The characters of fictional Dunder Mifflin in The Office have to work under Steve Carell’s socially-inept Michael Scott. (Or they did for the first few seasons.) Dilbert has an obtuse, pointed-haired drone of a boss. But what’s funny on TV or in comic strips can be miserable if you’re actually living it.According to career site Glassdoor.com, one in five employees have had their careers hurt by a boss. Often, this is because bad bosses lead to bad performance, experts say, and the effect can linger for years. “An employee with a bad manager compared to an employee with a good [manager] performs at a level that is 20% lower,” says Brian Kropp, managing director at CEB. “The impact from having a bad manager can actually drive down employee performance for up to five years.”So, which bosses are the worst? HR pros and academics who study workforce management say there are a few that stand out.The “crooked politician:” “Politically skilled leaders are perceived to be more ethical than politically unskilled leaders,” writes Paul Harvey, a management professor at the University of New Hampshire, in a research paper published in this month’s issue of the Journal of Leadership & Organizational Studies. This is true even when a glad-handing master of small talk is less ethical than a boss who lacks in that kind of social finesse, because the people who work for them are fooled by their charisma into thinking that they must be good people“The boss often sets the tone for what is considered acceptable but employees aren’t always as skilled in pulling off deviant behaviors so sometimes they’re the ones who get caught and face the penalties,” Harvey says. Even if your own ethics don’t lapse, your motivation probably will, he adds. “Less severe examples are employees becoming disillusioned and losing their passion for their work when they draw the conclusion that their bosses cheated their way to their positions.”The bully: The only thing worse than another kid stealing your lunch money is working for one of those bullies — they might have grown up, but in the adult environment of the workplace, bullies can be even worse because they’ve refined their techniques over the years.Unlike the stereotype of a bully as a ham-fisted thug, bully bosses have sufficient social skills to figure out who and how they need to coerce to get ahead on the job — which many do, writes Darren Treadway, an associate professor in the school of management at the University at Buffalo , State University of New York. Bullies crave power, Treadway says, and they have no compunctions about behaving aggressively to get it. In their drive to the top, they don’t care who they run over.Even if you’re not the bully’s target, your work is likely to suffer, Harvey wrote in another research paper, this one published last year in the Journal of Social Psychology. “Although the effects of abusive supervision may not be as physically harmful as other types of dysfunctional behavior, such as workplace violence or aggression, the actions are likely to leave longer-lasting wounds, in part, because abusive supervision can continue for a long time,” he writes.The micromanager: What drives many micromanaging bosses is a desire for control, so much so that they may insist on being cc’d on your email correspondence or make you wait while they put their own touches on your latest client proposal. “You really do want to be in control of everything and you want everything to be perfect,” says Seth Spain, assistant professor of management at University at Binghamton, State University of New York. “Making yourself the bottleneck that work goes through is a way of maintaining that sort of control.”Unlike the unethical schemer or the bully, this kind of bad boss isn’t necessarily trying to ruin your life, he says. Ironically, good workers can turn into micromanaging bosses when they rise through the ranks. Once in a management role, they’re no longer doing the job they were good at, but they think they still know best — sometimes even as their own technical skills slip away. “Maybe they have anxieties or insecurities about their own position, or maybe they just miss the job itself,” Spain says, so they cope is by getting way too involved in your day-to-day work.The workaholic: With recent headlines of bank interns dropping dead after working long hours or napping on the toilet, it shouldn’t surprise anyone that working under a supervisor who’s never heard of the term “work-life balance” is bad for you. HR software company BambooHR says 39% of employees work more than 40 hours a week, and that we’re working an average of 11 hours a week more than we did back in the 1970s.A close cousin of the workaholic boss is the technophile, the one who emails you at 10 pm. on a Sunday night and expects an answer back immediately — or who will email, then follow up almost immediately with an instant message to see if you’ve checked your email yet.“Employees who are expected to give and give to their jobs, during all hours of the day and night, will burn out quickly,” says Ben Peterson, co-founder and CEO of BambooHR. A study in the Journal of Occupational and Environmental Medicine last summer found that people who work demanding jobs with 60-plus hour workweeks are a whopping 15 times more likely to show signs of depression up to three years later.The BFF: This kind of toxic boss can be tough to recognize at first, but once you’re sucked into their orbit, that seemingly friendly relationship can turn into a downward spiral. The BFF boss has no concept of boundaries, Spain says, which means their bad day can become your bad day, or their flagging career can suddenly become your problem.Spain says this behavior hints at neurotic and histrionic — aka “diva-like” — tendencies, both of which studies show contribute to job-related meltdowns. “They would certainly be unburdening themselves to you in inappropriate ways, and in a way that would make it difficult for you to manage their own career as theirs is crumbling,” he says. Instead of learning from them, you become their sounding-board-slash-therapist, and just the emotional energy of dealing with their drama can distract you from your work, he says. “From the subordinate’s perspective, it takes a lot of resources from you to manage their emotions.”Which kind do you have?
