HEALTH-SYSTEM EDITION
SPECIAL REPORT

MOVING ON UP

With their clinical and financial skills, pharmacy managers are finding there's life beyond departmental directorships

Paul Pierpaoli has always been driven by the desire to start things from the beginning. "I'm excited by the energy that's in the early stages of development of an organization."

It was that passion for a "fresh start" that compelled Pierpaoli, a 35-year veteran of health-system pharmacy, to change career paths and accept an executive posi-tion with Medication Management, a wholly owned subsidiary of McKesson Corp.

Pierpaoli left the prestigious pharmacy directorship at Rush- Presbyterian-St. Luke's Medical Center in Chicago four years ago to become senior v.p. of pharmacy practice at Medication Management, where he oversees strategic direction for the company's pharmacy practice initiatives. Medication Management provides pharmacy management and consulting services to health systems, alternate site environments, and retail operations.

Pierpaoli represents a growing number of former pharmacy directors who have decided to switch gears—sometimes in mid-career—and put their diverse skills to work in a different venue. While there is no evidence of a mass exodus of pharmacy directors to the executive suite, industry observers note that it's not unusual these days for pharmacy directors to gravitate to various management and administrative positions in health systems, the pharmaceutical industry, group purchasing organizations, and drug wholesale companies. Ron DeChant, executive director of Illinois-based Management Recruiters of Lincolnshire, said it's not uncommon to find a former pharmacy director running a hospital or serving as a v.p. of clinical services for a large health system.

And it's not always the directors who make the first move out of the pharmacy department door. Increasingly, hospital administrators, recognizing the value of a pharmacy director's background and expertise, are recruiting these professionals for executive positions. "Pharmacy directors bring a fairly broad skill set into the equation, and they certainly have experience managing a large department and a large budget, making them attractive candidates," said Doug Scheckelhoff, director of the division of practice leadership and management for ASHP.

Scheckelhoff noted that pharmacy directors also bring their clinical background to the equation, an asset that can prove invaluable when dealing with physicians, nurses, and other clinical healthcare professionals. "Pharmacy directors know how the health system works, they have an understanding of IS systems, distribution systems, and personnel management issues." Those factors, asserted Scheckelhoff, give former pharmacy directors a distinct advantage over someone with just an MBA in hospital administration.

For Victor Perini, the positive assets that a pharmacy director brings to the executive and management environment are hard to discount. "Pharmacy leaders possess the kinds of skills that are needed to manage and administer a hospital." Perini, a former pharmacy director at Methodist Hospital in Memphis, is now the administrator and COO of Methodist Extended Care Hospital, a 36-bed facility that is part of Methodist Health System.

Perini pointed out that in addition to patient contact and clinical and scientific expertise, pharmacy directors have extensive financial management experience. "We purchase drugs; we understand what's needed at the bedside; we understand what the patient, the physician, and the nurse need." He commented that one reason some pharmacy directors seek upward mobility outside the pharmacy universe is that there aren't that many top-tier job slots available within health-system pharmacy itself. He contended that the opportunities to advance both in terms of status as well as monetarily are limited within pharmacy.

"There are only a couple of things out there—director of pharmacy positions at a few large academic medical centers and a handful of corporate directorships." He added that moving to a different career ladder is an appealing option.

For some former pharmacy directors, the decision to leave the day-to-day grind of running a pharmacy is a personal as well as a career-driven decision. "Some directors try something else and stay, some come back to pharmacy," explained Perini. "For me it was simply, 'Would you like to continue your career focused on pharmacy, or do you want to try something different?'" He went on to explain that he has taken his knowledge as a pharmacist and put it to use in his new role. " I'm still relying on much of the same knowledge base that I acquired as a pharmacist and a director, but in a different scenario."

Pierpaoli, a former ASHP president and Harvey A. K. Whitney Award winner, contended that just because a director switches venues doesn't mean he or she has abandoned pharmacy altogether. He said he's been able to transfer the same skill sets and knowledge base that he utilized as a pharmacy director into the area he's in now. "The experience I've gained as a pharmacy director at large and highly complex organizations has been of value primarily because of operational experience, depth of understanding of how those enterprises work, how decisions are made, and how you relate to the cultures in those institutions in the pharmacy and outside of the pharmacy departments."

Loyalty to the profession

One common denominator among many former pharmacy directors who have moved on to greener or different pastures is a passionate desire not to short-change the pharmacy department that they leave behind.

"You don't want to see directors advance at the expense of a decrease in the advancement of pharmacy programs," said Bruce Scott, v.p.-resource management for St. Paul-based Allina Health System. Scott, a former pharmacy director and past ASHP president, has moved successfully into the executive ranks. He explained that it's critical that an outgoing director leave the pharmacy department with competent leadership. ASHP's Scheckelhoff agreed, noting that it's important to make sure that key leadership roles within pharmacy departments aren't left open or filled by someone who's not interested in trying to move things forward. "As people move on, we need to make sure we have people right behind them ready to step into those positions."

Pros and cons

While new employment opportunities may be alluring, many former pharmacy directors realize quickly that they may have to sacrifice some aspects of the day-to-day pharmacy life that they find appealing.

"With any profession, as you move to higher and broader levels of responsibility, you lose some of the specificity and specialized knowledge, much like the clinical pharmacists who move into directors' roles," said Perini. "They're going to lose some of the specialized knowledge they may have had within their practice area."

In his new role, Perini has more off-hour responsibilities, including attending corporate social functions, that he admitted take up more personal time. Nevertheless, he urges pharmacy directors seeking new challenges to take advantage of alternative career paths out there. "The experience and skill one gains as a director of pharmacy is excellent preparation for many leadership roles in the healthcare industry."

For Pierpaoli, the new v.p. role has its share of rewards. "There is an infinite variety of problem sets and challenges I work with, compared with what I was doing before. That's stimulating, because you're always learning in that environment. You learn about yourself and your capacity to deliver."

He admitted, however, that he misses the ongoing personal connection with patients and making a difference in individual patient care outcomes that was a big part of being a director of pharmacy. "One plus in the pharmacy environment was that I had continuous relationships with people on a day-to-day basis." Now, he said, his weeks are filled with extensive travel, and his professional relationships are more sporadic. He conceded, though, that the lack of people contact has been offset to some degree by the personal challenges and opportunities to continually explore and discover his capabilities in a totally new context.

Pierpaoli said that while he had a very fulfilling career as a pharmacy director at three major academic medical centers over the years, it was time for a new beginning. "I was ready to reinvent myself. The new position reenergized my career."

Anthony Vecchione

 

Tony Vecchione. Special Report: MOVING ON UP. Drug Topics 2002;22:HSE42.