I'm not going to attempt to define artificial intelligence in detail here. Not because it isn't important, but because of the sheer speed at which it is evolving.
Any precise description risks becoming outdated almost immediately… and that is exactly the point.
AI systems are improving at extraordinary speed, constantly becoming faster, broader, and more capable of scanning huge volumes of information.
When viewed in this way, it can begin to feel like an impossible competitor. But that conclusion only makes sense if we assume the role of the MSL is simply to provide facts and figures.
Because that has never truly been the value of the role.
Comparing humans with AI capability is not comparing apples with apples. In reality, the people who will succeed in this new age of technology will not be those pitting themselves against it in this way… but those learning how to work alongside it.
In many ways, the AI age will heavily reward the people who double down on their humanness.
When information exists everywhere around us, the challenge is no longer simply in finding it. In many ways, the information now finds you.
While this convenience has clear benefits, it also raises an important question… what can we truly trust?
As mentioned, AI systems are remarkably powerful, but they're far from perfect. You may have heard a horror story or two from times where people have put their trust in what an AI platform generates, without too much human touch going into checking it.
On occasion, AI can draw from incomplete information, misinterpret context, or present confident summaries of data that still require careful scrutiny.
In environments where accuracy and interpretation matter, information still needs to be questioned, validated and understood.
This is where the real differentiator emerges.
The question shifts from "Who has the information I need?" to "Whose interpretation of this information do I trust?"
Your success as an MSL is unlikely to have come from being the first person at someone's door with new information. Instead, it comes from something far more valuable, your ability to help others navigate complexity, interpret evidence responsibly, and make informed decisions in areas where certainty is rarely absolute.
In other words, the role of the MSL has always been rooted in trust. And the level of your success is closely tied to how effectively you are able to build and sustain it.
So, if this is a key contributor to your future success, let's understand more about how we can become even better at building trust, via the Trust Equation.
First introduced in 2000 by David Maister, Charles Green and Robert Galford, the Trust Equation provides a useful framework for understanding how trust is built. The model suggests that trust is made up of four key elements:
Trust = (Credibility + Reliability + Intimacy) ÷ Self-Orientation
Credibility relates to the expertise and judgement others perceive you to have, reliability reflects your consistency and ability to follow through, and intimacy refers to the sense of connection and psychological safety people feel when interacting with you.
These elements are then divided by self-orientation, the degree to which others believe you are driven by your own agenda rather than their interests. When self-orientation appears high, trust erodes quickly. When people sense genuine care, attention and curiosity about their needs, the other trust-building elements are amplified.
Across this piece we will explore each element of the Trust Equation and what it means in a world where artificial intelligence is changing how information is accessed.
We begin with the first pillar.
Credibility.
At first glance, it may seem harder than ever to be perceived as credible. When information is readily available to anyone with Wi-Fi, it raises a fair question… what does expertise really mean anymore?
But credibility has never been built on facts alone.
Facts are important, of course. Yet what truly makes someone credible is everything that surrounds those facts… their judgement, their interpretation, and their ability to apply information responsibly in real-world situations.
When people see you as credible, they are not only trusting the accuracy of what you say. They are trusting your judgement, your understanding of how the information applies to them, your honesty about what the evidence does and does not show, and your willingness to stand behind your words.
Simply possessing information does not make someone the most credible person in the room. The real difference lies in how effectively that information is interpreted and delivered.
When you are able to judge information well, you can identify what data truly matters, what questions it answers, and importantly, what questions it does not. Your ability to interpret the evidence allows you to relate it to a specific context, such as a clinician's patient population, while filtering it through an awareness of real-world constraints and circumstances.
Integrity also plays an essential role. It reassures others that you will not be overconfident in your assertions, and that you recognise the limits of the information available to you, allowing you to remain balanced in your communication.
That confidence deepens further when people sense accountability behind your words. The kind that signals that you stand behind your interpretation and recognise the responsibility that comes with helping others make decisions based on it.
Credibility is not only shaped by what you know, but by how you communicate what you know.
This is where a significant part of the human value you bring to conversations becomes visible, something that cannot be replicated by even the most impressively comprehensive AI summaries.
When someone reads an AI-generated summary, they simply read words on a page. But when they discuss the data with you, they hear much more than the words you say.
They notice how calmly you explain complex ideas, they observe whether you truly listen to their perspective, they see how well you adapt your language, simplifying information without sounding condescending.
