affairs with Matt Nelson

As a Medical Affairs organization grows, completing activities stops being enough. Leadership starts asking whether those activities are working, and Medical Excellence leaders are often the ones expected to answer.

In this episode of OnPoint: The Medical Excellence Podcast, host Scott Thompson talks with Matt Nelson (Amicus Therapeutics), Head of Global Medical Excellence and Innovation, about leading change across two very different phases. Matt traces his path from Field Medical and a newly created Medical Excellence role at Biogen, through an MSL role at Novartis, to building the U.S. Field Medical team at Amicus ahead of its first product launch. The conversation covers why foundations come before strategy, how to handle team resistance to new SOPs, why Medical Affairs should define its own measures of success, and how to build champions who carry the work forward. It also explores how Amicus uses a scientific journey to keep teams anchored to strategy. A scientific journey is a structured way of capturing where HCPs are in their understanding of a disease state and how their beliefs align with the medical strategy. If you're leading change in a Medical Affairs organization that's still finding its footing, start here.

Key Takeaways

• Foundation comes before strategy. At Amicus, the team was implementing a CRM tool and writing field engagement policies while preparing for its first launch. As Matt puts it, "before we start thinking about how do we introduce new technology or skill development at all. We just even needed the basics to get the team up and running and be ready for that launch."
• Explain the need behind every new process. When teams read new SOPs as a lack of trust, Matt focuses on why the process matters and what's at stake: "we're not just asking you to do this because we want to create extra work for you, but where the actual need is and how it'll protect the organization."
• Medical Affairs should define its own success. "We don't want to wait for someone else to come and apply their own measurements of what success looks like to the medical affairs team." Industry estimates show the gap: ZS estimates that 90% of Medical Affairs organizations consistently track activity, while roughly half measure how external stakeholder knowledge and beliefs are changing (ZS, 2025).
• Tie every new idea back to strategy. Matt acknowledges that promising ideas from KOLs or advisory boards were sometimes pursued before "the question never was well, how's that tie into strategy and how is that going to move us forward and what we're trying to achieve in our strategy?" Mapping HCP beliefs against strategic imperatives now keeps those conversations anchored.
• A clear vision creates buy-in. Matt maps out the change, anticipates who will push back, and identifies likely champions before rolling anything out. "When I do clearly communicate the vision, that's when you can see the light bulbs go on and that's when you get the buy in."
• Champions are found by listening. "A lot of it was just kind of that individual networking and listening and picking up on key things and meetings if someone brings something up and then following up with them afterwards."

Resources Mentioned

Scientific Journey (Acceleration Point): A belief-mapping approach Amicus Therapeutics uses to connect where HCPs are in their scientific understanding to its medical strategy and strategic imperatives.

About Our Guest

Matt Nelson is Head of Global Medical Excellence and Innovation at Amicus Therapeutics. He joined Amicus as a field director before the company's first product launch, building out the U.S. Field Medical team, and later moved into a Medical Affairs operations role implementing new systems and processes across areas such as grants and training. Earlier in his career, he worked in Field Medical and led a newly created Medical Excellence role at Biogen, then returned to the field as an MSL at Novartis.

Connect with Matt on LinkedIn: https://www.linkedin.com/in/matthew-nelson-pharmd

FAQ

What foundations does a new Medical Affairs team need before pursuing strategic change?
In this episode, Matt Nelson describes joining Amicus Therapeutics before its first product launch, when the team was implementing a CRM tool and building policies and procedures for field engagement. Those basics had to be in place to get the team up and running for launch before introducing new technology or skill development.

How can Medical Excellence leaders reduce resistance to new SOPs and processes?
Matt Nelson recommends helping the team understand why a new process matters and what the potential consequences are without it, so it does not read as extra work or a lack of trust. He also suggests asking the field about their biggest challenges and delivering early, easy wins that build credibility for larger changes.

Why should Medical Affairs define its own measures of success?
As a Medical Affairs organization grows, the question shifts from whether activities were completed to whether they are working. Matt Nelson argues Medical Affairs should drive that conversation instead of waiting for another function to apply its own definition of success. A 2025 ZS white paper makes a related point: Medical Affairs is a nonpromotional function and should not be evaluated using profitability metrics.

How does a scientific journey support Medical Affairs strategy?
A scientific journey is a structured way of capturing where HCPs are in their understanding of a disease state and how their beliefs align with the medical strategy. At Amicus Therapeutics, Matt Nelson says this helps medical leads identify belief gaps that support evidence generation proposals and budget requests, and gives Field Medical teams a clearer picture of where scientific engagement is and is not working.

How do you build internal champions for Medical Excellence initiatives?
Matt Nelson describes listening for colleagues who share the same goals, often people with past experience implementing similar changes, and following up with them after meetings. He then shares his vision and seeks early buy-in from people who want to help execute the work, not only voice support.

Curious how this applies to your organization? Let's talk.

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.

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