What if there's no clear direction for your pharmacy leadership?

Last time, I left you with a dilemma: in what direction do you lead if a patient leaves your pharmacy, transfers to another, but then returns to you?

A few thoughts come to mind:

1. Probably most important thing is to improve your leadership skills in the first place because we know that patients will not simply do what they are told.
2. We need to understand the differences in directional leadership so that we invest our time to lead our patients better, whether it's leading across or leading up, according to the model we examined last time.
3. We need to make our teams aware of this model so that everyone is operating in harmony with these skills.

Over the last several weeks I have been writing longer articles, which our wonderful editor then carves into multiple shorter articles. As I write this, I am going to assume this will happen again, perhaps around this point. 

As I was writing this article, an appointment reminder came up on my calendar that I was to meet an old friend for lunch. He and I go way back to even before we were in elementary school, which puts our friendship over 40 years. He currently practises locally as a chiropractor. 

The purpose of our meeting was not to debate healthcare philosophy, but rather how best to help a local non-profit organization. My friend had recently read a book that he believes is the blueprint that will really energize this local organization. He is so excited about it, but he cannot get the leader of the organization to read the book (or adopt the blueprint). 

Towards the end of our visit, I took the cups and salt and pepper shakers which were still on the table and described directional leadership to him. Pointing to the saltshaker, I said, “This is you.” Then pointing to the other pieces on the table, I asked which one the leader of this local organization would be. Then one of the most satisfying things that any of us can experience happened: I was able to see the light bulb go off, and he got it!

As part of this conversation, we also talked about giving instructions to patients that they did not, would not, or even could not follow and how frustrating it is when that happens. This type of frustration is not limited to us as pharmacists; we must understand there is frustration on the patient's part as well. Sometimes that frustration is so great, the patient will seek out another provider.

Since that meeting, I recalled a more recent conversation I was a part of with an oncologist in California. The oncologist lamented that he could not get so many of his patients to even get lab work done. The words he used to express his frustration: “I am only trying to save your life!”

I may not be decided on whether we lead up or across to the patients for whom we provide care. But I am reasonably sure that we do not lead down to them. I am also reasonably sure that our colleagues who exclusively lead down to their patients are likely highly frustrated.

To that end, allow me to remind you what leading up and leading across may look like.  When we are leading up, we are noticing problems that the patient has and we are bringing suggested solutions to the table. When we are leading across, we are sharing solutions that others have had success with that may also be helpful to the patient. 

Here's an example. Jerry is a pharmacist and a diabetes educator. He is often helping patients who have just had their worlds turned upside down with a diagnosis of diabetes. Jerry tells a story of one of his patients just diagnosed with diabetes. This guy was struggling. He was thinking only about all the foods he would no longer be able to enjoy. Jerry asked the patient where he most liked to go out to eat. The patient said, a local barbecue restaurant. Fearing those days were done, the patient was surprised when Jerry informed the patient that he would indeed have to go back to that restaurant! The patient was surprised and nearly stood up out of his chair. Jerry told the patient to go to the restaurant and order what he usually would. The patient was on board. Then Jerry told the patient he would need to test his glucose two hours after the meal and report back to him.

The patient gladly followed these instructions. He went to lunch and ordered his favourite meal. He then tested his blood glucose two hours later. Reader, you will not be surprised to learn the test was high. How high does not matter for this story, as we are learning to become better leaders. 

The patient returned to see Jerry several days later and was deeply saddened to give the news of his blood glucose result. But he was surprised. You see, while Jerry might not describe it as such, Jerry was leading up. He said to his patient, “You know what you have to do. You have to go back to your favourite restaurant. And you have to order your favorite meal.” This was not what the patient was expecting at all. There was additional instruction given about some adjustment to make in what the patient could eat, but there was still the need to test his blood glucose two hours later. They eventually got things figured out. The patient learned and was empowered to take control of his diabetes. 

This is just one story that helps illustrate what leading up and across may look like in patient care. You likely have your own stories of leading up and across with your patients, and I, for one, would love to hear them. Please feel free to connect and share your stories with me through LinkedIn. 

In closing, let me ask you a question to consider between now and when next we meet.  Over the course of your career, do you find that leading others has become easier, more difficult or is about the same? Until we reconnect, I encourage you to lead those you have the privilege to lead well. Because everyone deserves to be led well.

Until next time

Jesse McCullough, PharmD

Connect with Jesse on LinkedIn