Management diplomacy: myths and methods

The importance of a manager's ability to tolerate and overcome ambiguity is discussed in relation to achieving excellence in hospital pharmacy management. Health-care programming and policy in the 1980s are shaped largely by financing and increased corporate control; in this environment, hospital pharmacy managers face new definitions of excellence in management. Today's director of pharmacy must be "bilingual" in a sense, since he or she must effectively relate to the hospital's corporate administration on the one hand and the professional staff and patients on the other. The hallmark of excellence in a modern director of pharmacy is the ability to tolerate and overcome ambiguity that arises from both of these sources. Ambiguity may be rooted in issues external to the pharmacy department, including structural or organizational barriers that distort power and authority, the gap between professional values and bureaucratic expectations of behavioral norms, the potential for encroachment on professional boundaries, and the difficulties associated with establishing the effectiveness of clinical pharmaceutical services. Intradepartmental ambiguity may be rooted in structural flaws in departmental organization coupled with inappropriate management styles. If the pharmacy profession is to cope effectively with mounting ambiguity, a theory of clinical systems and practice management will have to be developed. This will require the knowledge, skills, and leadership of "bilingual" directors of pharmacy.