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The Impact of Toxic Leaders on Your Healthcare Organization

June 10, 2024

BY J. BRYAN BENNETT
MBA, CPA, LSSGB, CEO & Chief Leadership Innovation Officer, Elite Leadership Academy, LLC., San Diego, CA

Toxic leaders are like weeds in your garden or lawn. If you don’t remove them right away, they will infest your entire organization, resulting in stifled growth, reduced morale and the departure of quality employees. 

Toxic leaders are everywhere, whether organizations want to admit it or not. They can be found in organizations with as little as 100 employees or found in multitudes in larger ones. 

Unfortunately, they are usually ignored and allowed to choke the growth of those around them, namely, their subordinates and their peers. They are usually accepted and described in satisfactory terms such as hard-working, results-driven or persistent. On the surface, these traits could describe great employees; but, when taken to the extreme, they result in negative outcomes, such as abuse, intimidation and manipulation.

Toxic leaders have a negative impact not just on the team they’re managing but can impact the entire organization through attrition or lack of productivity. Toxic leaders can be identified by several behaviors, including: 

  • Stifling creativity among their team 
  • Accepting accolades for any successes but blame others for any failures
  • Managing through fear and intimidation 
  • No interest in their team members’ personal or professional lives 
  • Refusing to accept any negative feedback, constructive or otherwise

The employees led by toxic leaders will also show behavior modification as a result of toxic leadership, such as: 

  • Energetic employees become reserved and no longer show initiative 
  • Employees begin to withhold innovative ideas 
  • Increased sick and vacation requests
  • Increased turnover

Peers that surround a toxic leader can be drawn into increased accountability for employees and productivity outside of their own team in an effort to “rescue” the team. Employees may start to vent to the leader of their choice, isolating the toxic leader from the manager/employee relationship. This creates a cycle of increased control from the toxic leader, which pushes the employee further away, which then pushes the leader into more toxic behavior. 

Working with a toxic manager usually leads to burnout, attrition and lower productivity. A recent study put the cost of bad managers at US companies at over $900 billion annually. Healthcare organizations need to identify these managers and take immediate appropriate action.

HOW TOXIC LEADERS SURVIVE

Believe it or not, you are probably complicit in the toxic leaders surviving in your healthcare organization. The same people you call hard-working, results-driven or persistent are some of the same people who are abusers, intimidators and manipulators. Toxic leaders survive because they are allowed to survive. This “head in the sand” approach to leading will not help the people who report to them or their peers who have to work with them. 

Toxic leaders are usually also politically savvy. They know how to handle anyone who could be a threat to their job or control. So, while you may be seeing someone who’s always smiling and saying the right things, their direct reports and peers may perceive them as an upset Godzilla crossed with the Predator. 

If you suspect someone might be a toxic leader, they probably are; so, you should take action before it’s too late. 

IDENTIFYING AND REMOVING TOXIC LEADERS 

In a healthcare organization, once a toxic leader is identified, there are two paths that can be chosen:

  1. Coach them for improvement if they are salvageable 
  2. Counsel them to move on

Identifying toxic leaders can be very challenging, especially the politically savvy ones. Communication and observation are effective leadership tools that can be used to better understand challenges facing a department or group leader’s team members, but they take a longer time to receive actionable information. 

For communication, focus on listening versus talking by getting to know basic information about the team members, such as their career goals, family life, outside interests, etc. When they see a general interest, they may feel comfortable enough to open up about other topics.

For observation, watch how people interact with their supervisor, fellow team members and the support staff. Do they largely interact in small groups or as a team? How do they interact with their supervisor? Understanding the team dynamics will help the group leader gather information about their members.

Many organizations turn to 360 reviews to identify toxic leaders. The problem with most 360 reviews is that they are not completely anonymous. Since most responses are text-based, readers can usually determine who provided a comment based on writing style or previous comments, which can lead to retaliation—an action toxic leaders willingly take. Reviewers may also be intimidated by the leader and not provide honest feedback. Lastly, the comments are open to interpretation by the person or persons reading the feedback.

A more effective approach is using data-informed 360. A data-informed 360 is quantitative-based, using proven research methods and is completely anonymous. Reviewers answer questions about a person’s leadership behavior using a seven-point Likert scale. The tool can then be used to measure the leader’s perception of their leadership against the team’s perception of their leadership. This provides a comprehensive picture of the leader, enabling the organization to identify potential toxic leadership behaviors and take action. This tool has been used to assess individuals for several years, thus also creating a statistical data pool to benchmark the leader’s results against.

For example, when actually used as part of a healthcare system’s team assessment, it very easily detected a toxic leader as a leader’s team, peers and supervisors assessed their leadership behaviors. The results were very clear and provided the department leader with the ammunition to have a very specific conversation with the leader. The results were supported by the department leader’s prior engagement with the communication and observation techniques previously discussed, which had pointed to a potential problem. 

Healthcare organizations have no excuse to continue accepting toxic behavior. A data-informed assessment tool provides the hard evidence needed to support suspicions derived from the effective use of communication and observation. It will support the hard choices that need to be made and verify any suspicions the healthcare organization has about their leaders. Toxic leaders must be identified and “weeded out” for the betterment of the healthcare organization.


Professor Bryan Bennett, MBA, CPA, LSSGB, is the founder and Chief Leadership Innovation Officer for the Elite Leadership Academy, a privately funded leadership research, training, coaching and advisory organization established to help individuals and organizations improve leadership with measurable results.

Professor Bennett has been a faculty member at Northwestern University since 2013. He has also been an adjunct faculty member at the University of Chicago, Judson University and West Virginia University. His academic experience includes developing and teaching courses in business analytics, leadership and marketing to domestic and international students both online and in classroom environments.

He is the author of the books, The Path to Elite Level Leadership: The 5-Step Program for Measurable Leadership Growth (2021), Prescribing Leadership in Healthcare: Curing the Challenges Facing Today’s Healthcare Leaders (2017) and Competing on Healthcare Analytics: The Foundational Approach to Population Health Analytics (2015).

His work has been recognized by Gartner and published in several academic and professional journals.

Professor Bennett is a highly requested international speaker on the strategic implementation and use of analytics in healthcare, leadership improvement and population health management. 

He has been recognized by Becker’s Hospital Review as one of the top African American Leaders in Healthcare for three years in a row. 

He has a Master of Business Administration from Northwestern University’s Kellogg School of Management and a Bachelor of Science degree from Butler University. He is a Certified Lean Six Sigma Green Belt, Certified Data Scientist, Certified Public Accountant, Certified Adjunct Faculty Educator and trained project manager. He can be reached at bbennett@eliteleadershipacademy.com.

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