The illusion of control

I remember opening a WhatsApp message in which fellow pharmacy owners were reacting to a recent corporate announcement about another round of technician hour cuts. My chest tightened. I typed out an angry response, deleted it, then read the stream of messages that followed. When I finally looked up from my phone, I felt worse, not better.That night, after venting to my wife, something shifted. I realized I'd spent more energy complaining about a decision I couldn't change than I would have spent adapting to it. The question that changed everything wasn't "Why is this happening to me?" It was "What's actually within my control here?"The concept of locus of control, defined as the degree to which people believe they have power over events in their lives, separates those who thrive from those who merely survive.1 In pharmacy, we often operate with an external locus of control: “Corporate won’t let me,” “The College is out of touch,” “Patients expect too much.” What I've learned is that these statements are true, but they're also traps. Every minute I spent complaining about systemic issues was a minute I wasn't using my self-agency.Research on healthcare professionals shows that those with a strong internal locus of control, those who focus on what they can influence, report lower stress, better job satisfaction, and stronger resilience. The question isn’t whether your complaints are valid. They are. The question is whether they’re useful.The resistance to simplicity“People don’t resist change; they resist being changed.”2 Change researcher Peter Senge suggests the same principle applies to thinking. When you challenge a colleague to stop venting about staffing and instead identify one micro-habit they control, you’re not invalidating their frustration. You’re inviting them into a different conversation.A study of 16 hospitals implementing new technology found that teams whose leaders invited feedback and explored new behaviours succeeded, while those who simply mandated change failed.3 The difference wasn’t the external pressure. It was the internal permission to experiment.Small wins compoundThe beauty of simplicity is that it doesn’t require grand gestures. Small, simple, repeatable actions can create exponential results through compound interest. In his book Atomic Habits, James Clear shows that if you improve by just 1% each day, that compounding effect can make you roughly 37 times better after one year.4 This is what researchers call the compound effect.Here's what I discovered works in pharmacy practice:The "decide once" strategyEvery time I made the same decision repeatedly, I realized I was draining my mental energy. Now I decide once, document it and free my brain for clinical decisions that actually matter by using a repeatable system.For example, I have a post-shift ritual that I adhere to. When I get home, I change out of my work clothes, drink a glass of water, take three slow breaths and ignore my phone for the first half hour. This simple boundary prevents work stress from contaminating my home life.The "two-minute rule"If something takes less than two minutes and will prevent future chaos, I do it immediately. For example, sending that quick message to clarify tomorrow's schedule. These micro-actions prevent macro-crises.Front-loading the drainI used to save the tasks I dreaded for "when I have time." This usually meant 4 PM, when I was already exhausted and trying to leave the store. Now I tackle them first thing ,when my mental energy is highest. This single change reduced my end-of-shift overwhelm.These aren’t revolutionary ideas. And that’s the point. “Simple can be harder than complex. You have to work hard to get your thinking clean to make it simple,” Steve Jobs once shared in an interview.Shifting complaining to curiosityWe all know colleagues who spend most of their energy complaining about what is not right. Their perspective is “Why is everything so broken?” I’ve been challenged by colleagues who still think this way. I’m expecting them to comment on this article! Although things in our profession need overhaul, we can reframe our outlook to ask, “What’s one thing in my control today that could make this 1% better?” Focusing exclusively on external forces is like trying to steer a ship by yelling at the wind. It wastes energy and needlessly gives away our power. Your circumstances are real, but your response to them is where your power lives.Use these questions to challenge yourself when you notice the complaint spiral starting:What percentage of my daily frustration is about things I cannot control versus things I could influence with a small habit change?If I had to pick one two-minute action that would make tomorrow slightly less chaotic, what would it be?The next time I catch myself complaining about staffing, what’s one concrete boundary I could set or delegation I could attempt?What ‘essential’ task am I doing that, if eliminated, would free up mental space without harming patient care?These aren't just feel-good strategies.A study published in the Journal of the American Medical Association showed that involving a senior clinical pharmacist in daily physician rounds in the ICU department reduced unnecessary prescribing by 66%.5 This was not a significant policy change, but a simple habit of daily team communication.Your moveThree years after that WhatsApp moment, I have developed a new awareness. Changes in pharmacy are still challenging to deal with. The healthcare system still frustrates me. But I've changed. And that changes everything.Adapting and leading change is one of the single most valuable skills. McKinsey Global Institute estimates that between 0% and 30% of hours worked globally could be automated by 2030.6 Those who succeed won't be those who resist change; they'll be those who learned to control what they can while adapting to what they can't.Start here: Tomorrow morning, before you check your prescription queue, take two minutes to write down your three priorities for the day. Not your tasks but your priorities. What matters most?Manjit Hansra is a consultant and CDE pharmacist focused on providing tools to help pharmacists prevent and manage burnout. Subscribe to his newsletter HERE.References:Locus of Control Theory In Psychology: Definition & ExamplesSenge, Peter M. The Fifth Discipline: The Art and Practice of the Learning Organization. New York: Doubleday/Currency, 1990.Edmondson, Amy C., Richard M. Bohmer, and Gary P. Pisano. “Disrupted Routines: Team Learning and New Technology Implementation in Hospitals.” Administrative Science Quarterly 46, no. 4 (2001): 685–716Clear, J. (2018). Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones. New York, NY: Avery.Leape, L. L., Cullen, D. J., Clapp, M. D., Burdick, E., Demonaco, H. J., Erickson, J. I., & Bates, D. W. (1999). Pharmacist participation on physician rounds and adverse drug events in the intensive care unit. Journal of the American Medical Association (JAMA), 282(3), 267–270.Jobs lost, jobs gained: What the future of work will mean for jobs, skills, and wages