Courage to Lead

Leading a team is tough.  It takes courage, strength and resilience. There are days where everyone is working together like a fine oiled machine, and there is positive energy, a lightness in engagement and great productivity.  Then there are days where every hour seems a struggle, relationships seem strained and the negativity that hangs in the air gets passed onto the patients we serve.  

With all the pressures on pharmacy managers, it can be extremely hard to focus on the health and functionality of our teams.  But without this focus, our teams are prey to negativity, competition, and complaining.  A team mired in negative behaviour is stifling to creativity, leads to poor performance and job dissatisfaction and ultimately less effective patient care..  

Leading a team is all about human relationships because teams are made up of humans.  Humans who all have their own stressors, insecurities, fears and anxieties as well as significant life events; all of which they bring to work with them.  So how do we, as leaders, foster a culture of cooperation, empathy towards co-workers and a sense of common purpose.   

I have said this many times, but it is worth repeating:  Our responsibility as leaders is not to drive results, but to create environments where our people can work at their natural best.  They will produce the results. 

Take a stance of empathy

See the person in front of you for who they are, not just their role.  We all have stresses, insecurities and fears.  As a manager It is easy to become frustrated with our people or to “label” a person as the problem rather than address a behaviour and work with the person to find the root cause .  Complaining to yourself or to others that “Dave just doesn’t know how to be on-time” is counter-productive, and if voiced to other team members, contributes to the negativity and break down of the team.  A strong leader would sit down with Dave, acknowledge the behaviour as an issue and ask Dave how he thinks it can be solved together and then create a plan you both agree with.  

In the same way, we need to take mistakes as learning opportunities, not as opportunity to blame and shame.  

I reinforce this with team members when one person comes to me with a complaint about another. I have zero tolerance for staff talking behind someone’s back, spreading negativity, or blaming. It requires strong emotional intelligence to not fall prey to these behaviours because we are human, and it makes us feel better to create “sides” and have people agree with us and be on our side.  Inter-personal issues always need to be addressed up front, and I always start with encouraging all parties to see the other person as human, to assume good intentions and to resist the tendency towards gossip and negativity. 

Check in 

We talk a lot about mental health, and as pharmacists we address mental health issues daily with our patients.  But how often do we make a point of assessing the mental health of the team members we lead?  I’ve talked about the importance of the ten-minute check in quite often, but it has been an eye opener for me to consciously focus  on mental health when I’m meeting one-on-one with a team member.  I assume everything is fine and when checking in I discover that I have a staff member who is really struggling.  Check ins have at times addressed such things as recommending counselling, suggesting simple self-care such as meditation or calming APPs, encouraging time off or a change of hours, and enlisting support of other health professionals.  It’s important to know what’s available for staff in your own organization (eg. coverage for services) and within your community.  When thinking about your team members, consider that if we aren’t checking in, maybe no one is.  




Model Healthy behaviours

Leaders need to be conscious of self-care.  Sometimes we are the worst models of healthy behaviour as we push ourselves to keep the engine running.  Be honest about what you do to stay balanced and the struggles you may have with implementing strategies to reduce stress.  If you follow Brene Brown’s work on leadership, you’ll hear that it’s not only okay to be vulnerable, it is necessary.  Team members will be more likely to adopt recommendations for self-care when they see and hear you talk about how you do this in your own life.  

Resources

https://hbr.org/2020/08/8-ways-managers-can-support-employees-mental-health

https://brenebrown.com/hubs/dare-to-lead/

We Have it Backwards

First off, you have to love the way AI creates images that are not quite anatomically correct. I decided not to fix this one as it seems quite indicative of how many pharmacists feel these days.

Not long ago I was talking to a class of third year pharmacy students about disruption, innovation and the value of the profession.  I asked the students if they felt like the public understood their job.  Did they really know what we did all day, besides the obvious injecting of countless vaccines and the handing out of pills.  I also asked if they had heard the line that as students they will push the profession forward, saving us from a patient drain to the likes of Amazon and other such distributive systems.  There were a lot of heads nodding yes.

And yet, when I sat in their place almost 30 years ago I had the same experience.  We knew then that patients truly did not understand what we did as pharmacists AND we were told we would push the profession forward as we embarked on our new careers.  

So what gives?  It’s been 30 years and not much has changed.  

While we may have the trust of the public, they do not see our value.  We still have to aggressively advocate for ourselves to the public, to government and to third party payers.  

How can students push the profession forward when as new grads they step into established practices and must conform to and adopt the current culture they find themselves working in?  It has to be us as established pharmacists and managers of dispensary teams taking the lead on practice change.  