If artificial intelligence represents artificial understanding, then this is where human intelligence and sensitivity come to the forefront.
One of the biggest MSL-sized traps you can fall into is shrinking your own value, because the role has never been about simply knowing the data.
It is about interpreting it, translating it, filtering it and turning information into insight. You are not the person who knows the data. You are the person who helps others make sense of it.
For them, you are confirmation, clarification, challenge and perspective.
So, if AI is not the real threat to the MSL role, what actually is?
Well, the real risk is misunderstanding the value of the role itself.
When we look at the role of the MSL for what it truly is, then AI becomes a very different, less frightening and more exciting proposition than the intimidating competitor it could be.
It is a powerful tool that makes our role as humans even more crucial.
Of course, as the Trust Equation reminds us, credibility alone is not enough.
Someone may be highly credible and still struggle to build trust if their actions lack consistency or if people do not feel comfortable sharing openly with them.
Credibility may get you in the room, but once you are there, trust is no longer built on what you know. It is built on how you show up.
This is where the next two elements of the Trust Equation come into focus. Reliability and intimacy (connection).
Trust = (Credibility + Reliability + Intimacy) ÷ Self-Orientation
As you've likely experienced, trust is rarely built in a single moment. More often, it is built gradually over time.
Like adding money into a savings account, each positive interaction adds to it. But just as importantly, missed expectations, inconsistency, or poor experiences can quickly withdraw from it.
So, the question becomes… what determines whether you are consistently adding to that account?
The answer is reliability.
Having a valuable interaction with an HCP is a strong start, but it is only a start. To maximise the value of being human, you need more than a great first impression. You need to reinforce that impression consistently.
That becomes impossible if you come across as chaotic or unpredictable. If an HCP is unsure which version of you they will encounter each time, how can they trust that what you share is consistent and dependable?
Trust begins to build when your behaviour becomes predictable in the right ways.
Consistently showing up prepared, with an air of assurance and comfort (more on that later), and following through on commitments is where you begin to build meaningful levels of trust.
It may feel unusual to say that how reliable you are is shaped before you are even in the presence of the HCP.
But we all recognise the feeling of listening to someone when it seems like everything is being improvised. The illusion of preparation is incredibly difficult to create. When you prepare with purpose for a specific HCP, you set the tone for the interaction before it even begins. It signals professionalism, intention, and respect for their time.
It also makes it easier to be fully present in the interaction, as you already have a sense of what they may ask, the concerns they may raise, and the information they may be looking for.
When this level of preparation is repeated, it creates a pattern… and this is where predictability becomes a strength. Not the kind that feels repetitive or formulaic, but the kind where your level of value becomes reliably high.
These early actions matter. But it is what happens next that gives reliability its real weight.
Following through on what you say you will do, from the smallest detail to the most important request, is what turns intention into trust. It shows that the HCP can rely on you not just to listen, but to deliver.
One area that can feel uncomfortable, but is incredibly powerful, is how you manage expectations. Adjusting expectations can sometimes feel like you are falling short. But in reality, it demonstrates honesty, clarity, and a strong understanding of what is realistic.
And in the long run, that builds far more trust than overpromising and potentially underdelivering ever could.
So, if reliability helps the HCP to affirmatively answer the question "Can I count on you?"
Then intimacy (connection) helps them to give a positive answer to the question "Do you understand me?"
It is important, especially in the modern world, to be clear about what intimacy means in this context, because it is a word with many different connotations. You'll notice that throughout this piece, we have paired intimacy with the word connection. That is because, in this setting, connection feels like a far more accurate description of what you are aiming to create with HCPs.
Unlike what the word intimacy might suggest, we are not talking about literal proximity or personal closeness. We are talking about the ability to connect with another human, and the comfortable atmosphere that you are able to create through that.
The kind of comfort that creates psychological safety.
When you create an environment where an HCP feels there is no judgement, that their perspective is being understood, and that they can be open and honest with their thoughts and feelings, it fundamentally changes the level of trust within that professional relationship.
People don't just want to be informed, they want to feel understood. To bring it back to AI, answers serve a purpose. However, conversation and discussion involving those answers create a very different, and far more meaningful, experience.
This is where the real value of your humanness, and your role as an MSL, truly comes to life, not just in what you know, but in how you make others feel when they engage with you.
Let's take a second to strip back some of the complexities of HCP interactions.
