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How to Create Good Incentives
Interviewing terrific leaders and sharing their insights with you brings a special joy, and I’m delighted to bring you this interview with Amgen‘s Bryce Fennewald, who heads their Inflammatory Rare Disease Unit.
We explored what it takes to lead commercial teams that must combine deep scientific credibility, persuasive communication, and unwavering patient focus.
He offered leadership insights that apply far beyond biotech, especially for leaders navigating high-stakes decisions, complex stakeholder ecosystems, and fast-changing operating environments.
Bryce and his leadership team participated in an off-site with me at the Antietam and Gettysburg battlefields in November. Their unwavering commitment to patient outcomes, desire to build an unstoppable workforce, and dedication to supporting each other and the mission stood out to me as evidence of an extraordinary team. I wanted to learn more from Bryce.
1. Rare disease isn’t “selling.” It’s a partnership.
Bryce started by explaining what makes rare diseases different from large population categories like diabetes or hyperlipidemia. In many therapeutic areas, providers constantly see and manage hundreds of patients.
“Rare disease is different. It could be 18 to 24 months before they see a patient. Maybe they’re managing one, maybe they’ve never managed any. So their openness to information is a little bit greater,” Bryce said.
That changes the posture required from the field team. This isn’t about showing up with volume. It’s about showing up with value.
“So it’s really more, in my view, a partnership between provider, office staff, manufacturer access, reimbursement care coordinators, all the surrounding support staff,” he said.
“Never underestimate the value you bring.”
When your team truly believes they bring insight that improves outcomes, they show up differently. They ask better questions. They listen better. They carry themselves with the quiet confidence that earns trust.
2. The credibility formula: competence + confidence
You can map credibility on a double-axis chart: competence and confidence.
“If you’re not in the upper right quadrant demonstrating both, then you’re probably not as impactful as you could be,” he said.
Why? Because in rare disease, trust is the currency, and trust erodes quickly when either dimension is missing.
If someone has high confidence and low competence, Bryce put it plainly: “Distrust, like they’re trying to pull a fast one.”
But the reverse can be just as limiting: high competence and low confidence. Those individuals may know the science deeply, but fail to influence provider behavior.
“We’ve had these instances with really good people. They know the science so well, but they’re having very little impact.” In those cases, the best answer isn’t always “try harder.” Sometimes it’s redesigning the fit: “Would they be better suited in the training capacity where we’re asking them to train up our sales staff?”
And when the fit can’t be solved? He doesn’t sugarcoat it: “We coach up or coach out if it’s not the right fit.”
Keeping someone in the wrong role isn’t kindness, it’s drift.
3. Incentives should drive the behaviors you actually want
One of the most interesting leadership lessons Bryce shared focused on system design.
“Sales incentive plans should be easily understood. They should drive the behaviors that you want, and be easy to measure,” he said.
Then he added the warning shot:
“If it’s convoluted, people don’t understand it, and people don’t know what good looks like, then it’s a failed plan.”
That principle applies in every industry. If your incentives reward activity instead of outcomes, or speed instead of quality, you’ll get exactly what you pay for.
Bryce also described how they maintain standards in the field by surveying physicians shortly after engagement: “Within 14 days, we’ll survey and ask your intent to prescribe, the value that this individual brought, and if good information was shared.”
Then he closes the loop by sharing the results with the team, reinforcing what excellence looks like in the customer’s eyes.
4. Ownership beats ambiguity
When we shifted to hiring and accountability, Bryce emphasized something many leaders say they want but don’t operationalize: real ownership.
“We look for people who want to own their territory and their performance and their results.”
He explained that their model isn’t a pod or matrix approach. It’s full accountability for a defined geography: “The performance of that geography is 100% on you and you alone.”
“Some people say that they want to live like that, but then they don’t.” The leadership takeaway is simple: clarity creates performance. Diffuse authority creates excuses.
I was also struck by his decision-making discipline: “I focus on the decisions that only I can make and delegate those that my regional and district leaders should make.”
We discussed the two models of delegation during the offsite, which Bryce and his team are putting to good use.
5. AI is “adapt or die,” but only if it serves the work
Bryce was direct about where he sees AI heading: “It’s one of those adapt or die situations. It’s inevitable.”
What I appreciated most was his clean framework for adoption. Amgen buckets AI value into three categories: “proficiency, efficiency, and intelligence.”
- Intelligence: “How are we equipping the team to make more informed sales decisions based on all the data at our disposal?”
- Proficiency: enabling better preparation and practice, “pre-call plan, role play, and preparation, with an agentic kind of interface.”
- Efficiency: making time and routing smarter, “If time is my greatest commodity, how can I maximize it?”
He also offered a phrase that nails the shift happening across industries: “People are going away from a search engine and looking more for an advice engine.”
Providers are using platforms like OpenEvidence to get advice on patient care. How well are your products showing up?
The implication for leaders is huge: your customers are increasingly learning, deciding, and acting through AI-mediated responses. That’s not a future problem. It’s now.
“If you’re unable to communicate [knowledge] in a way that changes behaviors, what good is it?”
That’s the rare disease challenge. But it’s also the universal leadership challenge.
Competence matters. Confidence matters. Systems matter. Ownership matters. And in the end, what matters most is whether your leadership turns capability into outcomes that improve lives and create deep, enduring prosperity for the people who matter most to you.
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