Key takeaway
KOLs earn influence through research and the podium; DOLs through online content and peer networks. What the difference means for pharma engagement, with lessons from BeOne Medicines' Nico Renner.
Short answer: A key opinion leader (KOL) earns influence through research, guidelines and the conference podium. A digital opinion leader (DOL) earns it through the content they publish online and the peer networks that share it. Many experts are both. For pharma commercial teams, the real shift is from pushing messages at HCPs to earning their attention with useful, transparent content that they choose to engage with.
ZS defines a DOL as "an individual who holds meaningful influence over scientific and clinical opinion … through digital channels and peer networks." A DOL is usually a physician, pharmacist, nurse or scientist who posts, comments, runs a podcast or newsletter, or shares cases with a large professional following.
The Medical Affairs Professional Society (MAPS) describes a KOL as "an expert or thought leader who has earned the trust of their peers." DOLs, by its description, tend to reach far larger audiences through online and streaming platforms, often as generalists, while KOLs usually speak to a narrower specialist community.
That gap is the opportunity. In May 2026, Pew Research Center analysed 6,828 US health and wellness influencers with at least 100,000 followers. 41% mention a health care profession, but only 17% are conventional medical professionals such as doctors, dentists and nurses; coaches (31%) and entrepreneurs (28%) are more common. When qualified clinicians are a minority of the health voices online, the DOLs who are qualified carry extra weight.
The two roles often overlap. A respected KOL with an active LinkedIn presence is also a DOL, and many younger DOLs will be tomorrow's KOLs.
The case for DOLs starts with time. In the AMA's 2025 survey of nearly 18,000 US physicians, the average workweek in 2024 was 57.8 hours, with 27.2 hours of direct patient care, and 22.5% spent more than eight hours on the electronic health record outside normal working hours. In athenahealth's 2026 Physician Sentiment Survey of 1,045 US physicians, 45% called their daily workload unsustainable and 63% said they feel overwhelmed by the amount of information in patient charts. An earlier study estimated that a primary care physician would need 26.7 hours a day to deliver all guideline-recommended care, falling to 9.3 hours with team-based care (Porter et al., JGIM, 2022).
Europe adds a workforce squeeze. The WHO projects a shortage of 950,000 health workers in Europe by 2030, and nearly one in three EU doctors was over 55 in 2023 (Euronews, December 2025, citing WHO and OECD).
So HCPs pick content that fits around their day. In the 2024 Van Ravenswaay study, the most used platforms were Facebook (70.7%), LinkedIn (52.2%), WhatsApp (50.6%), Instagram (41.7%), Twitter/X (26.6%) and TikTok (9.9%). And ZS found that 64% of KOLs use social media to keep up with guideline updates (Medical Affairs Outlook 2025).
At the 4th Pharma Omnichannel HCP Engagement Conference in Barcelona in March 2026, Nico Renner of BeOne Medicines spoke about trust, strategy and social media. He made clear in his presentation that he was speaking in a personal capacity: "This is my personal opinion, not my current employer's perspective."
He opened with the cost of HCP time:
"Every minute you waste is a minute an HCP can't treat a patient."
Nico Renner, BeOne Medicines, 4th Pharma Omnichannel HCP Engagement Conference, March 2026
On social media, his view was that the channel itself changes how brands behave: "Social media forces you to be customer centric." He argued that reach is not the goal: "A good marketeer does not only create 'share of voice', but sustainable thought leadership and trust."
He was also candid about the measurement gap: "We have little to no tools to measure 'scientifical credibility' or 'trust'." And he separated attention from trust: "The first 'impression' matters to earn attention. But the 'engagement' earns trust in the long run."
One point matters for field teams: "Trust is also transferrable from online to offline settings." His closing message was "Trust first, sell second."
Renner also asked the room to choose between "immediate info, rough design" and a polished design delivered three weeks later. It is a useful test for any content team working with DOLs, where speed often matters more than finish.
Renner put it directly: "In pharma marketing the strongest strategic lever is segmentation, not personalization." He added that "personal journeys are not linear (anymore)."
