A: BALANCING THESE RESPONSIBILITIES depends greatly on what the immediate business needs are. For example, earlier this year, I was primarily engaged in organizational change. Now, I'm deep into 2018 business planning. One notable difference in the two facets of my role is that I'm usually more in control of change in the MDU work. But when it comes to external medical affairs activities, change often is dictated by the external environment, the healthcare environment, or the political or legislative environment.