Though current cervical cancer screening guidelines generally recommend that women ages 30 and older get screened — either using a traditional pap smear or a complement of a pap smear and human papillomavirus testing — every 2 to 3 years instead of annually, a new survey published this week in the Archives of Internal Medicine finds that most physicians recommend screening far more frequently.
Cancer groups agree that high-risk women — such as those with a weakened immune system due to HIV or another condition, or who have had previous cervical abnormalities— should be screened more frequently, and for the most part there is consensus that women be screened less often after age 30. The American Cancer Society (ACS) recommends that women be screened annually throughout their 20s and should first be screened no later than age 21, but ideally within 3 years of first vaginal intercourse. At age 30, they suggest physicians incorporate both Pap smears and HPV testing for screening, and that women who have had 3 normal Pap results in a row delay screenings to once every 2 to 3 years. The American College of Obstetricians and Gynecologists (ACOG) recently changed its recommendations to suggest that young women begin cervical cancer screening at age 21, regardless of their age at first vaginal intercourse. ACOG also recommends that women ages 30 and older who have had 3 years of consecutive negative cervical cancer results delay screening to once every 3 years. Additionally, both ACS and ACOG have said that the addition of HPV co-testing strengthens the argument for less frequent screening. The U.S. Preventive Services Task Force has recommended screening once every three years for women ages 30 and older, and has not yet issued guidelines regarding the incorporation of HPV testing into cervical cancer screening protocol.
For the survey researchers from the Centers for Disease Control (CDC) and the National Cancer Institute asked more than 1,200 primary care physicians — including general practitioners, family medicine specialists, internists and obstetricians-gynecologists — what screening protocol they would recommend for 35-year-old patients with three different medical histories: a woman had had no new sex partners in the previous 5 years and had 3 normal Pap results in a row; a woman with no new sexual partners in the past 5 years and 1 normal Pap result; and a woman who’d had a negative HPV test and a normal Pap test result previously that year.
Despite current guidelines, however, researchers found that fewer than one third (31.8%) of physicians surveyed would delay screening to once every three years for a patient with no new sexual partners in the previous 5 years and 3 consecutive Pap results. For the scenario in which the patient had a similar sexual history but only 1 negative Pap result, the vast majority of physicians (81%) said they would recommend screening within a year of the last test. Additionally, researchers found that the tendency to recommend sooner screenings was most pronounced among obstetricians and gynecologists. In the scenario with 3 negative Pap tests in a row, 46.1% of Ob-Gyn doctors said they would recommend annual screening, compared to 30.7% of family physicians and 22.4% of internists. When the hypothetical patient history indicated just one negative Pap result, 89.1% of Ob-Gyn, 82.2% of family physicians and 72.% of internists said they would recommend screening no sooner than 3 years.
Incorporating HPV testing — which studies have suggested may be a more precise indicator of cervical cancer risk — into cervical cancer screening — didn’t dissuade doctors from recommending frequent screenings, the researchers found. For the scenario of a 35-year-old woman with a current normal Pap result and negative HPV test, fewer than 1 in 5 physicians (19%) surveyed said they conduct the next screening after at least 3 years. The majority of doctors surveyed (78%), said they would recommend another Pap again sooner.
The findings, the authors say, suggest that revised guidelines haven’t convinced physicians to spread out cervical cancer screenings when incorporating HPV tests or for patients with consistently negative Pap smears. Too often, they say, women are being screened too often — which can lead to more tests, unnecessary worry, and increased health care costs. They conclude that, extrapolating from the survey results:
“… the practice patterns we found in our study are likely to increase costs with little improvement in reducing cervical cancer incidence and increasing survival. Overuse of screening is expensive for the health care system and may result in unnecessary follow-up testing, increased risk of colposcopy-associated morbidities and adverse birth outcomes, and distress for patients. Evaluation of the cost-effectiveness of Pap and HPV cotesting strategies as implemented, along with other considerations, may be useful before resource-limited institutions choose one strategy over the other.”
In an accompanying editorial, Dr. George Sawaya, an associate professor of obstetrics, gynecology and reproductive sciences at the University of California, San Francisco, says that future study is needed to gain a more accurate picture of physicians’ adherence to screening guidelines, and that, ultimately, physicians need to be careful to find the right balance when it comes to fulfilling the oath to do no harm. To that end, he says longer intervals between screenings for low-risk women is a good place to start, and that this latest study should add to ongoing efforts to develop “rational approaches to screening.”