The Shadow Economy of Toxic Leadership in Healthcare

Given that the collapse of many well-known and reputable organizations has been largely attributed to leadership behaviors, it is imperative that healthcare organizations protect themselves from the array of negative outcomes associated with toxic leadership. This article illustrates how toxic leadership embodies a shadow economy as toxic behaviors are often unreported and untaxed, difficult to measure, span diverse activities, and thrive when formal leadership opportunities are uncertain or limited. The authors offer eight evidence-based strategies that span the leadership lifecycle. These strategies offer a menu of pragmatic approaches to measuring, monitoring, addressing, and reducing toxic leadership behaviors in healthcare organizations. Strategies that span the leadership lifecycle may serve as a blueprint for developing working environments that encourage awareness, support, and ethics among healthcare leaders, with the ultimate goal of enhancing the overall quality of medical training, scholarly discovery, patient care, and organizational health.