The unique thing about winning and losing is that it can be messy. The determination of a winner or loser can be quantitative, subjective, or both. Most coaches will tell their teams that a “win is a win,” regardless of the how close the score was. Unless you are playing horseshoes, it doesn’t matter how close one team came to winning; in most games, it is simply the team who scored more. Of course, if you are playing dominoes, the opposite is true: The player with the lowest score wins. Sometimes, it’s not based on a score at all but who made it over the finish line first. Horses often win races “by a nose,” while marathon runners can literally win by a “foot.” It doesn’t matter how fast the horse or marathoner ran during the race; it’s who beat whom to the finish line.
   
But winning can also be subjective. The winner of a boxing match is often based on who fought better, and many Olympic sports are based on performance and technique, not necessarily on who won the race. The game of baseball relies on umpires to determine whether a pitch is a strike or ball, or if a player safely made it to a base; and football relies heavily on the judgment of referees during a game.
    
In the final analysis, winning and losing usually incorporates some combination of quantitative and subjective values. It’s even possible to be a winner or loser and not even participate in the event; elections are a good example.
    
We went to the polls last month to vote for a presidential candidate who we felt shared our moral, ethical, business, and professional values. After the dust settled and all the votes were counted, we learned that winning and losing is indeed complicated. While according to the U.S. Constitution there was a clear winner based on the electoral tabulation, one candidate clearly won the popular vote by nearly 3 million votes, which left a lot of people scratching their heads asking themselves why they voted at all if their vote did not contribute to a win. While that discussion will continue until it becomes stale, pharmacists have to ask themselves if they were winners or losers based on their vote. While there were lots of narratives from both candidates about healthcare, it all centered on the Affordable Care Act (ACA), with no clear direction as to what it will mean for healthcare providers and their patients despite the fact that, according to the Kaiser Health Tracking Poll taken in October 2016, the high price of prescription drugs and survival of the ACA topped the public’s list of priorities. We learned nothing through the muddled rhetoric of both candidates. It simply isn’t clear if healthcare professionals, including pharmacists, are winners or losers as a result of their choice for president.
    
Hopefully, our new president will eventually spell out in clear terms, sooner than later, what will be in store for healthcare professionals under the ACA. Until then, pharmacists must continue to be their own advocates for the profession. Find out who won the elections in your community and state and study their proposals for healthcare. The only way pharmacists will be winners is if the newly elected legislators hear your voices loud and clear. Whatever ACA’s future will be, pharmacists continue to be at the very core of today’s healthcare environment and must be recognized as such.