The grey area of directional leadership

When I was in high school, I loved my trigonometry class. I do not know that I can describe why I liked it, but I did. Fast forward a number of years and my daughter is taking trigonometry this year. She came home the other day saying she was struggling with what they were studying. I went into boastful dad mode and began telling the stories of how I loved trig and was helping my classmates with the subject when I was her age; surely, I could help her figure it out. 

Then she opened the book.

I felt like Indiana Jones trying to decipher ancient hieroglyphics. There were these questions about “radians” which I had a vague recollection of – and that did me no good. I did have a moment where I recalled the “ambiguous case.” Do you remember that? These were situations where, based on the information in the problem, you could have multiple solutions to the problem. It could be one answer, but it could also be another answer.

Alas, we are not here to discuss trigonometry. We are here to discuss leadership. Taking into consideration our ongoing discussion of directional leadership, I wanted to submit to you something of an ambiguous case to consider. A grey area, if you will, that may very well have more than one answer. 

Are there times when we lead others from more than one direction?

More specifically, when leading our patients, what direction are we leading?

To me, or at least the me of several years ago, I would think it was leading down.  However, now that I have spent some time examining directional leadership, and more specifically traced the line of authority, I do not believe that is the case. We do not have direct authority over our patients. I think you could begin to make the case that our patients have some authority over us, so we should be leading up. After all, it is because of our patients that we get paid. This is somewhat similar to how we pay our support teams – where we lead down. 

You may also be able to see an angle where there is another payer involved and there is no direct authority one way or the other between you and your patient. In this case, we would be leading across.

In full transparency, I have no answer here. This is the current mental puzzle that occupies me throughout the days, most often during windshield time when I am in transit. I simply want to encourage you to consider this idea from a couple of different angles. From my current perspective, this is indeed ambiguous. 

Let’s take this a step further. Have you ever given a patient some instruction they did not follow? We all have! Follow-up question: have you ever “fired” a patient? That is probably infrequent at best, if at all. 

Or how about this situation? Have you ever had a patient who got upset with your pharmacy for some reason and then transferred business to another pharmacy? And then have you ever had that same patient later transfer the business back to your pharmacy? I can recall calling another pharmacy to transfer in a prescription and when I gave the patient’s name, the pharmacist on the other end of the line told his staff who was being transferred. He then (apparently) held up the phone so I could hear his staff celebrate that the patient was leaving! I clearly had no idea what I was about to walk into with this patient. 

This is further evidence that we do not lead down to patients. If it were, once a patient left, we would not accept them back. 

If this is true – that we do not lead down to patients – what do we do about it?

Come back next week to find out....

Until next time

Jesse McCullough, PharmD

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