For DOL programmes, this means starting with clear HCP segments and the questions each segment is asking, then choosing the DOLs those segments already follow. It also means saying no. As Renner warned, "Ambitions consume resources." And: "If your strategy does not come with a plan, you don't have 'goals', but 'dreams'." He also reminded the audience: "If your strategy is impossible to be executed, don't blame the executors."
For more on channel strategy, see Multichannel vs Omnichannel: What Is the Difference in Pharma?
Outbound engagement pushes messages to HCPs: rep calls, emails and banner ads. Inbound engagement creates content that HCPs look for and choose to follow. DOLs sit firmly on the inbound side.
Most budgets are still outbound. Medical affairs teams told ZS that in-person spend runs at about five times non-personal spend, and 78% said they were still at the ideation or foundational stage of omnichannel (Medical Affairs Outlook 2025).
The information journey is also moving to AI. Doximity surveyed more than 3,100 US physicians in two waves: 63% were using AI for work by November 2025 to January 2026, up from 47% in March to April 2025, and literature search was the top use (35%). IQVIA reports that 38% of HCPs rate generative AI as a critical or very important source, and 94% of users say it makes finding information easier. IQVIA also cites Offcall's 2025 report that 45% of US physicians had used OpenEvidence. Content that DOLs publish and discuss is part of the evidence these tools surface.
Renner's reminder fits here: "Your opinion doesn't matter. Your customers opinion does." To track whether inbound content is working, see How Do You Measure HCP Experience, Not Just Reach?
Influence brings risk. Havas Lynx found that 71% of HCPs believe pharma has a responsibility to tackle misinformation, but only 41% feel enough is being done, and 61% say misinformation has damaged trust with their patients (Doctored Truths, October 2025). A badly run DOL programme can add to that problem.
Audiences also judge credibility on surface signals. A Virginia Commonwealth University study published in October 2026 in the Journal of Consumer Affairs analysed 330 TikTok videos from 11 US physician-influencers and interviewed 26 Gen Z followers. Followers "don't check credentials", the researchers found, and judge legitimacy by cues such as scrubs, stethoscopes and diplomas. In their words: "What a physician-influencer recommends may carry more weight than what their own doctor tells them." That influence is exactly why pharma partnerships with DOLs need clear rules.
The main rules to follow:
Companies want more structure too. In Health Union's 2026 Pharma Marketing Pulse, 93% of marketers who work with influencers said partners need a validated medical and regulatory review system (small sample, 50+ marketers).
A practical checklist for any DOL partnership:
DOLs are not a replacement for KOLs or for the field force. They are a way to reach HCPs where they already spend their limited time. The teams that succeed will pick DOLs by segment rather than follower count, fund content that answers real clinical questions, and measure trust as carefully as reach. As Renner said, trust built online carries into the next face-to-face meeting.
These themes will be on the agenda at the Pharma Commercial Innovation Summit in Valencia on 24–25 November 2026.
Header photo: Vitaly Gariev on Unsplash.
A KOL earns influence through research, guidelines and congress talks. A DOL earns it through online content and peer networks. The difference is where their influence lives, and one person can be both.
Yes, under the same rules as other consultancy work: a legitimate need, a written contract, fair-market-value fees and full disclosure. In Europe, influencers must not be used to promote prescription medicines to the public.
In a 2024 study of 2,615 HCPs, social media users were most active on Facebook (70.7%), LinkedIn (52.2%), WhatsApp (50.6%) and Instagram (41.7%). TikTok was used by 9.9%.
In a 2024 Sermo and LiveWorld survey of 317 US physicians, 50% said they had changed a prescription because of influencer content and 69% engaged with such content daily.
No. Pew Research Center's 2026 analysis of 6,828 US health and wellness influencers found that only 17% are conventional medical professionals such as doctors, dentists and nurses. Coaches and entrepreneurs are more common.
Start with your HCP segments and the questions they are asking. Then use social listening and network analysis to see who those HCPs already follow and trust, rather than ranking by follower count.
The Pharma Commercial Innovation Summit, organised by UBIQ Events, brings together pharma commercial, marketing and medical leaders to discuss HCP engagement, AI and new commercial models. The next edition is in Valencia on 24–25 November 2026.
