Addressing Toxic Leadership Among Healthcare Providers to Foster Organizational Growth

Toxic leaders are akin to invasive weeds in a flourishing garden. If not swiftly uprooted, they will overrun the entire organization, impeding growth, diminishing morale, and prompting the exodus of valuable talent.

Whether organizations choose to acknowledge it or not, toxic leaders are pervasive. They may exist within small teams of 100 or less, or be rampant in sprawling corporate structures. Regrettably, they are often tolerated, permitted to stifle the development of their colleagues—particularly subordinates and peers alike. Frequently described in flattering terms such as “hard-working,” “results-oriented,” or “tenacious,” their attributes, while seemingly admirable, can morph into toxic behaviors when left unchecked—manifesting as manipulation, intimidation, and abuse.

The damage inflicted by toxic leaders extends far beyond the confines of their immediate teams. Their influence can ripple through the organization, leading to attrition, disengagement, and a marked decline in productivity. Characteristic behaviors of toxic leaders include:

• Suppressing creativity within their teams
• Taking credit for successes while deflecting blame for failures
• Leading through fear and coercion
• Demonstrating apathy toward team members’ personal and professional well-being
• Rejecting any form of feedback—be it constructive or critical

The employees subjected to such leadership inevitably undergo behavioral shifts, including: 

• Once-enthusiastic employees becoming withdrawn and disinterested
• A reluctance to share innovative ideas
• A rise in sick leave and vacation usage
• Escalating turnover rates

Colleagues working alongside a toxic leader may find themselves overburdened, compelled to compensate for failing teams by increasing their own accountability. As disillusioned employees seek alternative leadership figures for guidance, the toxic leader becomes increasingly isolated, which in turn triggers more controlling and damaging behaviors. This destructive cycle often results in burnout, disengagement, and ultimately, organizational decline. One study estimates the cost of poor management at over $900 billion annually in U.S. companies alone. Healthcare institutions, in particular, must act decisively to identify and remediate toxic leadership.

How Toxic Leaders Endure

Surprisingly, organizations often play an inadvertent role in enabling toxic leaders. Those labeled as “dedicated,” “goal-driven,” or “resilient” may simultaneously be perpetrators of emotional harm. These individuals persist because they are allowed to—shielded by leadership’s reluctance to confront uncomfortable truths. This willful ignorance does a disservice not only to their direct reports but to the organization as a whole.

Toxic leaders are often shrewd political operators, adept at deflecting threats to their influence. While they may project charm and competence to senior executives, their subordinates and peers may experience them as volatile and predatory.

If you suspect someone of being a toxic leader, it’s likely your instincts are correct. Immediate intervention is critical.

Identifying and Addressing Toxic Leaders

Once a toxic leader is identified in a healthcare organization, there are generally two paths forward:

• Provide targeted coaching to rehabilitate the leader, if feasible
• Initiate counseling or facilitate their exit, if not

Spotting toxic leaders can be challenging—particularly those skilled in corporate politics. However, two invaluable tools for leaders are communication and observation, though both require patience to yield actionable insights.

Through communication, prioritize listening over speaking. Build rapport by inquiring about team members’ career aspirations, family lives, and interests. Demonstrating genuine concern can open the door to more candid conversations.

Through observation, examine interpersonal dynamics: How do individuals engage with their supervisor? Do interactions appear collaborative or fragmented? A nuanced understanding of these dynamics can help leaders diagnose deeper issues.

Many organizations use 360-degree reviews to identify problematic behaviors. However, such reviews often lack true anonymity. Narrative responses are easily attributed to specific individuals based on writing style or prior remarks, making employees vulnerable to retaliation—something toxic leaders don’t hesitate to exploit. Fear of retribution also compromises the honesty of feedback. Additionally, subjective interpretation of qualitative comments limits their effectiveness.

A superior alternative is the data-informed 360 review. This approach is grounded in quantitative analysis, conducted anonymously, and based on validated research methodologies. Using a seven-point Likert scale, reviewers assess leadership behaviors. The resulting data compares the leader’s self-perception with how they are perceived by their team, painting a holistic picture of their leadership style.

This methodology has been effectively deployed in healthcare settings. In one instance, it exposed a toxic leader whose team, peers, and supervisors all provided consistent feedback. Armed with this evidence—and corroborated by earlier insights gathered through communication and observation—the department head was empowered to confront the issue directly.

Healthcare organizations can no longer afford to ignore toxic leadership. Data-driven assessments offer the concrete evidence necessary to validate concerns and support difficult but essential decisions. By rooting out toxic leaders, organizations cultivate a healthier, more productive environment—one where staff can thrive and patient care is not compromised.