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6/7/2004

Effective Leadership Is Vital to Pharmacy's Future

Donna Young

Desks overflowing with paperwork, e-mails and voice mails needing responses, and a calendar bulging with meetings are some of the challenges that prevent pharmacy directors, managers, and clinical coordinators from spending time mentoring, training, and socializing with staff, said Sara J. White, scholar-in-residence and a past president of the American Society of Health-System Pharmacists (ASHP).

White, who retired in 2003 after 11 years as pharmacy director at Stanford Hospital and Clinics in Stanford, California, and 20 years as associate director of pharmacy at the University of Kansas Medical Center in Kansas City, is studying leadership issues and the challenges that affect pharmacy, including a lack of future leaders, changes in school curricula, and the need for more postgraduate training.

Balancing the time spent with staff, at meetings, and on paperwork is a tough job for any leader, she said.

But, White declared, pharmacists in management roles should never sacrifice contact with staff to attend to other administrative activities.

People are a pharmacy leader's most important asset, she maintained.

Pharmacy leaders should be responsible and accountable for ensuring that all staff members are properly trained, competent to do their job, and successful in their work, White said, and must "not blame their people if things don't go as planned."

Pharmacists in decision-making roles have an obligation to openly share information with all staff, she asserted, and should be willing to train potential successors to "take over your job should you get an opportunity to leave or something happens to you."

Staff should also be included in developing a health-system pharmacy's goals and written vision, which should be frequently reviewed and updated, White said.

Decision-makers should be willing to try new ways of doing things and "dare to have big dreams," she said, and should not limit the pharmacy staff to processes used in the past.

Also key to a pharmacy leader's success is to keep a "positive, optimistic, enthusiastic, can-do, will-do" attitude and not act like a victim when having difficulties getting medical staff to come on board to a new concept or project.

"We tend to sit back and say, 'Well, physicians won't let us do something,'" she said. "That's the victim concept."

If one physician does not welcome a new idea, White said, a pharmacy leader should be assertive and keep persisting until he or she finds a physician who will be a champion for the idea.

"If you believe you can do it, you'll figure out a way to get it done," she said.

Carpe diem. Pharmacy leaders, White declared, should "seize an opportunity where ever they can find it."

"You can't wait to be discovered," she added.

Pharmacists in management roles must be willing to take some risks and "make mistakes, not with patient therapy, but with their services because they learn" from them.

Thomas Edison, she noted, "had to try a lot of times before the light bulb worked."

Projects should never be labeled as "pilots," White cautioned, "because the word pilot means it's going to be evaluated and it could be not continued."

Rather, she said, pharmacy leaders should confront other health-system staff with the attitude that "we're going to start this service and if we have a bump in the road we will just alter how we're doing things. I wouldn't even go into it thinking there are going to be obstacles. But there will be. But I wouldn't verbalize that. I would fine-tune it as I go.

"I wouldn't put anything in anybody's mind [suggesting] that it isn't going to work because you don't know. You may get lucky because it might go exactly as planned."

Pharmacy professionals are "our own worst enemies" when it comes to promoting pharmacists as experts in drug therapy, she admonished.

Now that 40 states have collaborative drug therapy management laws or regulations in place, she asked, "are pharmacists really stepping up and utilizing that authority?"

The pharmacy profession, she said, needs to work harder to "highlight" practitioners who are practicing collaborative drug therapy in their state.

What is the future? Critical to the outlook of pharmacy, White said, is the need for more health-system pharmacists to serve as preceptors and mentors for pharmacy students and residents.

"Regardless of the size of the place or the time you've got, it's so critical to teach, precept, and mentor pharmacy students and pharmacy residents because they are the future," she said. "Somebody did it for you. They probably didn't think they had the time, but they made the time."

Pharmacy student and resident programs also serve as an "excellent recruiting tool," White contended, and are an "excellent investment in the future and in keeping your positions filled," especially for small and rural hospitals.

"A lot of the smaller community hospitals really provide excellent clinical practice, but if students or residents haven't seen that, they may be reluctant to think about going to a more rural area or even considering it since there's such a [pharmacist] shortage," she said.

Step up and serve. Another way pharmacy leaders can give back to the profession is to volunteer to serve on committees at ASHP or their state pharmacy organization or seek elected leadership positions, White noted.

Some chair positions could also be split between two cochairs to allow pharmacists who want to serve in leadership roles the opportunity to accomplish their goal, she added.

Young pharmacists should also be encouraged to seek leadership opportunities, White declared.

"We need to get them involved early because they are still enthusiastic, they've still got time, and the concept that you have to have 'paid your dues for years' needs to be thrown out the window," she said.

Pharmacists in management roles should also attend and participate in local, state, and national professional meetings, White said.

Leaders who are planning meetings should try to schedule gatherings at the most convenient time and recognize that not all people will be able to attend the entire meeting, White said. "I think they need to be realistic," she affirmed.

Meeting planners should also use Webcast and teleconference technology where it is available, she added.

Pharmacy leaders or pharmacists who are seeking to become leaders, should search for opportunities to present posters at meetings or publish research and other information in professional journals, White said.

"Seek a mentor who has done these things and they will help you, and it's not so overwhelming that way," she advised.

Don't worry, be happy. Pharmacy leaders need to have a sense of humor in their jobs and "not take everything so seriously," White counseled.

"I think we're so aware that everything we do could harm a patient, and so we need to be serious in that mode," she said.

But when it comes to relationships with staff and organizing work and processes, she added, "we don't need to be quite so serious."

Pharmacists in management roles should hold social events for staff to celebrate birthdays and other special occasions and should "find successes to celebrate," White said.

Pharmacy leaders should try to hold parties and other special events near a shift-change time, she added, so that as many of the staff as possible can participate.

Pharmacy leaders should always act with integrity and "manage themselves so that people want to be around them," White said, and "seek to continually grow and develop yourself."

"You have to do what you love and love what you do," she said. "If you don't, get out. Life is too short."