Agencies often pitch exciting, ambitious "North Star" campaigns that get one department excited. However, these ideas frequently fail because the client's internal teams (e.g., digital, PR, comms) are siloed and not aligned. The agency sells a vision that other departments ultimately block, leading to an inability to deliver.

At Expedia, 20 million customers called to get their itinerary because no single department owned the problem of preventing calls. Marketing, product, and tech teams were all focused on their individual metrics. This shows how specialization, while efficient, can fragment ownership and perpetuate costly systemic failures.

The FDA previously operated as seven distinct centers, each with its own legal and communications teams. This extreme siloing created nightmares for developers of combination products and led to absurd inefficiencies, like employees being unable to email files between centers.

Effective healthcare requires connections far beyond the doctor and patient. A truly connected system integrates caregivers with management, the hospital with the patient, the patient with their community, and the entire system with government bodies. Operating in silos guarantees failure.

Experts often design components in isolation, perfecting their specific 'Lego' piece. When it's time to assemble the final device, these pieces fail to fit together because a systems-level approach was missing from the start, leading to costly rework and integration challenges.

When patient engagement is owned by a single department, it's often treated as optional. To make it a core business driver, responsibility must be shared across R&D, medical, regulatory, and commercial teams. This requires a structural and cultural shift to become truly transformational for the organization.

Expedia received 20 million support calls for itineraries because each department (marketing, tech, product) focused only on its own metrics. No single silo owned the cross-functional problem of preventing calls, so the problem festered despite its massive scale. True ownership must transcend departmental lines.

Functional silos cause Brand, Market Access, and Patient Services teams to view the same patient through different lenses, effectively creating three distinct customer profiles. This fragmentation means no single program addresses the whole person's needs, causing patients to "fall through the gap" between uncoordinated strategies.

Departments often leave meetings believing they are aligned on strategy. However, because each team operates from its own siloed data and customer view, they have actually agreed to different, conflicting plans. This "illusion of alignment" leads to wasted resources and ineffective strategies that fail at launch.