Sometimes when we are thinking of trying to change and move forward we can get into a rut of idea gathering and thinking about all the ideas we encounter.   We are always looking for new methods, new concepts, new inspiration to really motivate change.    I would argue however that we have it backwards.  

Inspiration often does not motivate us enough to move into action.  It can often leave us in the planning and ruminating stage, and often we are stuck here indefinitely not knowing how to actually move forward.  As James Clear states in his book “Atomic Habits”, “The most effective form of learning is practice not planning.”

It’s often when we take that first step to implement a change, even if it is a baby step, we see the fruit of our action, the positive impact, the benefits to our patients, our team and to ourselves as clinicians.  This experience is then what inspires us to endure when things are difficult and motivates us to continue to move forward when it is so easy to slide back into what is familiar and what we have “always done”.  

It takes a strong leader with a vision for their team to implement change and then to keep coming back to the core values and reasons for doing so.  Reminding team members of why we do what we do and providing opportunities for impactful experiences, creates a positive feedback loop that gives fresh inspiration and motivation for the action we want to encourage. 

Culture: The Missing Piece

When I graduated with my pharmacy degree all those many years ago, I came out trained to be a pharmacist.  Nowhere in my education was I taught how to be a leader.  Yet many pharmacists are thrust into the position of pharmacy manager or leader of the dispensary team and many more choose leadership as owners of their own practice.  When I started out as owner/manager six years ago I had no idea how to manage “people”, yet I soon discovered that productivity in the dispensary is at its highest when pharmacy teams work as a cohesive unit. I also quickly learned that being a leader is tough because it means managing a group of people, each with their own personality, history, experience, skills and challenges. 

Most often as managers/owners we focus on strategic planning, goals, getting “stuff” done, and sometimes cannot understand why our plans are not well implemented, why execution is lagging and negativity abounds.  Most often this is due to not understanding the power of culture.  Group culture is one of the most powerful forces on the planet, yet it is difficult to define.  We can sense when a strong group culture is present in successful businesses, championship teams, or philanthropic causes, and we sense when it is absent or toxic.  According to a Harvard study of over 200 companies, a strong culture increases net income 765% over 10 years. 

What is culture?  It is the tacit social order of an organization: It shapes attitudes and behaviors in wide-ranging and durable ways. Culture defines what is encouraged, discouraged, accepted, or rejected within a group.

Why is a strong common team culture important?  Because it correlates with levels of employee engagement and customer orientation; and both employee engagement and customer orientation correlate with productivity and profitability in business. 

If a team or business culture is properly aligned with staff’s values, drives, and needs, culture can unleash tremendous amounts of energy toward a shared purpose and foster a business’s capacity to thrive.  Cohesive culture allows creativity to flourish. Problem solving is innovative, identification of inefficiencies comes from the ground level as all team members strive to achieve common goals.  Leaving team or business culture to form on its own can confound strategic goals and lead to poor performance and dissatisfaction in employees which ultimately leads to unhappy patients/customers.  A pharmacy team culture that has been left to form on its own tends to be negative and staff’s internal dialogue can look something like this:


“That customer is difficult, I’m just going to put my head down and hope the other staff will take that prescription.”
“Why am I working so hard? He’s over there being so slow.”
“I don’t understand this. I’ll just leave it for the next shift.”
“I wonder if Pharmacy X is a better place to work?”

“I’m just going to use the washroom- but really I’m going to check my phone.”

Culture is not tangible, so how does it work?  We tend to think about it as a fixed trait, like DNA, some groups just have it and some don’t.   This however is not the case.  Team culture can be shaped and managed.  The first and most important step leaders can take to maximize the value of team culture and minimize its risks is examine and understand their business’s culture and assess its intended and unintended effects.  What is the implicit social order, the values, leadership style and team dynamics?  Once the culture is understood, leaders can work on shaping and changing team culture to align with the goals and strategies of the organization.  Successful change requires leaders themselves to align with the culture they wish to espouse.  Organizational conversation must underscore the change and so must organizational design.  As employees start to recognize that their leaders are talking about different business outcomes—for example patient care or innovation instead of revenue or quotas—they will begin to behave differently themselves, creating a positive feedback loop and ultimately meet and exceed the organizations goals. 

 “Leading with culture may be among the few sources of sustainable competitive advantage left to companies today.”  Harvard Business Review 

Resources:

  1. Start with Why: How Great Leaders Inspire Everyone to Take Action by Simon Sinek
  2. The Culture Code: The secrets of Highly Successful Groups  by Daniel Coyle
  3. The Culture Factor  Harvard Business Review.  HBR.org 
  4. Leader’s Eat Last: Why some teams pull together and others don’t.  by Simon Sinek.  Penguin 2014
  5. Corporate Culture and Performance  by James Heskett and Dr. John Kotter. Harvard Business School.