Leading in an ambi-dextrous way requires leaders to ride the wave of uncertainty with just enough pinned down and regulated while they keep one eye on the future and its evolving possibilities and the other eye firmly on today / next week’s performance. This is a big ask – not only because of the personal capability it suggests, but also because of the major challenge it presents to ingrained, relatively high degrees of rigidity and conformance.


Leading in Complexity

Many new organisations / start-ups are being set up by people who have not been ‘schooled’ in these well worn and conformist mindsets and habits, have not seen ‘good leadership’ as the mastery of order, control and minimising exceptions. Their more ‘go with the flow’ attitudes and confidence illustrate a looser leadership approach. Of course, we have yet to see how their organisation’s fare and how they deal with growth, but we can use them as one benchmark for a different leadership perspective and approach.

It is harder for older, more established organisations and the leaders within to adapt, to shift towards ambi-dextrous leadership – especially in a highly regulated and controlled environment.

Consider the complexity of industries like pharmaceuticals:

  • Pressure on drug-pricing – how to optimise cost of development and production
  • Global / international – how to satisfy a range of demands, standards, regulations, QA, priorities and still make money
  • Depth required in functional expertise – no such concept as General Manager – and deep sensitivities about sacrosanct methods and procedures.  Can these be challenged?
  • Health economics – real-time comparisons on health options so no certainty of market or price, and both may change
  • Pressure on the ‘next great find’ – how to source ideas, speed up cycle time for development phases
  • Massive levels of financial and time investment before you know you have a commercial product – so, balancing commercial realities with the need to fund research
  • Pressure and opportunity to collaborate – with universities, start-ups, competitors, health sector bodies.  How are these coordinated and made sense of for critical decision making?
  • Regularly defining the organisational ‘greater good’, given the variables at work that can affect organisational benefit and strength.


Leading in an ambi-dextrous way requires leaders to ride the wave of uncertainty with just enough pinned down and regulated while they keep one eye on the future and its evolving possibilities and the other eye firmly on today / next week’s performance.”


While these sorts of challenges have parallels in other industries, the scrutiny and regulations that underpin pharma are among the most stringent and demanding of all sectors.  As experts in a complex area, it is not hard to see why pharma organisations have been used to calling the shots – but that is no longer the case. Faced with this new reality, how do leaders in pharma organisations now direct and drive towards success?


Lessons from Pharma

In broad and general terms, pharma organisations seem to have been characterised by two main leadership models:

  • Highly structured, clear boundaries and roles, hierarchical, functional and resource holder power;
  • Fluid, multi-matrix leading to multiple and impermanent team memberships, specialities more than functions, goal and outcome focused, though with a ‘crown’ of executive leadership.  Nevertheless, more incidences of network and interpersonal power.


These are not mutually exclusive and elements of both will be evident in the same organisation. From a leadership perspective, each model brings significant challenges.  While the latter seems better placed for an ambi-dextrous approach, it has its difficulties too – how to create and maintain sufficient focus, how to know what is going on / who is contributing to what, how to assure adherence to standards and regulations where needed.

There is not a single leadership model in the pharma industry and the emergence of something more ambi-dextrous, I suggest, is still in a fledgling state, as a common modus operandi.  As some organisations seek to move towards more ambidexterity in their leadership there is an interesting transition afoot.


So how are Pharma leaders building ambi-dexterity from a more hierarchical base?

The challenges start at the Executive team level in terms of establishing appropriate governance and accountability to allow a combination of both fluidity and tight adherence to a mixed bag of regulations and standards to secure performance.  What we have seen in some organisations is the dominance of functional expertise having precedence over the corporate role (not exclusive to pharma, I hasten to add), and with some legitimacy given the depth of regulation and expertise that applies.  The risk lies in the extent to which the leadership share a consistent and clear understanding of what has primacy, without which any well-intended effort may result in poor levels of performance and success.

In any organisation one ‘function’ will be more critical to success than others, at given points in time – in pharma it depends on whether the specific organisation covers everything from drug discovery to development through to commercialisation.  And it depends on their current market position, their partner relations, performance and so on.  While all functions are important, there needs to be a common sense of who is serving whom – at least for the foreseeable future.

Ambi-dextrous leadership includes the facility to question primacy periodically and to set up governance structures to suit, and to be prepared to change them as primacy shifts.

In some cases we are seeing hierarchical organisation structures being replaced, or at least tempered, by looser vertical and horizontal boundaries; relying more on shared understanding of the greater good and fundamental values to guide behaviour, decisions and actions.  It could be argued that hierarchical structure is becoming less important than other features of how the organisation works.  (see Gary Ashton’s article).  This is especially the case where a global or international matrix exists, comprised of partners as well as core operating units.  The vertical lies in being very focused on where decision-making rests on specific agenda items; and the horizontal in terms of changing combinations of who needs to be involved, in whatever capacity, from available areas of expertise.

