Fear: It is said that as babies, we are born largely unafraid. It has been suggested that we learn to be fearful as we grow either from our parents or from our own experiences. The purpose of this column is not to debate the psychology of fear but rather to share my observations how this strong emotion can impact our lives, the business environment and even the business of drug development.

While I am no expert on the topic, I think it is fair to say that we all have a fear of something. While it is something that I try to confront, I still have “ophidiophobia” – a fear of snakes. I’m getting better at it but I haven’t held one yet. During our nearly 23 years of marriage, my wife has made remarkable progress with her “arachnophobia” – a fear of spiders. Because I travel a lot, I periodically encounter individuals who have “aviophobia” – a fear of flying. Isn’t it interesting that the anticipation of a specific experience can trigger an almost debilitating fear response in one person and yet have no impact on another? [Maybe “impact” was the wrong choice of word.-ed]

As a consultant, I get to see a lot that goes on in preclinical drug development. I am often supporting the outsourcing activities of pharma and biotech sponsor companies with multiple CROs. I get to meet a lot of people and get to experience a lot of company cultures. In preparing for this article, I checked the website, www.phobialist.com, and was quite surprised at what I found there. There are phobias that describe a lot of what I see in the industry today. In fairness, I am sure that the behaviors that result from these fears can be found to some degree in all industries, all governments, all academic settings, and all societies around the world. It has always been my nature to take note of what is going on around me so here are some of my observations from my business experiences:

Although I couldn’t locate a formal phobia name for it, I believe that the fear of looking bad is the most powerful and debilitating emotion in our business environment today. It exists in our society and, boy, have I seen it in the drug development industry. Publicly traded companies fear how they will be viewed by Wall Street analysts. Company A doesn’t want to appear to be inferior to its competitor, Company B. Management teams want to be sure that they can effectively answer investor questions. Management wants to be sure that they are saying the “right” things. Employees want to be sure that they can answer management questions. Employees want to be sure that they are giving the “right” answers. Manage-ment doesn’t want to look bad to employees and employees don’t want to look bad to management. Regardless of level, those in management want to be sure that the performance of their functional components reflects favorably on them. If the fear of looking bad exists among the senior management in a company, you can bet that it exists everywhere in the organization. Sadly, in some companies, the fear of looking bad is the company culture. This particular fear is so powerful it can impact basic every day decisions: office attire, meeting participation (or lack thereof), lunch companions, social settings, and dating selections. The list can go on and on. Why do I raise this observation? The fear of looking bad can have a tremendous negative impact on an organization and its employees. It is the anchor that holds an organization back while management is yelling, “Full speed ahead!” It results in a tremendous waste of time.

When this fear is entrenched in a company’s culture, employees can spend as much or more time trying to look good to management rather than focusing on the job at hand. Some may label this as “company politics.” Whatever you want to call it, I believe it is the top reason for poor organizational productivity. In the pharmaceutical and biotechnology industries, this fear can slow drug development pipelines. Why? Incredibly, in some companies, delivering bad news can adversely impact careers. In preclinical CROs, the fear of looking bad can result in poor organizational quality and/or ineffective operations. Executives can provide all kinds of metrics and explanations as to why their organizations haven’t achieved optimal productivity when the basic problem may be that their employees are afraid. Frequent organizational changes and changing marketing themes can be symptoms of this organizational fear. If employees don’t feel secure in their jobs, they will adopt behaviors that seemingly provide this security even though it can bury vital information that is needed for a company to move forward. The fear of looking bad is so powerful that it nurtures the existence of other fears:

Atychiphobia (fear of failure) – This is another powerful emotion that permeates our society. When this fear exists in an organization, the way that the organization or its employees address it may not ultimately be in the best interest of the company. In drug development, this is something that sponsor companies mull over all of the time. Since the preclinical CRO industry is so competitive, will sponsors always be told bad news in a timely manner? Will operational failures be shared openly or will a gag order be placed on employees? In the latter case, the fear of looking bad has now created a situation where the organizational trust is called into question.

Cenophobia (fear of new things or ideas) – There is comfort and security in what is familiar to us, yet organizations that squash new ideas limit their ability to achieve greater levels of productivity. New is not always better, but the environment should at least allow the discussion to occur.

