The Arsehole Boss a Totally Different Type of Difficult Boss

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The Worst Bullys in Medicine are what are termed in the Organizational Psychology Literature Assholes or Arseholes.

The Arsehole Boss is a term made popular by Robert Sutton from Stanford University in his Best Seller “The No Asshole Rule”.  Sutton has worked with a number of top companies, not for profits and even hospitals (like the Cleveland Clinic) and has identified asshole problems and solutions across the board.

As Sutton points out everyone is capable of being an arsehole at work at times but true arseholes are consistent.  They engage in bullying and belittling those with less power than themselves and leave them feeling oppressed, humiliated and de-energised.

We might also refer to these people as sociopaths or antisocial.

As we have pointed out their presence in the workplace as bullies is much rarer than the other more common explosive bully.  So exactly how prevalent are they?

The societal prevalence of Antisocial Personality Disorder is somewhere between 1-3 percent (with at least a 2:1 ratio between men and women).  Psychopathy or sociopathy is not recognised as a Mental Disorder in DSM5 but often still used as a diagnostic label by mental health professionals and studies have shown higher rates in corporate settings as well as certain disciplines in Medicine, in particular, Surgery.

COMMON BEHAVIOURS OF ARSEHOLE BOSSES IN MEDICINE:

  1. Personal insults
  2. Invasion of personal space
  3. Uninvited contact
  4. Threatening behaviour (often references to their ability to help or hinder a trainees career)
  5. Dirty looks
  6. Sarcastic jokes and teasing
  7. Rude email behaviour
  8. Public shaming (such as putting the trainee on the spot in the ward round)
  9. Rude interruptions
  10. Nicknaming

What can be done about an Arsehole Boss?

For a true sociopath change in behaviour is difficult.  Many successful organizations will focus on preventing arseholes joining in the first place and having rules for ‘managing them out’.

The consequences of failing to eliminate arsehole bosses and arsehole behaviour can be dire in an organization such as a hospital.

Self-selection in recruitment is a common bias and when arsehole bosses are put in charge of hiring and firing decisions this means more arseholes entering the organization.  After a time other initially civil workers learn to also be arseholes to get along.  Over time those that have a choice will leave the organization, often depleting the organization of its best talent.  Eventually, a death spiral can take place.

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