I don't know. Is it that obvious or simple?
I have trouble imagining that all the people around them are so easily conned and/or willing to support this type of behaviour.
I suppose I shouldn't be surprised or baffled by this but I am.
It's just my opinion. I'm not implying it is simple - far from it - but I do think that this probably underpins it with the controlling individual. I'm sure there are other factors in addition to this.
Think about a doctors who has serial killed - time and time again like Dr Shipman, or publically adored figures like Jimmy Saville who were able to abuse 100s of people.... People even assisted him in perpetrating the abuse and/or turned a blind eye, yet because of his overall charismatic and beloved public persona no one believed it when victims or others tried to raise potential red flags.
How do dictators and leaders get their underlings to perform atrocious acts? Or to 'knuckle under' and just accept the status quo. How are entire nations such as Russia or North Korea controlled by one person (and their underlings)? Or cults exist with one leader...
There seems to be brainwashing, manipulation, implied threat (of harm to person, family or career etc - keeps everyone in check), charisma, skilled lying, myth creation ('the great leader' of a nation) etc ...
I can imagine in medicine those under the person's spell probably have an ingrained respect for hierarchy.
Example, if person A worked under Dr Evil, and saw him for who he really was, yet everyone else was drinking the 'he is the almighty all knowing Dr E' coolaid, would Person A blow the whistle and risk their career/being blacklisted for potentially no gain... Even if they did, would they be believed?
I know of numerous patient/doctor situations where the patient doesn't risk complaining because there is the implied threat that if they do, they will be blacklisted and no other doctors will touch them. This happened to a friend of mine in Ireland with complex medical problems, and another friend in the US who has botched surgery that has damaged her for life. They filed complaints and both became unable to get help from other doctors/surgeons - they closed ranks with their colleagues. In fact my friend in Ireland warned me not to complain in case t happened to me.