Difficult Bosses in Medicine

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Difficult Bosses in Medicine

We cannot emphasize enough how important it is to view your Boss emphatically.

Managing well is hard.  Most bosses struggle with some aspect of management.  Most Bosses in Medicine want to do well and help other members of their team.  If you think hard about it its very likely that your Boss has a number of strengths that you appreciate, its just that there’s one or two habits or behaviours you are really struggling with.

It is hard to hear and accept criticism.  Especially if this is the first time that someone brings the issue up with you.


Before you decide that your Boss is useless, check your own biases and whether you have understood the situation well enough.  Do you have all the relevant information?  In particular its highly likely that you are not privy to any stressors placed on your Boss by their Boss or Bosses in the hospital or health system.


Look for support outside of the hospital that you are working in.  But don’t make this a whinge fest.  External people can give you fresh perspectives and are far less likely to know your Boss and therefore be put in a difficult situation in terms of loyalties.


Many of the solutions for avoiding working with a Difficult Boss or dealing with a Difficult Boss involve either talking directly to your Boss or others who know them.  When you do its important to do so with respect and to have thought about how you might phrase your questions and comments. Consider practicing the discussion it first it with a trusted mentor who you know will treat your matter with confidence.

If you are talking to other colleagues about your Boss situation, consider whether they are trustworthy and respectful workers themselves.  Its best to approach such situations as if you expect that your conversation may be reported back to your Boss (even if it isn’t).  So talk about your Boss in generalities like “What’s Doctor X like to work with?”, “Any tips for how to prepare for the Ward Round?”, “What’s the best way to get feedback from Doctor X?”.

If you have decided your best option is to raise a concern with you Boss.  Think about the setting.  Is it better to book a time to see them when it can be private and one on one?  What exactly will you talk about?  In most cases an appreciative inquiry approach may be less confrontational and lead to a useful dialogue.

For example, if your Boss is particularly rules focused and a stickler for formality and authority.  You might choose to book an appointment to see them via their secretary (they probably have one).  You might choose to open the conversation as an effort on your part to better understand from your Boss (to learn) what protocols and processes are particularly important to him/her.  You might reflect that other Bosses that you have worked with have had different perspectives on rules and would really value learning from someone who has put some time into thinking about what is important in the hospital.

This approach is called “appealing to someone’s narcissism”.


You might be in a situation where you feel it might be necessary to go above your Bosses head.  Sometimes there is even a duty to do so.  But before you do so think about the consequences.  There is a reason its called a hierarchy.  Complaints about individual Bosses can quickly move from being seen as individualized to being a general complaint  against management and blow back on the individual.  Talk to some trusted others.  Consider whether its possible to gain strength and safety in numbers.


This ultimately should be about you and your needs.  We have talked about the negative effects of working for a Boss who places stress upon you.  It maybe that you can stick it out till the next rotation.  But there may be situations where cutting your losses make sense.  Quitting is always an option (but should be done in a calm moment).  There may also be ways of swapping from your current Boss to another.

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