When he arrived at Guidemark Health in March 2018, CEO Michael Parisi didn’t know exactly what to expect. While he’d led agencies before and was looking forward to “getting outside the network model,” as he puts it, he acknowledges that he hadn’t done so for nearly two decades.

A little more than a year in, Parisi uses the same adjective to describe himself and the company he leads: energized. “What we’re doing here is refreshing in a way that is very different than where I came from — which is not a criticism of where I came from,” he says. “The flexibility here surprised me. The diversity of talent for an agency our size surprised me.”

Indeed, there’s a sense that Guidemark has reinvented itself. The agency has streamlined its offerings and rethought its mission. “We’re all about ‘working one need ahead,’” Parisi says, quoting the new Guidemark mantra. “Our job is to always be thinking about solving your problems rather than trying to sell you 10 things. It’s about asking, ‘What are you facing today as a business?’ and ‘What will you face tomorrow?’”

Clients have responded warmly to the new approach. Additions during 2018 included Nestlé’s Atrium Innovations natural health/supplements subsidiary, Helsinn (as AOR for skin cancer drug Valchlor and chemotherapy treatment Akynzeo), Bayer (for project work on oncology drugs Xofigo and Aliqopa) and Tocagen (for medical affairs work on an in-development glioblastoma drug).

At the same time, Parisi cites awareness of Guidemark’s offerings and especially its people as an ongoing challenge. Asked about the agency’s perception among would-be clients and other outsiders, Parisi responds, “I’m not sure there is a perception, quite honestly.”

Perhaps that’s why Parisi is as keen to define what the circa-mid-2019 Guidemark isn’t as what it is. “You won’t see any managed-care clients here. We could pull some people together to fake it, but that’s not who we are,” he says. “We have the ends of the spectrum covered — health and wellness on one side, oncology and rare disease and IBS and ulcerative colitis on the other — but don’t take that to mean we can do everything in between. It’s about focusing people in distinct areas and not trying to be everything to everyone.”

While revenue declined slightly in 2018 — to $28.5 million from 2017’s take of $30 million — and head count fell from 104 to 78 as the agency relied more heavily on outside contributors, Parisi says Guidemark is “projecting pretty aggressive growth” for 2019. He’s particularly optimistic about the company’s new patient-engagement offering: “The idea is to consider the patient community as a professional audience in certain cases.”

And almost alone among agency heads, Parisi is quick to rattle off his client wish list. “I have lots of respect for how BMS does things. The Bill and Melinda Gates Foundation would be great, not just from a philanthropic standpoint but more and more from a knowledge standpoint,” he says. “You’re going to see a different mix of clients than you have in the past.”