23rd Midyear Clinical Meeting
American Society of Health-System Pharmacists
December 6, 1988
"Leadership - Remembering Forward"
Roger W. Anderson, R.Ph., M.S., Dr.P.H., FASHP
Class of 1967
I was honored to receive the Latiolais Award in 1988. I title that I selected for my acceptance remarks was "Remembering Forward." In my mind, this was a direct reflection on the Harvey A. K. Whitney acceptance speech that Dr. Clifton J. Latiolais gave in 1968 entitled "As We Move into History." From the time that I heard his comments in 1968, and throughout the past 46 years of my professional career, I still resonate with his closing comments: "A solid foundation has been laid for the development of an elite, corps of career-minded hospital pharmacists. The founders of our Society, Harvey A.K. Whitney and his colleagues, left us a rich, proud tradition, a dedication towards professional ideals, a challenge to the pursuit of excellence, a strong, effective goal-oriented organization with proven success, and a membership with the intestinal fortitude to submit to organizational self-appraisal for the common good. Whit such a background, hospital pharmacy is but one step away from greatness - a mere attitude away from the Jeffersonian dream of an aristocracy of achievement. With properly directed, goal-oriented society, let us take that step, let us mold that attitude to achieve that dream. Slowly yet methodically, practically yet idealistically, authoritatively yet softly...as we move into history."
In my remarks, I emphasized how much we have learned about leadership from past leaders within our profession, our personal community, and especially our family. In my own life, I believe that some very basic fundamental foundations of leadership values that I "remember forward" came from my parents and grandparents. While neither grandparents nor parents were involved within pharmacy, or even healthcare, they demonstrated very fundamental leadership characteristics in on a daily basis. Particularly, I watched my grandfather successfully run a small retail business for over 60 years, and my father rise from a bank teller to executive vice president in a small town bank over a 38 year career. Likewise, my grandmother and mother demonstrated more family-oriented personal leadership values as they each raised families with four children each. While not in our normal "professional training" mentality, I continue to use these valuable learnings on a daily basis.
While in undergraduate pharmacy school at Ferris State University, I experienced leadership values from various professors and interaction with fellow students - especially in my involvement with student professional organizations. I also "remember forward" my responsibilities as a dormitory resident assistant. In this role, I needed to develop my leadership skills to "manage" the environment of a 40 student floor and share the leadership responsibilities with another student resident assistant. There were many experiences that called upon leadership abilities to be sure that the students followed the rules and were respectful of their fellow hall-mates. While not very sophisticated in nature, I have continued to use some of those practices over the years.
My first pharmacist position was in a small town pharmacy. It was the only pharmacy in the town and the pharmacist owner had been practicing there for over 25 years when I was hired. He taught me so many leadership principles relating to the management of a small staff, but more related to how to use leadership fundamentals to foster customer service, loyalty, and especially trust. I "remember forward" his teachings today as my earliest foundation for "direct patient care principles and responsibilities." So many times today when I experience the average patient's experience in a chain store pharmacy, I only wish that his principles were still in place as regretfully that is not the norm today.
I was fortunate to be accepted into The Ohio State University Master's program in 1965 and assigned to Grant Hospital in Columbus, Ohio for my Hospital Pharmacy Residency program. Even during my interview with Dr. Latiolais, I could sense the strong leader that he was and that expectation was fulfilled many times over. I was also pleased that my residency director at Grant Hospital was Benjamin Holland. He had worked for Dr. Latiolais before coming to Grant Hospital and was a tremendous leader in his own right. My experiences over the two years of the residency helped me understand the leadership responsibilities in an inpatient pharmacy and expanded my scope well beyond the pharmacy to nursing, the medical staff, and other departments. Without question, I have "remembered forward" so much of what I learned during the residency and from personal mentorship of Mr. Holland and the pharmacy staff. During this two year period (1965-1967), I was also taking the M.S. in Hospital Pharmacy courses at the university. While a variety of classes, many were taught by Dr. Latiolais. While he covered many practice specific subjects, none were covered without weaving in leadership responsibilities. He was also determined to give us a historical perspective as to how we got to where we are today. He was sure that we knew all the hospital pharmacy leaders that were instrumental in the early development of every aspect of the practice methods that are currently employed. I will always "remember forward" those discussions and looked forward to meeting some of those individuals at future ASHP Annual and Mid-year Clinical meeting. To this day, I admire and respect all the former leaders of the past and try to instill an appreciation of this history in all my staff and students. I believe this historical perspective is so important and is not widely communicated and respected by most of today's pharmacists. Following my residency, I was offered an Assistant Director with Dr. Latiolais and it rapidly became a "second residency" with daily teachings and role model illustrations by Dr. Latiolais and other leadership staff. He also gave me responsibility for managing the Sterile Central Supply department which broadened my management and leadership scope beyond pharmacy. One of my fellow Assistant Directors was Harold Godwin. Harold and I have continued to be close personal and professional friends. We discuss items on a regular basis and value each other's guidance. Many times we reflect on how fortunate we both were to be selected to the Ohio State program. Our primary focus in these discussions usually revolve around the leadership style, commitment to the highest level of quality service, and visionary skills the we learned and saw demonstrated on a daily basis. This is certainly one of my most cherished "remembering forward" experiences and one that I have been committed to over all of my professional career and personal life. In 1969, I was offered the position of Director of Pharmacy back at Grant Hospital. While surprised to be given such a major responsibility so early in my career, I felt ready for the new challenges and put into practice my recently acquired leadership experience. All went well and we were able to extend the pharmacy practice substantially and elevate the pharmacist's role in direct patient care. In 1973, I was recruited to become the Vice President of Operations for a new company, Pharmacy Systems, Inc. in Columbus, Ohio. While I was the only pharmacist in the corporate team, we quickly added some hospitals under a management contract and once again "remembered forward" the past learnings regarding leadership and practice standard ideals.
