You’ll see pharmacists on Reddit using the term “three letter chain,” fearing the wrath of CVS like Harry Potter for Voldemort.

You’ll see pharmacists on Twitter preface their tweets with “all thoughts are my own” as if it protects them for all the terrible things they have to say about their own company.

“Stay away from retail pharmacy if you want to love your job and patients.”

Do you ever wonder why pharmacists are so quick to snap at the limbs when talking about the company they work for?

The Source of All Misery

Of course you have.

All across the nation, pharmacists with decades of work experience desperately trying to convince you to reject a job offer or a promotion.

Twenty years of tenure with the company, and the only thing keeping them going is the paycheck.

As a practitioner that cherishes evidence, it’s hard to ignore all the anecdotal evidence from so many different sources at different times.

So many fingers point at the same few companies, chanting the same warnings.

Blanket statements like, “CVS will micromanage you into the ground with all the metrics you have to meet.”

“Walmart will cut your tech hours, then expect you to do 2,000 flu shots.”

“Walgreens forces you to skip lunches and work off the clock because there’s no other way to finish everything.”

Why do all these complaints sound so similar?

That’s because pharmacists in retail have been conditioned to respond this way.

That’s because corporate cultures are breeding grounds for poor leadership and management.

Number-driven demands in a cut-throat, fast-paced environment leads to quick fixes and band-aids rather than true leadership.

Root Cause – Pavlov Conditioning

Under good or bad leadership, Pharmacists want to be the best clinicians and deliver healthcare to their patients.

But then they hear “metrics, metrics, metrics” ringing in their heads as they fall asleep at night.

The leaders punish, micromanage, and punish some more.

The end result?

Pharmacist anxiety, stress, and fear.

In the classic study of Pavlov’s dogs, the association between a conditioned stimulus (metronome or bell) and conditioned response (salivation) persisted even in the absence of the unconditioned stimulus (food).

In other words, food was not required to elicit salivation. Only the bell.

Sadly, this is exactly how pharmacists are being conditioned in retail pharmacy.

Failing to meet metrics and budgets normally leads to anxiety, stress, and fear.

Then leaders introduced healthcare and metrics simultaneously, while continuing to punish and micromanage.

After conditioning is complete, metrics don’t even need to be discussed for pharmacists to experience increased cortisol levels.

Talking about new healthcare initiatives, clinical roles, and saving lives now causes fear and a conditioned response.

Retail pharmacists everywhere hate the white coats they wear and mock the clinical programs they’re meant to promote.

But There is Hope

But then I think about the company and leaders I work for.

This is not the same message that I hear, nor do I ever experience anxiety or fear.

While the masses hear cracked whips, chains, and shackles, I hear a completely different tune.

“Don’t chase a metric; focus on the mindset and the right behaviors.”

Numbers are not the goal because there are such things as false negatives and inflated metrics.

I hear “wear the white coat proudly” and “own your business.”

We earn respect and have full autonomy to lead.

“Do the right thing for your patients, your colleagues, and your pharmacy.”

I think about purpose, leadership, and patient care every single day.

I’ve been in role for 5 years now, and I love my job, my boss, and my patients.

Why is that?

We all work for the same company with the same goals.

Maybe I’m drinking too much of the “Corporate Kool-Aid?”

This “Kool-Aid,” aka growth mindset, is what enables me to see the bigger picture and grow beyond normal limits.

But what most cynics don’t see is that someone has to pour the Kool-Aid before I can drink it.

The Gatekeeper

All these positive or negative messages all come from our leaders, the C-Suite at the very top.

But most pharmacists don’t talk to Regional managers, Area Directors, or Chief Executive Officers.

They interact with one person on the regular: the district manager.

This is who I call the gatekeeper, the one who keeps all the Kool-Aid.

This person is the one who makes a pharmacist’s job a living nightmare or a purpose-driven mission.

They can make or break you, all in the name of dollars or health care.

How they do this is directly tied to profitability.

It’s no surprise that corporations are for profit with financial agendas.

“No margin, no mission.”

Business owners always have an eye on the bottom line.

But the very best leaders know how to use purpose to drive performance.

They divide profitability into more than one bucket: short-term and long-term.

Poor leadership is faced with the dilemma of driving a profit or doing what’s right.

Drive the numbers or build morale.

Short-term execution or long-term investment.

And they always go for the low-hanging fruit, the cheap stuff:

Short-term profitability and micromanagement

However, the best leaders find ways to execute both in the short and long-term.

Yes, corporate agenda is the Kool-Aid.

But how the leader spins the agenda is what entices everyone to drink it.

Burden of Leadership

This is the dilemma that the district leader faces every day.

It’s up to them as the gatekeepers to filter, condense, and convey a purpose-driven message that satisfies healthcare and financial purposes.

A good leader doesn’t force others to accept corporate values and blindly follow initiatives.

They carve out multiple paths, align interests, explain the risks/benefits, and give their followers every opportunity to make their own path.

The best district managers empower their people with the right mindset to make good business and clinical decisions.

They forego punishment and micromanagement, even though it’s the easiest and quickest path to reaching goals.

The product of all this hard work and investment?

Teams that understand the purpose behind the numbers and metrics and aren’t stressed about targets.

Pharmacists that are bought into delivering world-class healthcare while making money for the company.

Teams that aren’t afraid of exceeding goals because there aren’t any punishments for doing so.

Pharmacists that love being healthcare AND business professionals.