Is your office manager a tyrant?

Jenny, you did it again! Get in here!"

The manager of a Midwest group used to yell like that from her office to summon a subordinate for yet another tongue-lashing. Everybody could hear it, even patients in the waiting room-everybody, it seemed, except the doctors.

Abusive bosses are especially prevalent in hospitals and doctors' offices, says Gary Namie, a social psychologist and president of The Workplace Bullying and Trauma Institute in Bellingham, WA. "Healthcare has a built-in reverence for status, with doctors enjoying the most," says Namie. "Anybody who's viewed as closely aligned with the doctor has the second-highest status."

In this pecking order, many rank-and-file workers make ideal targets for sharp beaks, says Namie. "They tend to be more empathic, more sensitive. And they usually don't challenge the status quo." Instead, they might react by limiting their encounters with the manager-coming in late and leaving early, using all of their sick days, or skipping office social functions-none of which is good for morale, or your bottom line.

Clearly, it behooves physicians to understand what conditions breed tyrannical managers, and how to cultivate civil, yet effective ones instead. We interviewed experts like Rentze and Namie to help you take the bully by the horns.

Signs of a problem: be willing to see them

High turnover isn't the only tip-off that a tyrant's on the loose. Dead silence and frowns also may point to trouble at the top. "I visited one office where nobody was smiling," says Sharon Rentze. "At first I thought it was a bad staff. Then I realized it was a depressed staff."

Remember the manager who roared from her office? Public reprimands of employees also signal despotism, says Diane Cate, a practice management consultant in Santa Rosa, CA. "You need to do that behind closed doors. Otherwise, it's humiliating." You should also pay attention whenever you hear the manager use insulting words like "stupid," "dumb," or "idiotic" in conversations with subordinates.

It would be unfair to chalk up all heavy-handed management to a mean streak, however. Experts say that most managers given to authoritarianism are well-meaning, but unprepared for the job by dint of disposition and training. Frequently they're longtime billing personnel, good with numbers, and especially good with money, and therefore prized by physicians, says management consultant Judy Bee in La Jolla, CA. However, they're often not as good at people skills-listening to others, resolving conflicts, promoting teamwork, doling out praise, tactfully delivering criticism. "Promoting from the front desk creates the opposite problem-weak financial skills, strong people skills," says Bee.