But who owns accountability for what?  Is accountability so fluid that in effect it becomes redundant and success becomes increasingly fragile based on hope and tightly closed eyes?  Well, no.  The notion of accountability is vested temporarily until a task has delivered and the job is done, combining a project management approach with specific expert contribution.  There is often additional accountability in the form of delivering to vested interests of diverse stakeholders and making judgements on which are to be more or less satisfied.  So, making trade-offs in the spirit of delivering to an overarching greater good / desired outcome.  This welds accountability to understanding the broader purpose and values of the organisation.

Getting to that point is a challenge too.  If people are used to a more hierarchical structure and possibly a function or unit specific allegiance, it is a significant shift to ask the same people to operate using their own judgement within given parameters and to consider the good of multiple functions or units as well as hitting the overall goal.  And how do you assure or measure performance, its delivery and best use of resources?

What we are seeing in some cases is use of a matrix governance structure that extends down the organisation to include at least senior and middle managers – people who get things done, the operational side of business.

If we link this with the earlier point about primacy you start to see ways of leading the business that might look a bit like the diagram below (albeit a simplistic version).



page8-diagram-noshadowDiagram 1: An Example Matrix Governance Structure



This model challenges notions of power, its sources and application as it is fluid within a small suite of absolutes – who decides per event, who has primacy, the enablers, the regulations, the need for strategic and operational measures.  The membership in each pot might well change, but the governance model still holds.  Indeed, individuals may be members of several teams and hence have multiple masters.

This takes some getting used to.  It makes unusual demands of senior leaders to allocate how they use their time doing what, and how they, at the same time, maintain a future focus to identify and articulate the next set of requirements, deliverable to whom, with whom and by when.

What the diagram doesn’t show is the range of relationships between a pharma unit / organisation and its partners, payers and other key stakeholders.  The need to build strong relationships across an ever-wider spectrum of players is stretching leadership roles to the maximum.

It has raised a considerable debate about how that breadth of relationship management challenges how leaders currently see the primary purpose of their roles and added value, of how they spend their time, doing what. It leads to questions of the consequent impact on empowering a wider cadre of leaders in their business.  For many, especially those leading specialist functions from their own areas of in-depth expertise, shifting a significant portion of their interest and contribution to external relationships is not always easy.

It carries in its wake too the need to build leadership capability more broadly in the organisation to assure the tactical and operational business activity continues effectively.  Of course, some of the relationships – with partners, start-ups, academia, competitors, health sector, funders and so forth – do not need to be managed by senior leadership.  However, the composite picture of the stakeholder arena and the relative importance to the business of each player must be shared and consistently applied – until of course the pecking order changes for some good reason.

So, leaders in pharma faced with the necessity to become ambi-dextrous are squaring up to a number of challenges in making that move:

  • Enabling reporting lines to be shaped by specific deliverables and being ‘servant’ to multiple ‘masters’ – and therefore fluid
  • Core leadership teams balancing an ‘enabling’ role with a strong ‘delivery’ role, while maintaining a strong future focus
  • Greater dispersal of power held together by focusing on an overarching ‘greater good’
  • Exploring and re-examining how leaders use their time / what they regard as their main contribution, often prompted by the demands of building and sustaining a diverse arena of stakeholders.


the concept of collective effort, unshackled by formal organisation, with nevertheless immensely strong shared purpose and codes of conduct, paints for me a strong picture of the ambi-dextrous environment.”


Ambi-Dextrous Leadership – Implications for Recruitment and Learning

These changes make demands on what kind of people to recruit and what learning and development will help leadership most.  We believe that ambi-dexterity is both a mindset and an ability, borne of experience and personal preference / personality.


The ideal ambi-dextrous leader is one who is:

  • Comfortable with delivering within temporary arrangements, happy to move from one to another
  • Able to serve different masters, making judgements and trade-offs to optimise their own outputs for a greater good
  • Agile and responsive in spotting relevant stakeholders and building the relationships
  • Concurrently managing immediate needs with medium and long-term risks and opportunities, while keeping an eye on possible futures
  • Able to find their own personal anchors and aware of their own sources of power.


The sum does not provide a simple profile against which to assess, as such leaders will have had specific experiences and backgrounds that prepare and enable them to comfortably deal with moving tectonic plates as they deliver the goods. So suitable players will come from a number of combinations of capability and backgrounds.

I am reminded of the Hanseatic League (1) which has been described as ‘a commercial and defensive confederation – to protect economic interests and diplomatic privileges’.  While the defensive element is less to do with warring practices these days and the diplomatic privileges may be better described as mutual protection and reinforcement, the concept of collective effort, unshackled by formal organisation, with nevertheless immensely strong shared purpose and codes of conduct, paints for me a strong picture of the ambi-dextrous environment.

Leaders within it need the fortitude and confidence to throw in their lot with a volatile crowd who share a desire to deliver effective drugs, ethically and cheaply. Any assessment of candidates needs to test for this ‘spirit’ as well as the range of competences, personality and skills.





1. Hanseatic League - Wikipedia