Decidophobia (fear of making a decision) – It is understandable that no one wants to make a wrong decision. One way to avoid this concern is not to make a decision with the hope that other information eventually becomes available to guide the decision. The problem here is that your colleagues or other companies – preclinical CROs in particular – might need your decision so that they can perform their duties. Many in preclinical CROs will tell you that this is one of the most frustrating concerns that they have in dealing with sponsor companies. What’s worse, slow decision-making can adversely impact the quality of the work at a CRO.

Hypengyophobia (fear of responsibility) – This one is closely tied to the fear of making decisions. If you consider that, in theory, nothing bad can happen to someone who isn’t responsible or accountable for an outcome, then it is easy to understand company cultures where “finger pointing” and “passing the buck” are a way of life. Again, these are additional reasons why the focus is not on doing actual work.

Liticaphobia (fear of lawsuits) – Do you know any company that actually looks forward to a lawsuit? Of course not! The problem in some organizations is that this fear is so pronounced that the workaround solutions can cripple an operation. This is a particularly challenging issue when dealing with underperforming personnel. If you are in a sponsor company, would you want to work with a preclinical CRO knowing that underperformers were working on your studies because the CRO was hesitant to address performance issues? I don’t think so.

Macrophobia (fear of long waits) – If you are an outsourcing professional in a pharmaceutical or biotechnology company, you know that one of the worst things that can happen is if you can’t find the capacity at a preclinical CRO to start your study in the timeframe that is designated by the project plan. If you can’t manage external capacity, you will look bad internally. Preclinical CROs know this and, until 2009, playing off the sponsor fear of having a long wait until the study could start was an effective marketing strategy. With so much open preclinical capacity in the industry now, this marketing advantage no longer exists. Ironically, it is now the CROs that may be afflicted with “macrophobia” as the study backlogs of the past are gone and many are waiting for work to be committed by sponsors.


Based on what I described above, I think it is fair to say that fear is a factor in the workplace. In drug development, these are some of the reasons why sponsor representatives worry so much about outsourcing their work. It is one thing to effectively communicate science or a study design but you have no idea what is going on in the CRO work environment. This is why spending time to develop outsourcing relationships is so critical. Sponsors can assess the work environment at the CRO and the CRO employees can better understand how to work effectively with sponsor companies. Some CROs have announced multiple layoffs this year. Layoffs may be necessary but the magnitude or frequency can leave employees to wonder, “Will I be next?” Do CRO employees fear for their jobs?

In these situations, sponsors need to determine if the remaining employees have sufficient experience and if there will be sufficient focus on the sponsor’s studies. The only way to do this is to go in and talk to the staff. Of course, this assumes that, as a sponsor, you knew that the CRO had undergone layoffs. If the CRO management team didn’t disclose this, was it because they were afraid of looking bad? If so, what else haven’t they told you?

It has been said that the best way to get over a fear is to face it. Many sponsors fear being out of control when it comes to outsourcing their preclinical studies. The complexity of preclinical operations is one concern and, when you add in what I mentioned above, I don’t think that it is ever possible to be in control as a sponsor. I think “control” is something that you strive for but I don’t believe that it is achievable. Be careful; management teams don’t like to hear that, but denial does not change the reality. What sponsors (and preclinical CROs) should strive for is risk mitigation. Risk is mitigated through effective communication, building sound outsourcing relationships, and knowing as much as possible about your CRO’s operations. Sometimes you may realize concerns before they are seen by the CRO staff.

I don’t think fear will ever be eliminated from the workplace. It is sad that it exists and it would be convenient to blame it all on senior management. While I do think that effective leadership can reduce workplace fear and provide a more secure work environment, management teams are subject to the same societal pressures. Like I said, it helps if you can at least acknowledge the fear. Have you ever heard how some organizations talk about staff reductions? This is how the terms “downsizing,” “right-sizing,” and others originated. If your organization can’t say or use the word “layoff,” you may have bigger issues than just your fear of looking bad.

I know; this is a scientific-oriented publication and here I go with all of this talk about emotions and relationships. Who would ever imagine that emotion could impact drug development? There is a whole lot more to outsourcing than the effective communication of science or the technical effectiveness of a preclinical operation. In my opinion, fear plays a significant factor in the workplace. If you can’t discuss it, you can’t address it.

Steve Snyder is a consultant with more than 25 years of experience in preclinical toxicology as an outsourcing customer and provider.