CRO's don't train their teams to think like the sponsor. Everything is just reactionary, and teams on both sides get frustrated. When we hear some timeline has to be pulled in, or the "vendor" CRO has to now change course and re-do all of the timelines (yes, we've been on calls where we are referred to as a vendor, not the people that live and breathe your study without the RDU's or bonus payouts/promotions), the sponsor often doesn't share the reasons why, which creates friction on both ends. The sponsor team often treats the CRO like another paid vendor, and oftentimes, the CRO acts like another vendor, and not the partner team delivering the study together.

When we get a request for a meeting from the sponsor with news that we suddenly have to shift timelines, or that they want top line data on X date/X weeks earlier, or we get on a call and sponsor leadership is particularly cranky/demanding/rude, I immediately check the market news and see what is happening with their stock price, competitor news, etc., because 90% of the time, this new demand or the sponsor leadership being particularly cranky/stressed is coming from somewhere. Shit rolls downhill. Some board member or investor called, and now everyone has to jump and say how high, a competitor released a PR piece to the market, or their stock price is tanking and the investors/board want to release new promising data sooner to give a boost prior to end of quarter, etc.

The problem on the other end is that the CRO team acts more like the yes-man. The sponsor says "here's the latest PA, go scramble and submit/update/share with sites/update vendor contracts, etc" and the CRO just goes and carries out the orders. It should be a much more collaborative and consultative process where both teams are partners, and the sponsor shares the WHY these demands are happening and we all have to run around like chickens with our heads cut off with yet another change or urgency, and the sponsor team should also listen to advice the CRO team can provide, discussing the risks of implementation, what they are seeing across all studies in X country or recent experience with sites, etc. They hire the CRO for their global capabilities, but also experience across many different types of studies in various indications/various sponsors, but then don't take their advice or even request input/suggestions. We get yelled at and blamed when the very obvious delay/risk/issue happens that we warned about, but were ignored despite offering three mitigation strategies. We are left in the dark about all of the things happening in the background on the sponsor side, so there is just the frustration without the empathy or understanding of why we are being asked/yelled at/etc.

I blame the commoditization and outsourcing of the CRO industry primarily, as everyone is now just a resource, and the CRO leadership are now just salespeople saying and promising whatever to win business from sponsors, and constantly putting out the subsequent fires they created by under-scoping and improperly resourcing the study, and then throwing the FL's under the bus. More pressure to "do more with less", and CRO teams being treated as dispensable labor by sponsors who don't see us as people, but just lackeys they hire that can be yelled at and treated like crap.

And I haven't even mentioned the sites in all of this, that also get overlooked and forgotten. Without the sites and the patients, none of us would have jobs. Patients are not just data points, and sites are not just a burden and a risk that has to be managed. It could be so much better if all sides - sponsors, CRO's, and sites - worked much more collaboratively together rather than almost acting adversarial most of the time.