Archetypes of bad physician leaders - a qualitative study from a large Finnish central hospital

This study aims to explore the archetypes of bad leaders as perceived by Finnish physicians across various hierarchical levels. Understanding these archetypes is essential for addressing leadership deficiencies and mitigating the detrimental effects of bad leadership and the positivity bias in leadership research.

Data were collected through in-person, semi-structured interviews with Finnish physicians (n = 50), including residents, specialists, heads of departments and chief physicians. Inductive content analysis, followed by thematization, was used to identify recurring themes and patterns of bad leadership behaviors. Initial codes were generated and subsequently categorized into archetypes of bad leadership, which were further organized into broader thematic categories of bad leadership.

Based on our findings, the authors identified four main themes of bad leadership encompassing seven archetypes of bad leaders, addressing incompetence, lack of transparency, exploitation, bad workload management, bullying, psychological harassment and inequity: lack of support and accessibility (absent and dismissive), authoritarianism and abuse of power (autocratic, bully and manipulative), incompetence and ineffectiveness (incompetent) and unfairness and discrimination (unfair). These issues occurred occasionally in different situations.

The findings indicate that a leader's behavior and leadership style directly affect physicians' well-being and work satisfaction, potentially contributing to higher physician turnover and reduced quality of patient care. These results underscore the importance of fostering leadership education that emphasizes communication skills, emotional intelligence and conflict resolution to enhance constructive leadership behaviors.

To the best of the authors' knowledge, no prior empirical research has specifically examined the archetypes of bad physician leaders.