The Pharmaceutical Journal
Vol 278 No 7442 p284
10 March 2007

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Can management training be used to advance pharmacy practice?

By Chijioke Agomo

Agenda series

Most pharmacists in the community are now faced with increased pressures at work due to the burgeoning demand for new pharmacy services. Permanently employed community pharmacists and managers are struggling to cope, and the impact on locum pharmacists is intense.

Locum work can be difficult, because different pharmacies have different computer systems and operational styles. But, even though they are working in unfamiliar environments, locums pharmacists are often professionally in charge of the pharmacy. Sometimes, however, this is not the case. In larger stores there may be a store pharmacy manager or supervisor, which can result in conflicts whereby the professional duty of the pharmacist is compromised by store procedures. So there is a need for pharmacists and managers to have appropriate management skills in order to manage and minimise common conflicts that arise in the day-to-day practice of pharmacy.

Such management skills are taught in some US pharmacy schools but British pharmacy students want to learn them too. In a recent letter to The Journal, Jennifer de Val, the president of the British Pharmaceutical Students’ Association, highlighted the desire of the BPSA membership for the incorporation of management training into the MPharm degree course (PJ, 11 November 2006, p572).

Basic leadership models

In an attempt to help pharmacists manage some of the difficulties presented at the workplace, I shall present two popular leadership models.

The first is the traits model of leadership, which uses the observed personal and physical characteristics of many leaders — both successful and unsuccessful — to predict leadership effectiveness. According to the model, four traits are shared by most (but not all) successful leaders. These are: intelligence, maturity and breadth, inner motivation and achievement drive, and honesty.

However, there are several reasons why the traits model of leadership is not enough to predict leadership effectiveness. First, in terms of personality traits, there are no consistent patterns between specific traits or sets of traits and leadership effectiveness. Another limitation is that the model tries to relate physical characteristics (for example, height, handsomeness) to effective leadership. Leadership is far more complex than that.

The second model, the behavioural model of leadership, pays attention to what leaders do and how they do it and puts forward the notion that effective leaders help individuals and teams achieve their goals in two ways. First, they build task-centred relations with employees that focus on the quality and quantity of work accomplished (initiating structure) and, second, they are considerate and supportive of employees’ attempts to achieve personal goals and work hard at settling disputes, keeping people happy, providing encouragement and giving positive reinforcement.

This model also has some limitations. Studies reveal that leaders who focus more on initiating structure generally improve productivity, at least in the short term. However, leaders who are good on initiating structure but poor on consideration generally have large numbers of grievances, absenteeism and high turnover rates among employees. Hence, it is generally accepted that to be an effective leader, you need to be considerate and be able to initiate structure at the same time.

Working as a pharmacist, whether as a locum or as permanent staff, brings responsibility. This responsibility is similar to that found in most managerial positions, since other members of staff look to the pharmacist for guidance on issues relating to medicines use. A manager is someone who supports and is responsible for the work of one or more people, and management is the process of planning, organising, leading, and controlling the use of resources to accomplish performance goals.

Among the many changes affecting managerial work today is the concept of the “upside-down pyramid” (Figure 1). This new way of thinking puts customers and operational workers in an organisation at the top of the pyramid and supported by managers below. The implications of this are that the best managers will be known more for helping and supporting than for directing and giving orders. Increasingly, even the title of “manager” is now frequently replaced in organisation charts by terms such as “co-ordinator,” “coach,” or “team leader.”

Increasing pharmacists’ effectiveness

Suggestions for increasing the effectiveness of pharmacists as managers are shown in the Panel (below).

Finally, let all pharmacists and managers in position of leadership be guided by the following quote from Management News (February 1990, p6): “All managers have a duty to motivate their teams. Motivated people take more pride in their jobs and work better. But many managers don’t know how to motivate their staff.”