At its core, this is a professional discussion. A conversation between people with common interests.
A great thing to consider in any interaction is your versatility and adaptability. If you have knowledge of behavioural styles and communication preferences for example, you will understand that as individuals, we all have different preferences for communication. Some prefer high-energy conversations that include personal topics and tangents before getting to the point, whereas others prefer to minimise that "chat gap" and move straight to the facts for maximum efficiency.
Being able to recognise these preferences and adapt your approach accordingly makes you a far more effective communicator. It also makes the interaction feel more natural for the HCP, which is a key part of building connection.
We also want to show that we are listening to the HCP to understand them, rather than simply to formulate a response.
Sounds simple, doesn't it?
However, it is an easy place to fall short. All of the behaviours that can happen in casual conversations can happen here too. Interrupting, finishing someone's sentences, appearing distracted, thinking about your response before they have finished speaking.
These behaviours create a disconnect, and without connection, intimacy cannot develop.
More specific to your role as an MSL, connection is also built through how you communicate information. Your ability to simplify complex information in a way that is clear, relevant, and appropriate, without diluting the message or sounding patronising, is incredibly important.
Because if an HCP does not fully understand what you are sharing, it can quickly feel like you do not fully understand them, or what they are actually looking for. Once information is shared and understood, the nature of the interaction changes. It becomes easier to engage, to ask meaningful questions, to explore their perspective, and to acknowledge the value of their experience.
And that is where real connection begins to build.
In a world where information is increasingly accessible, these behaviours become even more important.
Because while AI can provide answers instantly, it cannot show up consistently in a human way, it cannot seamlessly adapt to the individual in front of it, and it cannot create the feeling of being understood.
There is still one part of the Trust Equation we have not yet explored, though. And in many ways, it is the part that determines whether everything else you have worked to build actually makes a noticeable difference.
Trust = (Credibility + Reliability + Intimacy) ÷ Self-Orientation
We are now moving along to the denominator. The part that, depending on how it shows up, can either amplify or quietly undo all of the good work you have done so far.
Self-orientation.
Self-orientation refers to the degree to which others believe you are focused on your own agenda, rather than theirs. It is something palpable too, because we can all likely think of moments where discussions feel like they are happening at us, rather than with us.
It is worth noting that this is not necessarily about whether you actually have your own agenda. We all do, to some degree. The question is how that comes across to the person sitting opposite you. Whether you are letting them in on it or forcing it upon them.
When self-orientation appears high, even small amounts of it can dilute the trust you have built through your credibility, reliability and ability to connect. When it appears low, those same elements are amplified, and trust deepens far more quickly.
After all, whilst many of us enjoy buying, we seldom enjoy being sold to. Ultimately, we should be helping HCPs buy into our ideas rather than trying to sell them our data.
This is also why self-orientation sits as the denominator in the equation, rather than another element to be added. Because no matter how strong the other three pillars are, if the HCP senses that you are primarily focused on your own outcomes, the value of everything else begins to shrink.
It is as if those trust-building elements happened in a different dimension.
You may be the most knowledgeable person in the room, you may follow through on every commitment, you may have a wonderful ability to make people feel comfortable. But if the HCP feels that the conversation is ultimately about what you need from them, the trust that those qualities should be earning you simply does not accumulate in the way it should.
They might think that you were only being attentive to them to receive something in return.
In a world where HCPs can access information in seconds, the value of any interaction with another human becomes more scrutinised, not less. I like to think of it as how some people view ineffective meetings. You may have heard the saying "This could have been an email."
If someone can find data on their own terms, in their own time, and at their own pace, then the time they spend with you needs to feel meaningfully different. It needs to feel like the conversation is genuinely about them, their patients, their challenges, and their thinking.
The moment an interaction starts to feel transactional, or worse, like it is being forced towards a particular outcome, the HCP has every reason to disengage… because they have alternatives that do not make them feel this way. They always have, but those alternatives are now faster and more accessible than ever.
This is where self-orientation becomes a quiet but powerful differentiator. The MSLs who continue to be valued are those whose interactions consistently feel like they exist for the benefit of the HCP and not the other way around.
Reducing self-orientation is rarely about a single grand gesture, more often, it is about small, repeatable behaviours that signal where your focus truly lies.
