Tip of the Week: Leadership and Power Should Be Acquired, Used Wisely

We often hear about leadership and how sorely it is needed, particularly in pharmacy. In fact, it has been said that there is a “leadership crisis” inhibiting successful practice change and evolution.

Leadership can mean many things to many people and does in fact have many implications. In an organization, leadership would signify someone with the courage to proffer a vision of the future for that organization and able to rally people behind that vision to make it happen. Leadership in local pharmacy organizations would suggest that someone sacrifices their time to lead a group of willing volunteers to promote positive change and brand pharmacy in the neighboring community. As a practitioner, leadership would indicate a sense of altruism and acting as a role model that extends the current boundaries of practice and serves as a beacon for future pharmaceutical services delivery. None of these conceptualizations of leadership is wrong and all are important, but how do community pharmacists currently characterize the concept of leadership?

Gregory et al conducted a study of how pharmacists perceive leadership, specifically within the community setting.¹ In doing so, the researchers first defined different types of power, remembering that power—while often thought of in a pejorative sense—can actually be a really good thing, particularly if used for benevolent purposes and, in the case of pharmacy, to advance the practice paradigm.

• Positional power is one associated with a form title, role, or position within a hierarchically constructed organization.
• Charismatic power is that associated with personality, style, and presence. The ability to leverage one’s charm, humor, and effective communication plays an important role in influencing others.
• Relational power is associated with the influence people have through formal and informal networks and relationships they possess. It can be established through social and professional connections, and in pharmacy might include local leaders and other health professionals outside of pharmacy.
• Informational power is linked to the control one has over critical pieces of data desired by others. With the democratization of information facilitated by social media, informational power relationships have changed dramatically.
• Expert power describes the influence that arises from having acquired specialized and unique knowledge or skills that is desired or admired by others, such as the power possessed by specialty pharmacists with knowledge in niche topics.
• Rewarding power is the ability to control and distribute scarce but highly desired commodities (salary, awards, etc). It is often linked with positional power but might manifest in persons who have developed other types of power.
• Punishment power, likewise, is the ability to impose sanctions or penalties on those who fail to conform to expressed wishes, goals, or agreements.

In their study of leadership in pharmacy using personal interviews of key informants, the researchers found an over-reliance by pharmacist leaders on charismatic power, with many trying to leverage such power for their own popularity. Yet they also found that positional power is rarely as important as managers or leaders might think. They also found that pharmacy leaders have difficulty leveraging their rewarding and punishment powers and that their use of informational power might produce unintended consequences by inhibiting the free flow of information.

Although these results might sound bleak, there are bright spots. There are many opportunities for pharmacists to hone and overcome their personal discomfort with exercising power and to broaden their repertoire of leadership skills. All leaders need to understand how to best leverage diverse styles of power to be more effective. When combined with appropriate negotiation skills and ethical decision-making, leadership and power can be used at the local, professional, national, and societal levels concomitantly. There are many resources to help pharmacists along the way.

Additional information about Leadership in Pharmacy Practice can be found in Pharmacy Management: Essentials for All Practice Settings, 5e.

Shane P. Desselle, RPh, PhD, FAPhA, is a professor of social and behavioral pharmacy at the Touro University California College of Pharmacy.

REFERENCE

Gregory PAM, Seuthprachack W, Austin Z. Community pharmacists’ perceptions of leadership. Res Social Adm Pharm. 2020; https://doi.org/10.1016/j.sapharm.20202.02.001