Micromanagement in Healthcare: A Narrative Review of Antecedents, Consequences, and Mitigation Strategies

Background: Micromanagement is an extensively prevalent yet relatively under-theorized management process in healthcare organizations. This narrative review synthesizes the literature on micromanagement and related leadership practices in healthcare, focusing on its antecedents, manifestations, consequences, and mitigation strategies. Methods: A structured literature search was conducted on 10 May 2024 across eight electronic databases. Eligible studies included qualitative, quantitative, mixed-methods, and applied studies published between 2003 and 2024. The main outcomes were the underlying causes and behavioral measures of micromanagement, examined directly, or closely related constructs such as excessive supervision, reduced autonomy, authoritarian leadership, toxic leadership, and controlling managerial behavior. The secondary outcomes involved organizational and patient-related effects and their respective interventions. Results: A total of twelve studies were selected. The identified antecedents of micromanagement were authoritarian leadership styles, autocratic and toxic leadership personality traits, overly intrusive supervisory practices, poor employee empowerment, complicated regulation, unclear definition of professional roles, and inherent structural challenges. Micromanagement behavior was seen in authoritative decision-making, transactional supervision, systematic reduction in employee autonomy, and institutionalized distrust. The consequences recorded include high levels of occupational stress, poor organizational productivity, poor quality of healthcare services, high employee turnover rates, and psychological problems. Conclusions: This review represents a preliminary conceptual synthesis of the literature that addresses micromanagement in healthcare. The evidence base is inconsistent, with many studies focusing on constructs that relate to micromanagement while not studying it directly. In future research, validated tools to assess micromanagement should be designed, as well as leadership interventions that benefit both workplace and patient outcomes.