In 1978, I was given a tremendous opportunity to become Director of Pharmacy at The University of Texas M.D. Anderson Cancer Center in Houston, Texas - one of the largest cancer specialty institutions in the world. When I arrived, it had a pharmacy staff of about 87 individuals. Over the next 26 years, we moved the Department of Pharmacy to a full Clinical Division. This status fully recognized pharmacy as a clinical entity and moved my reporting position to the same level as the Division of Medicine, Surgery, Pediatrics, and others. I have always attributed this recognition to the promotion of professional ideals and leadership style that I learned from so many individuals in the past and "remembered forward" in this setting. We greatly expanded the division staff over the next many years. When I retired, the Division of Pharmacy staff numbered over 400 with close to 200 pharmacists - 65 of which were full time clinical specialists assigned to the various sub-specialty medical, surgical, and pediatric divisions. With all the successes we had, I always was quick to give credit to the many individuals in my personal and professional life that mentored me and challenged me to do the best and foster the very best care we provide to the patients we are privileged to serve and trust their lives to us. During much of my time at M.D. Anderson, we conducted many research trials, but one of the most notable was the work on the occupational exposure to hazardous drugs.
During the 1980s, I was very involved with ASHP serving on the Board of Directors and President 1987-1988. While a tremendous effort and time away from my family and the pharmacy, I always reminded myself ("remembered forward") of the multiple times Dr. Latiolais talked to us about commitment to the profession and professional organizations. During the 1990s, I enrolled in a Doctorate Program in Public Health at The University of Texas. Finishing the program in 1997, I was pleased to have a more broad perspective of health care and the enhanced vision for the pharmacist's role. In 1999, I was appointed to the Texas State Board of Pharmacy for a six year term and served as President of the Board from 2002 to 2003. This was a significant honor and gave me the opportunity to offer leadership guidance to the overall progressive practice of pharmacy and specifically in the area of health-system pharmacy.
In 2004, I was asked to become Chief Pharmacist for Medco Health Solutions, Inc. This was a major shift in practice from my hospital career training and experience. However, as I "remembered forward," I saw that the same principles of patient care and advancing pharmacists practice were apparent. With a national staff of over 3,000 pharmacists caring for over 65 million patients, we were able to establish a network of pharmacies and pharmacists (Therapeutic Resource Centers) with a focus on best management of patient in nine different chronic disease categories. This concept has continued to promote both higher level of patient care, lower overall healthcare costs, and provide tremendous new career opportunities for pharmacists.
In conclusion, my ideas on leadership have really not changed much over time. I seem to apply the basic fundamentals of leadership beginning at a family level and incorporating valuable direction and mentorship along the way. While my general beliefs regarding leadership principles have not changed, the application of these principles in health-system pharmacy has changed. In the beginning of my career, we focused on the operation of the hospital pharmacy department and the implementation of many different programs to improve the distribution and control of drugs thorough the institution. Prime examples of these programs are unit-dose drug distribution programs and centralized IV admixture programs. Much of the country's program innovations in these areas came from our program at OSU. Later, we expanded to promote the pharmacist's role in Nuclear Medicine. Not only the programs for drug distribution and control, but major emphasis on the hours of operation. Many hospital pharmacy departments did not have 24 hour coverage - almost regardless of bed size. In the 1970s we began to promote the clinical role of pharmacists starting with centralized drug information centers and then moving toward the concept of "floor pharmacists." Over the next 2-3 decades, we have watched the education of pharmacists move to the all Pharm.D. degree and the documented value of pharmacists direct contribution to the clinical care and decision making regarding drug therapy. Today, I believe we need to expand the scope of pharmacy to the leadership of pharmacy as a clinical profession. This is not different that medical departments such as Laboratory Medicine and Diagnostic Imaging. While clinical at the core, they have major service and products to effectively provide and manage. Pharmacy leaders of the future must adapt to this leadership model and while not moving away from past operational approach, but incorporate the operations/distribution functions totally integrated with clinical practice responsibilities. One of many examples that demonstrate this mutual responsibility is in the area of medication safety - everything connected from the time of order conceptualization to the safe and timely distribution of the product. I believe there is a significant void in individuals today that understand this responsibility and are ready to promote this internally and externally. Regretfully, there are many in health-system administration that do not understand or value this role. My hope as we "remember forward" we bring to bear all of our past growth and significant advances and continue to make the strides that necessary for the safe and effective care that the patients who trust their lives to us - as we Move Into History.