From managerialism to toxic leadership: The moderating effect of ethical climate in the healthcare sector

Abstract A hegemonic neoliberal ideology dominates all areas of work in Turkey, including healthcare. Though neoliberalism has been studied extensively from the perspective of meaning, values, and processes, managerial and leadership behavior dynamics require further research. This study analyzes the relationship between managerialism, toxic leadership, and ethical climate in an industry swept up by untamed neoliberalism, particularly in a nation where employment and human rights are ceremoniously protected. Through an analysis of medical doctors working in 207 public and private university hospitals in Turkey, we explored the role of managerialism and four distinct ethical climate types, resulting in the emergence of toxic leadership behaviors during the global pandemic. We theorize the extent to which toxic leaders emerge from managerialism. We further explain why the hegemonic Turkish leadership culture thrives in toxic behaviors such as paternalism, fealty, ingratiation, nepotism, and cronyism in the context of neoliberal expansion.