Harvey A.K. Whitney Award Lecture

2005 Award Recipient

Thomas S. Thielke, B.S.Pharm., M.S., FASHP

"My life's work has been searching for excellence"

Searching for Excellence in Leadership Transformation

I stand before you today with great pride and humility. I am proud to be a healthsystem pharmacist. I am proud to be part of a great university and university health system where I have been fortunate to practice for 36 wonderful years. I am also proud to have been part of a pharmacy residency program that has allowed me to mentor over 200 pharmacy residents, many of whom are here tonight. I accept this award with great humility because it comes from a very distinguished group of leaders, many of whom have been my personal heroes and professional colleagues over the past 40 years. Life does not get any better than this. Thank you for this wonderful honor, and thank you all for being here with me tonight.

I began to reflect on my career after being notified that I would receive this award. How did I get here? Who or what helped me along the way? How did I transform from a shy and clueless first-year pharmacy student to a leader in a large health system?

This journey is all about searching for excellence in leadership. Some of my life’s passions have been to study the concept of leadership, continue to develop my leadership skills, and transfer this knowledge and skill set to future health-system pharmacy leaders. During Jim McAllister’s Whitney address two years ago, he asked, “What will be your legacy?”(1) As I thought about his question, I concluded that my legacy is the 207 pharmacy residents whom I have trained during my pharmacy career, 138 of whom were part of Wisconsin’s leadership and management residency combined with a master’s degree. My life’s work has been searching for excellence in leadership transformation.

In 2004, the Health Systems Pharmacy Executive Alliance sponsored by McKesson began working on a project called the “high-performance pharmacy.” The first part of this project was to produce an article that described the leadership skills required for an effective, high-performing health-system pharmacy department. Four of my colleagues, Rita Shane, Bruce Scott, Billy Woodward, and David Zilz, and I wrote a commentary for the American Journal of Health-System Pharmacy (AJHP) that brought together a combined total of 140 years of pharmacy leadership experience.(2) We had a great time reflecting on individual leadership journeys and some of the keys to success. That experience was a great precursor to this Whitney address, since it forced me to reflect on what I had learned about leadership along my journey. I want to take you on my personal journey tonight, which will identify who and what influenced my search for excellence in leadership transformation, as well as the leadership knowledge that I transferred to future pharmacy leaders whom I helped to train.

The inner self

Where did it all start? The foundation for the start of one’s professional journey begins with the inner self, one of the core principles described by Billy Woodward3 in his Webb lecture. My core principles came from my family, who are here to support me tonight. These are my values: traditions, principles, integrity, and honesty. The influence that early leaders, such as teachers, scout leaders, and friends, had on me helped develop this core self. My first jobs in high school taught me some of life’s tough lessons and confirmed that I needed a college education. This is the kind of information we need to assess when we are reviewing candidates for pharmacy school or residencies. We must interview all applicants and attempt to extrapolate their core principles and the traits required for our future pharmacy leaders. Highly developed communication and social skills are leadership traits that are as important or more important than the best grade point average. We need to work more closely with schools of pharmacy and residency preceptors to develop their interviewing skills as part of pharmacy school applications.

The professional self

The second of the core principles is the professional self. Bill Zellmer(4) recently wrote an article published in AJHP entitled “Unresolved Issues in Pharmacy.” He described the weak pulse of professionalism in many pharmacy practice settings today. This starts with how we professionalize our pharmacy students in schools of pharmacy, an ideal that is nonexistent in many curricula. We need to expose our pharmacy students to healthsystem pharmacy leaders early in the curriculum to exert some influence on the professional self. Assessment of this professional self is critical when hiring residents and health-system pharmacists. My professional self took a big step forward during the middle of my second year of pharmacy school. I signed up for an interview for a student technician job in the pharmacy department at the University of Wisconsin (UW) Hospital. I was working at a drugstore on the Capitol Square selling cigarettes and other essentials. I was trying to figure out how this related to all the basic science and pharmacology I was taking in the pharmacy school. At this interview, I was introduced to two pharmacists from UW Hospital who would profoundly affect my career and life. They were Winston Durant, the director of pharmacy, and David Zilz, the associate director of pharmacy. I spent the next year and a half working as a pharmacy intern and technician at UW Hospital. It was here that I first recognized the importance of a vision for pharmacy practice. Win Durant invited me to a seminar at his home in the summer of 1966. He had gathered his leadership team and his three residents who were part of his M.S./Residency Program. Win presented his vision for pharmacy services at the UW Hospital for the next 10 years. I listened to terms such as unit dose, i.v. admixtures, decentralized pharmacists, pharmacy computer systems, and a clinical pharmacy elective for the school of pharmacy.

