Leaders or managers for difficult times.

INTRODUCTION The past decades have been tumultuous for pharmacy and pharmacists. Ethical lapses have been much too commonplace and have included: * diversion of medication samples and illegal reselling of such by pharmacists * importation and distribution of counterfeit medications * outdated drugs (prescription and over-the-counter (OTC)), infant formula sold in pharmacies * scourge of disreputable online pharmacies * Medicaid and Medicare fraud * violation and compromising of the North American Licensure Examination (NAPLEX) in Georgia * continuing illegal selling of non-narcotic and narcotic controlled substances * cheating of various varieties Health care system impacts with great importance for pharmacy and academia include: * implementation of the Medicare Drug Discount Card in 2004 followed by the rollout of Medicare Part D in 2006 and beyond * the payment opportunities for medication therapy management services for pharmacy and other providers * continued erosion of pharmacy profitability, especially so during the current economic downturn * decreasing margins within third party payment plans * dramatic increases in the number of outpatient prescriptions * $4.00 generic prescription surge and availability * continuing consolidation of health-system pharmacy services yet continuing recognition of the importance of pharmacy services within healthcare institutions * proliferation of new schools and colleges of pharmacy during the present financial and economic crisis * continued shortage of pharmacists * new calls for reimportation of prescription drugs to lessen drug expenditures from within the newly elected administration. Are these lists presented above just lists, or are they opportunities for leadership within pharmacy to address the changes these impacts present? Do these challenges (opportunities) call for pharmacy leadership within us all? Within us all can mean individually or collectively. In effect, we all must assume some degree of leadership. Leaders are not only among us in pharmacy, the opportunity for leadership rests within each of us in pharmacy. The focus of the leadership may vary, but each of us needs to be a leader. Leaders are not born as leaders. Leadership skills must be brought forward from within us to address challenges that will be with us throughout our careers. Leaders can address minor or major challenges daily, and there are some among us who are called to lead in major capacities. We give thanks for them in these times of uncertainty. Leadership and Management Numerous authors have written of the difference between management concepts and leadership traits. Kotter's view of leadership involves strategic thinking, precise communication skills, and repetitive reinforcement of the leader's need to involve others in the organization for optimal success. (1) Regarding management, Kotter notes: "Management is a set of processes that can keep a complicated system of people and technology running smoothly. (1[p25]) Management segments include: budgeting, planning, organizing, staffing, problem solving. Kotter also suggests that leading and managing need to be complimentary. (2) Leaders need to be good managers, but a manager is not necessarily a leader. Why the distinction? Leaders need to provide a vision for those surrounding them so as to move the enterprise forward. This might be a group within your school or college, a research group, a department or division, the classroom, or a practice site. Some who do not at present aspire to be leaders will progress to leadership positions within academia and beyond. In each of these above positions of authority, leaders will follow the goals and objectives of the specific school or association, but individual leaders will necessarily impart a sense of direction for the future. …