Power dynamics or a race to the bottom? Bullying, harassment and tall poppy syndrome in radiology

Negative workplace behaviour (NWB) - including bullying, harassment, mobbing, and tall poppy syndrome-remains a significant, under-addressed threat to healthcare professionals. This commentary explores NWB drivers, consequences and mitigation techniques in medicine, with a particular focus on radiology, using an evidence-based approach. The drivers of NWB are multifaceted, encompassing power imbalances, leadership failures, implicit bias, and institutional culture. Evidence highlights the disproportionate impact on women, who are more frequently targeted and more susceptible to burnout and severe mental health outcomes. Beyond individual harm, NWB degrades team performance, increases turnover, impairs patient safety, and erodes institutional integrity. Mitigation requires a commitment: fostering ethical, inclusive leadership; instituting zero-tolerance policies; supporting effective bystander intervention; and ensuring safe, transparent reporting mechanisms. Authentic leadership, diversity initiatives, and well-being support programs play critical roles in prevention. This paper highlights collective accountability to create psychologically safe workplaces in healthcare-where professionals can speak up without fear and are protected, respected, and empowered to thrive.