Early mentoring

That session with Win Durant had a dramatic effect on me by demonstrating how important the strategic planning process and a leader’s vision are to operating a highperformance pharmacy. This leadership element has remained a cornerstone of all future training of pharmacy residents in the UW program. This early experience supports the importance of Sara White’s ninth recommendation in “Will There Be a Pharmacy Leadership Crisis?”(5) She stated that we must assist colleges of pharmacy in professionalizing students and offer students opportunities for training in leadership and management.

During my first 18 months at the UW Hospital, I was exposed to the concept of student advising, which we now call mentoring. I took every opportunity I had to spend time with Win and Dave to learn more about these exciting times of change in hospital pharmacy. When Win asked me to apply for the two-year master’s degree and residency program at the UW Hospital, I immediately said I would and rushed home to tell my wife that I was going to spend two more years in school, as well as work 60-70 hours per week in a residency program. At the time, we had one son at home and were expecting a second son that winter. Boy, was she excited.

During my undergraduate pharmacy program, some of my professional self was influenced by my classmates in the class of 1967. A phenomenal number of my classmates became very influential leaders in pharmacy. Spending time with this class of 90 students certainly had a positive effect on my professional development. Two of my classmates preceded me in receiving the Harvey A. K. Whitney award: Marianne Ivey and Bill Zellmer. I listened with pride to their Whitney addresses and have learned much from both of them when we have crossed paths in our professional lives. When my son was selecting a pharmacy practice residency, I told him that the best choice was to spend a year under Marianne’s mentorship.

The next steps

The next two years of my journey were some of the most gratifying of my life and probably had the most profound effect on my journey for leadership excellence. Just think about the opportunity of training under the watchful eyes of two great pharmacy leaders, both of whom would be ASHP president and one of whom would be a Whitney award winner. I eagerly watched, listened, and soaked up as much as I could about leading a high-performance pharmacy department. From Win Durant, I learned the importance of a strong vision with a capacity to change when opportunities presented themselves. I saw hardiness that never, never gave up. His tremendous self-confidence, that at times became tenacious and overpowering, was a style I strive to emulate. He had a tremendous ability to multitask and complete many projects at the same time. I saw that a true measure of a leader is his or her influence. His influence on the practice of pharmacy in the five years I worked for him was phenomenal. Win demonstrated that when a real leader speaks, everyone, including all the leadership in the corporate suite, listens. He taught me how to seize the power that pharmacy leadership can have.

Under David Zilz’s mentorship, I learned the power of thinking about the future and thinking out of the box. His ethics, values, and integrity helped form many of my principles in this area. Dave could walk into a pharmacy and easily assess the areas that needed improvement. Dave had great coaching and mentorship skills that I tried to emulate. He was an idea-a-minute leader who taught me that leadership develops slowly, not in a day. Dave taught me that cross-functional teamwork is much more important than organizational structure, a concept that the current ASHP Board of Directors needs to understand when developing policy for state affiliates. From him I learned that trust is the foundation of leadership, especially as it relates to external interests and interdependence, which he discussed in his Whitney address.(6)

I recently read the book Good to Great.(7) In it, the elements of a level-5 leader are discussed. Some of these elements I learned from Dave and Win and served as part of the foundation of the UW Hospital and Clinics pharmacy program and the residency training program. Level-5 leaders channel their ego needs away from themselves and to the larger good of building a great organization. These leaders are a study of duality: modest and willful, humble and fearless. The author was struck that “good to great” leaders do not talk about themselves.

Venturing out

As a resident, I was introduced to pharmacy organizations by my preceptors. I was encouraged to join local and state hospital pharmacy committees and introduced to the leadership of these organizations. Mandatory participation in organizations through committee work and service as board members and officers should be required of all aspiring health-system pharmacy leaders. This has been a mentoring priority for all UW Hospital residents. I try to follow up with all residents after they have their first job to make sure they live up to this commitment.

In addition to my involvement in local and state organizations, I have spent many hours traveling with residents and preceptors to visit other health systems in Kentucky, Ohio, North Carolina, and Michigan, just to name a few. What a great opportunity to stay at the homes of Paul Parker and Cliff Latiolais, to sit on their porches at night listening to these heroes discuss their vision of pharmacy. These trips continue today for all pharmacy residents at UW and have expanded to many other high-performance pharmacy departments. I am convinced that these trips have had more value in leadership training than most pharmacy organization meetings. Three- to four-hour discussions between preceptors and residents while driving between sites served as wonderful learning experiences.

After completion of my residency, I was hired as an assistant director of pharmacy at the UW Hospital. A pharmacist’s first job after the residency is a critical step in the leadership journey. We have incorporated career counseling into our residency program. It is a formal process preparing residents for their first job and the selection of that job. A relationship with an established mentor is integral to the continuation of the leadership development process during this time. Steering residents and young leaders into these rich learning environments, instead of putting first priority on the higherpaying jobs with all the bells and whistles, is an important element of fostering their leadership success.

