Abstract
As pharmacists, we must be perfectionists when we work with medication orders. We must never take risks in responding to orders; we must know the outcome of any changes, stay in our comfort zones, be totally responsible for our own actions, and ensure the medication use system does not harm patients. Since perfectionism is so ingrained, it is easy for us to approach everything we do as a perfectionist such as our personal lives, hobbies, community involvement, and church activities, which may result in feelings of frustration and guilt about falling short of being perfect.
In thinking about perfection, envision a continuum with “poor” on the far left side and “perfect” on the far right. In between are “fair,” “good,” and “very good.” Moving from left to right takes more concentration, focus, and time. Is it worth the extra time to achieve perfection? Could you have done more things and been happier with your performance, if you weren't trying to be perfect with everything? In a presentation, will anyone recognize the extra time it took to get the slides perfect? If you stopped when they were just very good, would you have enough time to do another project? Do you need to be state chapter president now when you have young children, or can you wait because you actually have decades left to work? The key to achieving a good balance is to make conscious decisions about how you want to spend the finite time you have and to be happy with your choices rather than striving for perfection and driving yourself crazy.
Leadership behavior is often opposite from a perfectionist pharmacist perspective. Leaders are proactive, work through people, take calculated risks with no guarantees, learn from “mistakes,” are nimble, deal with ambiguity and lack of clear direction from above, deal with actions that may not seem logical nor rational, and utilize organizational politics. Effective leadership as an art is different from being a pharmacist, which is a science. Perhaps it is helpful to think of 2 different hats, a blue pharmacist hat and a red leader hat; exchange these hats depending on the needs of the situation to remind you to switch your approach. You might want to use the different hat concept with your personal life as well.
In this rapidly changing health care environment, no one has specific answers nor is there just one right answer. We need to be willing to step out of our comfort zone and volunteer to take on responsibilities in the organization's initiatives, because we understand patient care and the financial aspects of providing that care. Thus we can make and seize opportunities such as in accountable care organizations, medical homes, medication therapy management, prescribing and ensuring the desired therapeutic outcome is achieved, and minimizing readmissions.
At the start of the current IV admixture, unit dose, and clinical service programs, there were no guarantees that these services would improve patient care, but we felt that they would and so we began the best we could and quickly improved as we learned from our “mistakes.” We took calculated risks by planning as completely as time allowed but not delaying implementation so we would not miss the opportunity. It is easy when thinking like a pharmacist to get tied up in analysis paralysis, wanting everything to be perfect before proceeding. This can lead to missed opportunities and allows others to step in and define and limit our roles. We must be willing to innovate and experiment and to accept the less than perfect.
In being a leader and making changes, we need to get comfortable with not having all the information we would like, nor perhaps exact direction from above, but trusting that we can figure it out as we get experience. Working in the grey or ambiguous areas allows us to do what makes sense for patient care and perhaps seeking forgiveness instead of permission. We need to be willing to start without all the resources we know we will eventually need so we can demonstrate the value of the change and establish buy-in from stakeholders. We can't afford to exhibit the all-or-none thinking of perfection versus failure, but must be willing to experiment and learn as we go. If we are just maintaining the status quo, others are passing us.
As leaders, we should be actively asking ourselves where the opportunities are for pharmacy services in the future around such innovations as personalized precision medication, knowledge of the human genome, nanotechnology, CRISPR/Cas9 gene editing, 3D printing, robotics, automation, wearable technology, artificial intelligence, Google Glasses, smartphone apps, compliance packaging, drones, and telemedicine. We should do pilot projects to validate the applications. It is critical that we share our thinking and experiences through publications, presentations, and blog posts, so we can help teach each other.
Other than when you are functioning as a pharmacist, your challenge is to try to let go of being a perfectionist. Exchange hats and begin with small steps so you build up slowly to being able to switch from perfection to good or very good with most of what you do. Easier said than done, but give it a try. For the profession to move forward and our patients to totally benefit from our expertise, we must all be effective leaders. ■