From leadership research to district action: Archetypes of bad physician leaders – a qualitative study from a large Finnish central hospital

AI-assisted editorial implementation guide. Proposed district actions are separate from the original authors’ findings and recommendations. Independent peer review of this guide is not asserted.

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Evidence and transfer

Education-related source: verify which participants, institutions and outcomes were actually studied before district adoption. Source publication type: research-article. License and identity checks do not establish study quality or causality.

Original authors’ abstract, reproduced under the source license:

Abstract Purpose 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. Design/methodology/approach 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. Findings 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. Practical implications 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. Originality/value To the best of the authors’ knowledge, no prior empirical research has specifically examined the archetypes of bad physician leaders. Keywords: Physician leadership, Bad leader, Archetype, Health care

Study methods

The subjects of this empirical study were physicians of the Central Finland Health Care District, in which approximately 800 physicians are employed (Finnish Medical Association, 2016). The informants were invited to participate voluntarily in the study via an internal e-mail. All participants were eligible for inclusion in the study, as its objective was to identify elements of bad physician leadership as perceived by members of the doctor’s profession.

Limitations

The semi-structured interviews enabled a thorough exploration of participants’ perspectives, yielding valuable insights into bad leadership. The diverse sample, including physicians from various hierarchical levels, ensured broad representation across the medical profession. Despite these strengths, several limitations remain. Inductive content analysis provided a structured framework for identifying and categorizing archetypes of bad leadership, enhancing the validity of the findings. However, reliance on self-reported data may introduce bias, as participants might underreport negative experiences due to fear of consequences. In addition, focusing solely on Finnish physicians limits the generalizability of the findings to other health-care professionals or cultural contexts (Onyura et al., 2019). Future research should include cross-cultural comparative studies to assess the universality of these leadership archetypes. Furthermore, longitudinal studies could explore the long-term effects of bad leadership on physician well-being, turnover and patient care outcomes.

A 90-day district inquiry

Days 1–15 · Appraise. Read the source methods, recruitment, comparator, outcomes and limitations. Record how the study setting differs from your district and which claim the design can support.
Days 16–30 · Design. Choose one recurring leadership practice described in the source. Map its participants, incentives and constraints to a district setting, then design a small reversible staff pilot with an accountable owner. Agree participation, privacy protections, baseline and stopping rules before starting.
Days 31–60 · Observe. Collect the pre-agreed measures, keep a log of implementation changes and invite confidential voluntary feedback. Preserve existing support for staff and learners.
Days 61–90 · Decide. Record implementation fidelity, staff review time, task quality and unintended burdens against a baseline. Use a comparison team where feasible and document alternative explanations before expanding. Make a dated decision to stop, revise or extend the inquiry.

Board decision brief

Present the local problem, source setting, evidence limits, intervention, responsible owner, total cost, measured changes and uncertainty. Separate staff perceptions, implementation measures and student learning outcomes.

Attribution and reuse

Sari Huikko-Tarvainen; Tommi Auvinen. Archetypes of bad physician leaders – a qualitative study from a large Finnish central hospital. Leadership in Health Services (Bradford, England) (2025-05-27). https://doi.org/10.1108/lhs-12-2024-0154

Prepared 2026-11-07. Source authorship and DOI are preserved. The abstract and source passages are attributed extracts; this editorial guide is offered under the same CC BY 4.0 license.