The Project Management Paradox: Why Big Pharma Execs Struggle in the Real World

Project management—the noble art of being handed a budget, a timeline, and a goal, then tasked with delivering results while herding cats, pleasing stakeholders, and absorbing the blame when things inevitably go sideways. It’s the quintessential middle-management domain, and if it sounds like I know exactly what I’m talking about, it’s because I’ve been there. Spoiler: I hated it.

The reality of project management, especially in big organizations like Big Pharma, is a far cry from the sanitized frameworks you see in glossy corporate training decks. Instead, it’s a messy balancing act, where responsibility far outweighs authority, and success is often measured by your ability to dodge the fallout.

The Middle-Management Squeeze

If you’ve ever managed a project in a large organization, you know the drill:

1. You report to the leadership team (LT).
2. The LT, in turn, reports to their leadership team.
3. Everyone spends more time “aligning” and “socializing” the project than actually doing the work.

For a while, having an “LT” was a status symbol in its own right. If your team didn’t have one, you simply created one—after all, what’s another layer of hierarchy in the grand corporate machinery? But while the leadership teams align and strategize, the project manager is left in the trenches, juggling resources, chasing approvals, and bracing for the inevitable turf wars.

The Turf Wars and Toy Thieves

In big companies, chasing internal stakeholders can feel like trying to pry a favorite toy from a stubborn toddler. People guard their projects and priorities as if their careers depend on it—which, in fairness, they sometimes do. Even minute decisions can devolve into drawn-out battles, as department heads stake their claims over who owns what.

The result? Endless friction, delayed timelines, and a lot of meetings where nothing meaningful happens. If you’re thinking, “This sounds miserable,” you’re not wrong. It’s precisely why I ran for the hills and never looked back.

The "Consultant Boom" Post-Redundancy

Here’s where it gets interesting: many of the former Big Pharma execs who were recently made redundant (particularly in Switzerland) are now flooding the market as consultants, advisors, coaches, or ‘founders.’ On paper, this sounds great—lots of experience, impressive résumés—but the problem is that many of them are products of the same broken system.

In big organizations, it’s remarkably easy to “hide.” You follow the processes, check the boxes, and get things done as told, but that doesn’t mean you’re actually achieving anything. When you’re parachuted into smaller, fast-moving companies—or trying to sell your expertise as a consultant—this mindset doesn’t translate.

The Process Trap

One of the biggest flaws in the corporate mindset is an obsession with internal processes. In a large company, these processes are necessary to manage complexity and ensure compliance. But they also foster tunnel vision, where success is defined by how well you navigate the system—not by your actual impact on the outside world.

Once you leave the big-name corporate badge behind, the world looks very different. People don’t respond to your emails just because you were a VP at Pfizer. Your process slides don’t impress a scrappy biotech startup. And your meticulously crafted project plan? It’s obsolete the second something goes wrong—which is pretty much guaranteed.

Why Project Management in Startups is Different

Managing and delivering on projects is certainly important, but in smaller, emerging companies, the game is entirely different:

• Speed Trumps Process: In a startup, decisions have to be made quickly, often with incomplete information. There’s no time for endless alignment meetings or leadership “check-ins.”
• Adaptability is Key: Plans will change. Directions will shift. You’ll have to pivot midway through a project—and probably more than once.
• Execution Matters More Than Titles: No one cares about your fancy title or your LT. What matters is whether you can roll up your sleeves and make things happen.

This environment is chaotic, unpredictable, and at times infuriating. But it’s also where real innovation happens.

The Bottom Line

Project management in big organizations is often a thankless job, caught between responsibility and authority, internal stakeholders and external realities. In smaller, faster-moving companies, the stakes are higher, the pace is faster, and the rules are different.

The key to success isn’t more process or better frameworks—it’s adaptability, decisiveness, and a relentless focus on outcomes. And if you’re one of those former Big Pharma execs looking to make your mark outside the corporate machine, the lesson is clear: it’s time to let go of the safety nets and learn to thrive in the chaos.