Power dynamics or a race to the bottom? Bullying, harassment and tall poppy syndrome in radiology

Negative workplace behaviour (NWB) - including bullying, harassment, mobbing, and tall poppy syndrome - remains a significant, under-addressed threat to healthcare professionals. This commentary explores NWB drivers, consequences, and mitigation techniques, with a focus on radiology. The drivers of NWB are multifaceted, encompassing power imbalances, leadership failures, implicit bias, and institutional culture. Evidence highlights the disproportionate impact on women and marginalised groups, who are more frequently targeted and more susceptible to burnout and severe mental health outcomes. Beyond individual harm, NWB degrades team performance, increases turnover, impairs patient safety, and erodes institutional integrity. Mitigation includes a commitment to foster ethical leadership, institute zero-tolerance policies, support effective bystander intervention and ensure safe reporting mechanisms. Authentic leadership, diversity initiatives, and well-being support programs play critical roles in prevention. This paper highlights collective accountability for creating psychologically safe workplaces in healthcare ultimately ensuring the best patient outcomes.