Why Most Leaders Fail at Difficult Conversations

In this episode of The Pharmaverse Podcast, host Michael Pietrack speaks with Rajat Mishra, co-founder and CEO of Present Vivo, about how AI is changing medical affairs, scientific content creation, and the future of the Medical Science Liaison (MSL) role. Rajat explains how AI can help teams turn a single publication into presentations, posters, brochures, and other materials more quickly. But speed alone is not enough: scientific accuracy, useful context, and human review remain essential. He shares why MSLs who experiment with AI while strengthening their communication, judgment, and relationships will be better prepared for what comes next. The conversation also moves beyond technology. Rajat reflects on overcoming a childhood stutter, the mentor who changed how he worked with others, and the leadership practices he uses to build a fully remote team. In this episode: How AI can accelerate medical affairs content creation while keeping experts involved Whether AI could replace MSLs and which skills may become more valuable A practical way to start experimenting with AI in an existing workflow Why personalized communication starts with the audience’s preferences How to hire for initiative and build culture across a remote team Rajat’s leadership principles: move quickly on execution, stay patient with strategy, and remain open to changing your mind Chapters 00:00 – Preview: AI, communication, and the future of MSLs 00:44 – Meet Rajat Mishra 01:35 – Overcoming a childhood speech impediment 03:17 – A mentor’s lesson about working with people 04:40 – AI and human review in medical affairs content 08:02 – Will AI replace the MSL role? 10:52 – Skills that matter in an AI-driven industry 11:38 – How MSLs can start experimenting with AI 14:14 – Personalizing content with a “communication fingerprint” 16:55 – Rajat’s outlook on the future of AI 20:12 – Judgment, empathy, and creativity when intelligence is widely available 22:37 – Building culture on a fully remote team 25:45 – Hiring people with initiative 28:30 – Rajat’s top leadership advice Subscribe to The Pharmaverse Podcast for conversations with leaders across pharma and biotech, and share your thoughts in the comments: How are you using AI in medical affairs today?