A useful place to start is with the way you enter conversations. If your opening moments are filled with what you want to share, what you want to discuss, or what you want to leave behind, the tone is set. The conversation begins from your position, and not theirs. It also feels like there is no room for them to even negotiate how to have their say. They could feel as though they might as well not be there, and that you don't really need them if you are to just talking about yourself.
Compare that with an opening that creates space for the HCP. Asking what is currently on their mind, what they are seeing in their patient population, or what would be most useful for them in the time you have together. These small shifts immediately reframe the interaction as one that is fluid and willing to mould around their inputs and needs, rather than being predetermined and spoken to them like it was rehearsed.
Another helpful behaviour is being comfortable with silence. Of course, silences can feel quite awkward, itchy and like this is the moment where we should be doing something. However, when we are highly self-oriented, even unintentionally, we tend to fill quiet moments quickly. We move on to the next point, restate something, or steer the conversation back to where we wanted it to go.
When we are focused on the HCP, silence becomes useful. It gives them space to think, to reflect, and often to share something that would have remained unsaid if we had jumped in too quickly. Especially if they view silence as being something they ought to fill.
It is also worth paying attention to how you respond when an HCP takes the conversation in a direction you were not expecting.
Do you instinctively try to steer it back to your original plan? Or do you follow their thinking to see where it leads?
Neither one is wrong every single time. But the balance between them tells you a lot about where your focus naturally sits, and more importantly, where the HCP feels your focus naturally sits.
Lowering self-orientation and increasing HCP-focus are very closely related, but they are not quite the same thing. Let me explain.
Reducing self-orientation is largely about removing the behaviours that get in the way. Increasing HCP-focus is about actively demonstrating that the HCP and their world are at the centre of the interaction and crucial to driving what comes next.
One of the most powerful ways to do this is through the quality of your questions. Questions that show genuine curiosity about the HCP's experience, their patients, their decision-making process, and the challenges they are navigating, all communicate something important. They communicate that you are interested in understanding their reality before offering anything into it.
Remember you cannot fake genuine curiosity. That in itself is an oxymoron. HCPs can sniff out faux curiosity, and the moment they do, every other question you ask in that conversation gets quietly filed under the same suspicion.
Another important behaviour is acknowledging what you have heard before responding. This may sound small and potentially trivial, but it has a significant impact.
When an HCP shares something, and you immediately move into your response, it can feel like you were waiting for them to finish so you could speak. When you acknowledge what they have said first, even briefly, it confirms that you have genuinely taken it in and that you were not just waiting impatiently for the final word of their last sentence.
HCP-focus also shows up in the moments where what the HCP needs and what you had hoped to discuss are pulling in different directions. The temptation here is obvious. You came prepared, you have a plan, and there is a part of you that wants to keep things on the rails.
But being willing to follow their priority, even when it means setting your own to one side, is one of the clearest signals you can send. It says that this conversation is for them, not for you.
Doing the opposite is about as useful to them as taking a train that has travelled past their stop.
Over time, these behaviours create a pattern. And once that pattern is established, something interesting happens. The HCP starts to walk into conversations with you expecting them to feel useful, regardless of what is on the agenda. They become more open, more engaged, and more generous with their time.
All because you made it clear, again and again, that the conversation was for them.
Now that we have walked through every element of the Trust Equation, the bigger picture starts to come into focus.
Credibility, reliability and connection are the elements that you actively work to build. Self-orientation is the element you actively work to reduce. Together, they shape how trustworthy you are perceived to be in any given interaction.
In a world where AI is changing the way information is accessed, every one of these elements becomes more valuable.
Not less.
Because the things that AI cannot replicate are the very things the Trust Equation is built upon. The judgement behind your interpretation, the consistency of your behaviour, the connection you create in conversation, and the genuine focus you bring to the people you serve.
This was the central idea we set out to explore at the start.
The real threat to the MSL role was never going to be artificial intelligence. The real threat is misunderstanding the role itself and undervaluing the deeply human skills that have always sat at its core.
If those skills are recognised, developed, and consistently demonstrated, then AI becomes something very different to a competitor. It becomes a tool that frees you up to do more of what only you can do.
And that is the most exciting part of this new chapter.
If you would like to explore how Excel Communications can support your medical teams in developing these vital human skills, we have been training medical teams successfully since 1986. Different tools and technologies have come and gone over that time, but our focus has always remained on the skills that underline effective medical dialogue.
See how we help medical teams develop these skills in practice here.
Thanks
Alex & The Excel Team