Involvement with ASHP

My leadership journey continued as I began to get involved in ASHP. I was fortunate to work for two ASHP presidents while they were in office. I met many national leaders during this time and was appointed to two ASHP councils and several committees through these professional relationships. Some of the most important relationships were developed with many of my peers during my council work. On my second council assignment, I was fortunate to become the council chair. That year, two aspiring ASHP leaders were appointed to the same council, with whom I developed a lifelong professional and social relationship: Phil Schneider and Jim McAllister. During our 25- year relationship, they have taught me so much that helped further develop my leadership skills. These types of peer leadership relationships are a requirement for any aspiring leader’s journey.

My election to the ASHP presidency gave me the opportunity to be mentored by another one of my professional heroes, Joe Oddis. Joe’s Whitney lecture described the importance of commitment and involvement as essential elements of excellence.(8) My inaugural address, “Reaching Out,” called for our profession to reach out to physicians, hospital administrators, standard-setting bodies, legislators, and patients.(9) Joe Oddis gave me the confidence and political savvy to accomplish this. He was the ultimate team player who always put ASHP presidents and his organization first.

I learned the art of building coalitions and networks without rigid authority from Joe, and I try to pass that on to my residents. Much of my leadership training from Joe came late at night after all the formal business was finished. We spent countless late hours discussing health-system pharmacy challenges, during which he often reminded me to act presidential. This taught me that true leaders are always on stage.

Joe introduced me to another leadership opportunity when I was ASHP president in 1989. He took me to my first International Pharmaceutical Federation (FIP) meeting in Munich, Germany. He introduced me to the FIP leadership, and I became an FIP convert. I was encouraged by Carl Lyons, past ASHP president and FIP hospital pharmacy section president, to consider a section board position. I was elected the following year; this year I will complete my 15th year as a board member and presidential officer in FIP. This leadership experience has opened my eyes to the global challenges facing our profession and the many ways that American health-system pharmacists can help pharmacists worldwide. I have developed lifelong professional and social relationships with several international pharmacy leaders, such as Colin Hitchings, who received the Donald E. Francke Medal at this meeting, and Dieter Steinbach, who received an honorary membership from ASHP last year. International pharmacy opportunities and challenges have been common discussion topics with UW residents over the past 15 years.

Balance

In our article about leadership skills for a high-performance pharmacy,(2) we address the need for balance in our career-counseling sessions with residents. We spend a significant amount of time discussing the importance of balance in a leader’s career. There is no way that I could be standing in front of you without my greatest life partner sitting next to me tonight. Ruth has supported me through thick and thin and has been the copilot in my leadership journey. She has also been a mentor to all my residents over the past 30 years.

Training future leaders

ASHP’s leadership has preached a lot about its leadership agenda over the past several years. There has been a lot of rhetoric about the organization’s role in training and developing leaders. In the early 1990s, with the formation of pharmacy practice residencies, ASHP’s Commission on Credentialing stuffed management into the medical model with the other specialty residency standards. I was critical of the term “practice management” at that time, as we were moving to an expanded health-system pharmacy role in our new health systems. We were not about managing practice, but leading and managing a more complex health-system pharmacy environment.

I certainly applaud Sara White’s work as a visiting scholar at ASHP and the very recent effort to create a Center for Health-System Pharmacy Leadership. But for some reason, our Commission on Credentialing and ASHP leadership have not embraced a group of ASHP residency programs with proven track records for developing many of the current health-system pharmacy leaders. Despite the very limited practice management residency standards, these programs have continued to strengthen the leadership training aspects of their programs, as well as the redesign of their master’s degree curricula to create an excellent, synergistic relationship between the academic and residency parts of the programs. ASHP has not lived up to its promise to promote these programs to schools of pharmacy across the country and has not accepted the offer from these program directors to help develop a new set of residency standards for a leadership and management training program for health-system pharmacy. I believe we need at least 15 of these programs nationwide to help close the leadership gap that Sara White(5) spoke about. The proliferation of these programs will help our profession with its search for excellence in the leadership transition.

Youthful leadership

As my leadership journey has begun to mature and I see some of my peers retire or move on to less stressful jobs in other industries or academic endeavors, I wonder if my journey should end before I discover the level of excellence required in our leadership transformation. Last year, I read a book by Bennis and Thomas(10) entitled Geeks and Geezers: How Era, Values and Defining Moments Shape Leaders that helped me refocus and reaffirm my desire to accomplish much more. Bennis interviewed several leaders, young and old. He discussed the term neoteny as a description of several older established leaders who continue to work on and on. Neoteny is defined as the retention of youthful qualities by adults. The words he used to describe the mature leaders were curiosity, playfulness, eagerness, fearlessness, confidence, energy, optimism, and adaptive capacity. These leaders continued to be hungry for knowledge and were risk takers. As I described these traits to my residents and young managers, they began to smile at me and said, “We think that is still you.” That convinced me to stay on this journey. Several years ago a colleague gave me the following essay by Samuel Ullman(11) that describes the neoteny to which I aspire.

