Perspective No. 2 What if There is a Better Way?

Leadership Begins with a Different Question

By Dr. Ruth Nemire

People ask me how I became interested in leadership, innovation, and organizational transformation. The answer usually surprises them. Before I became a pharmacist, earned a doctorate, led colleges of pharmacy, worked in clinical research, or advised healthcare organizations, I studied theatre. Most people assume those worlds have nothing in common.

I think they have everything in common.

Theatre taught me that before you move a chair, hang a light, or rehearse a scene, you have to understand the experience you're trying to create. Once you know the outcome, every decision becomes intentional. Should the sofa be stage right or stage left? Should an actor enter from the back of the house instead of through the wings? How should the lighting make the audience feel? Those questions weren't about furniture or lighting. They were about purpose.

Decades later, I realized I was asking the same questions—not about stages, but about healthcare, education, and leadership. Why can't pharmacists do more than put pills in a bottle? Why do students spend so much time watching instead of doing? If we're building a new pharmacy school, why should classrooms look like they did fifty years ago? Why can't learning happen around tables that encourage collaboration instead of rows that encourage passivity? Why do we continue projects simply because we've invested time in them when the evidence tells us we should change course? As a leader, what is the most important thing I should do first? For me, the answer has always been the same:

Decide what outcome you're trying to create—and then work backwards.

It sounds simple, yet I've found that many people and organizations do the opposite. They begin with what they've always done, or with the resources they have, or with a checklist of tasks. They focus on activity before they define success. I've always believed that leadership starts with a question, not an answer.

Theatre also taught me something else that has shaped every role I've held.

Every member of the cast matters. The audience may remember the lead actor, but no production succeeds without the lighting designer, the stage manager, the costume crew, the musicians, the set builders, and countless others working together behind the scenes. Every role contributes to the story. Healthcare is no different.

The best patient outcomes don't happen because one profession is exceptional. They happen because physicians, pharmacists, nurses, therapists, technicians, administrators, and countless others work together toward a common goal. That's why interprofessional education has always made perfect sense to me. I understood the power of the ensemble long before I understood the language of collaborative practice.

Over the years, I've learned that curiosity isn't a personality trait. It's a leadership discipline.

Curious leaders ask questions that challenge assumptions. They listen before they prescribe solutions. They aren't afraid to rethink a curriculum, redesign a room, revise a strategy, or change direction when the evidence points to a better path. Most importantly, they create environments where other people feel safe asking questions, too.

Looking back, I realize my career has never been about pharmacy, higher education, consulting, or executive leadership alone. It has always been about asking better questions.

Questions that improve learning. Questions that transform organizations. Questions that help people see possibilities they hadn't considered before.

Because every meaningful change begins with someone willing to ask,

"What if there's a better way?"