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Part 1: The Influence of Leadership

Adapted from 2011 Drake Pharmacy and Health Sciences Day Keynote Address

“Leadership is influence – nothing more, nothing less.” – John Maxwell

In the course of my work, I am responsible for continually assessing and identifying opportunities to provide additional education to help new practitioners as they get started in their careers. I often hear from new practitioners that they need additional guidance on areas that, “they just didn’t teach us in pharmacy school.” This, by no means, is an insult to pharmacy school curriculums. It is simply the reality that there is only so much time allowed during your education and the didactic curriculum continues to grow and takes up that available time. As a result, I spend a lot of my time providing resources to new practitioners on topics such as how to be a good preceptor (because, after all, they were the ones being precepted just a year or so ago), how to manage relationships with people that are older or more experienced, how to build credibility, and how to become a change agent. Last week, I was in a studio in downtown Washington D.C. filming a continuing education video on ‘influencing” change as a member of the healthcare team. This sounds a bit broad, but the content comes down to how do we, as pharmacists, build credibility and influence and ultimately, due to strong relationships, effectively influence other members of the healthcare team to accept our recommendations about medication therapy as we all work toward an optimal patient outcome.

That word, “influence,” is a word that seems to pop up often in the context of our work as health care professionals. Interestingly enough, this video was being developed by new practitioners for new practitioners- definitely not individuals that are in recognized leadership roles. Leadership doesn’t always mean a leader with a title.

Of course, leadership has always been a component of many pharmacists’ careers, or we wouldn’t have experienced the advancement we have in the profession compared to many years ago. The topic of leadership in health-system pharmacy really hit a fever-pitch in 2003 – 2004. Sara White, a retired Director of Pharmacy from Stanford Hospital and Clinics and a 20-year Associate Director of Pharmacy and the University of Kansas Medical Center, became a Scholar-in- Residence at ASHP for four months during 2004. Her project was to assess the status of health-system leaders and determine if there would be enough leaders for the future. Her findings indicated that there was potential for a leadership gap as the make-up of the profession was changing as more females entered the workforce and as our generation demanded a degree of work-life balance. Additionally, effective mentoring was being underutilized. Sara’s paper on this issue, “Will There Be a Health-Systems Pharmacy Leadership Crisis?” established the foundation for much of the emphasis on leadership we hear about today in our profession and has become a commonplace reference in our day-to- day pharmacy lives.

Another issue that was widely discussed as this pharmacy leadership gap phenomenon was identified was a recognition that as our profession has shifted to a more clinical focus, those in clinical practice have not exhibited a natural tendency to engage in recognized leadership roles. Why waste time in potential management positions? We want to spend time using our clinical skills with patients. Basically, we were recognizing a bit of a conundrum – we were successful in achieving more clinically-focused career opportunities in pharmacy because of previous pharmacy leadership with vision and influence to create those opportunities, yet once we were successful in establishing these roles, we backed off of the leadership component a bit. The reality is that pharmacists – all pharmacists – must be leaders or others will step in and lead us. I think something that most of us who have practiced in one realm of pharmacy or another will agree – things can become quite difficult when pharmacy services are being led by individuals other than pharmacists, so it is important that all pharmacists recognize the importance of stepping up and leading pharmacy endeavors.

As I mentioned, Sara’s work has become the impetus for many other projects and initiatives as pharmacists work to address the recommendations she established in her report. Another report that I would like to mention is the “Leadership as a Professional Obligation” report issued in June 2008, from the ASHP Student and New Practitioner Leadership Task Force. This Task Force was convened by the ASHP Research and Education Foundation Center for Health-System Pharmacy Leadership. In a nutshell, this group was tasked with looking at the exposure (or lack of exposure) students and new practitioners have to leadership in their studies or practice training and identify opportunities to incorporate leadership education into any identified gaps. Additionally, the task force highlighted issues and challenges that uniquely impact students and new practitioners’ desire or ability to assume formal or informal leadership roles. The report offered a number of novel recommendations and many of those recommendations have become the basis for new projects and initiatives. In closing, I would like to share one strong statement that comes directly from the task force’s report: “(The) key to our existence and future is our ability to successfully influence others. Thus, leadership is not an option; it is a professional obligation.”