Youth is not a time of life; it is a state of mind; it is not a matter of rosy cheeks, red lips and supple knees; it is a matter of the will, a quality of the imagination, a vigor of the emotions; it is the freshness of the deep springs of life. Youth means the temperamental predominance of courage over timidity of the appetite, for ad-venture over the love of ease. This often exists in a man of sixty more than a boy of twenty. Nobody grows old merely by a number of years. We grow old by deserting our ideals. Years may wrinkle the skin, but to give up enthusiasm wrinkles the soul. Worry, fear, self distrust bows the heart and turns the spirit back to dust. Whether sixty or sixteen, there is in every human being’s heart the lure of wonder, the unfailing childlike appetite of what’s next, and the joy of the game of living. In the center of your heart and my heart there is a wireless station; so long as it receives messages of beauty, hope, cheer, courage and power from men and from the Infinite, so long are you young. When the aerials are down, and your spirit is covered with snows of cynicism and the ice of pessimism, then you are grown old, even at twenty, but as long as your aerials are up, to catch waves of optimism, there is hope you may die young at eighty.

Succession

Ullman’s message has made me think a lot more about a very important element of the leadership journey: succession planning. A leader’s lasting value is measured by succession planning in an organization. Effective mentoring of aspiring leaders can lead to a succession plan that enables a pharmacy department to maintain a consistent and growing level of service and influence within an organization beyond a leader’s retirement or matriculation. I know that continued growth in depth and breadth and success of the health-system pharmacy program at UW Hospital and Clinics over the past 46 years is due to a formalized process for succession planning for the director of pharmacy position. Each new leader was identified well before the departure of the previous director, and the mentoring shaped that individual to become the new leader. The handing-off of the director of pharmacy baton from Win Durant to Dave Zilz to me and now to Steve Rough was synergistic and seamless.

Another part of succession planning is the lifelong mentorship responsibility of the pharmacy leadership at UW Hospital and Clinics to act as a job placement office for all past master’s degree/resident program graduates. A U.S. map in our pharmacy department conference room with an accompanying spreadsheet shows the current geographic location and position of all past residents. As job opportunities arise, we contact individual residents ready for their next move with a goal to promote these past residents to the best possible leadership position. Annual receptions and luncheons occur at every ASHP Midyear Clinical Meeting to keep the past residents in touch, and every five years we hold a resident reunion in Madison to rekindle the fire within this group of fine leaders and promote the legacy of the UW program. This has been key to our past residents’ leadership journey.

Closing thoughts

To summarize my leadership vision, I would like to read a message that I delivered to many current and past UW residents at my Winston J. Durant lecture eight years ago:

I believe that you the future Wisconsin residency graduates (as well as past residents) must always be the consummate leader. Your strategic plans and service philosophy must have both an offensive plan and a defensive plan. You must be patient in the new environment but still strike quickly when opportunities present themselves. You must be relentless— you will never, never give up under any circumstances. You must be devoted team players who play intensely and unselfishly. You must remain humble with the many victories in your pharmacy life and remain passionate about our profession. Even though you will lose some battles during your professional endeavors, you must always think of these losses as more opportunities. Be thankful for these opportunities. Through these victories and defeats, you must remain unified for your profession and continue to network with your colleagues, fellow residents and friends to support each other. I know that I can be assured that you, the graduates of the Wisconsin Residency Program, will always provide quality services to your patients and customers and dedicate yourselves to a safe medication use system. Thank you for this dedication. The current challenges in health care are difficult and challenging but you will overcome these obstacles and continue to be leaders in the profession of pharmacy.

This concludes tonight’s journey and many of you may be thinking that I have reached the twilight of my career. I want to thank all of the staff that I have worked with over the past 40 years at UW Hospital and Clinics and the school of pharmacy. Certainly my leadership journey has been supported by all of you. But with my new leadership position within the UW health system, and the leadership team that I am fortunate to be part of, I have a renewed commitment to continuing my search for leadership excellence. If I do get bored, I have found a new purpose in my life: mentoring my two grandsons. I think it is working, since my grandsons can be heard walking around the house saying things like “fire up,” “down the hatch,” “live each day like there is no tomorrow,” and, of course, “On Wisconsin.” Thank you.

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Any references cited in this lecture are available in the PDF version.