Firing a Medical Practice Employee


Here are 9 tips to make the process easier

Firing an employee is hard, and requires skill to do it right. Physicians and office managers can be too talkative, belligerent, or even apologetic when telling an employee that he is being "let go." Others "cave" if the employee becomes too emotional, and give her another chance.

"The way I look at it," one physician told me, "firing a staff member, particularly from a job she's held for any length of time, is the most traumatic thing next to divorce. She's going to be understandably upset, perhaps bitter, and ready to put the blame on someone else. If the doctor isn't careful, his or her reputation and practice may be the target of a very disgruntled and resentful employee - possibly a lawsuit."

While there is no way to make a dismissal pleasant, you can minimize the pain and hostility. Here are 9 tips to make the process a little bit easier:

1. An employee should never be surprised at being fired. If a person's job performance is not satisfactory, advise him or her of the problem, how it can be fixed, and set a reasonable date by which you expect an improvement. If no improvement is seen, a second interview should again address the issue and make clear the consequences of inaction. In each case, document everything in the employee's personnel file, recording the date of the meeting and the substance of your comments. If the desired improvement does not occur after this second discussion, the consensus of physicians and office managers with whom I've spoken is to terminate at that point without further notice -again documenting the reason for the termination.

2. Don't delay. "Once you make the decision to let the person go, get 'em out quick." That's the overwhelming recommendation of those I've asked about the timing of an employee's dismissal. Two weeks notice? No. Most agree it's a mistake to have a "lame duck" employee in the office. A depressed or disgruntled employee is bad for everyone's morale - patients included. Better to give the employee one or two week's additional pay in lieu of notice and ask the person to leave immediately.

3. Prepare in advance. When the day of dismissal arrives, have well thought-out notes about what you want to say to the employee. Avoid a discussion of the employee's "attitude." It's subjective and open to debate. Limit yourself to behaviors and actions that can be observed and documented.

4. Don't go into too much detail. If you specify all the ways your employee has failed, you defeat your purpose. What do you accomplish except to inflict pain? Avoid at all costs, spur-of-the-moment criticisms you may later regret.

5. Have a witness. Lawyers recommend having someone else in the room, because their presence can eliminate the risk of the employee later claiming you said things you didn't actually say.

6. Keep it short. Get to the point as gently as possible and keep it short - seven to 10 minutes. Simply indicate that things have not improved since the last conference and that you have no alternative but to terminate employment. Acknowledge the person's capabilities and strong points and let it go at that. Refuse to be sidetracked into reconsidering.

7. Timing. Letting someone go early in the week is preferable to Fridays; early in the day is preferable to the end of the day. In this way the person can immediately begin looking for another job rather than agonize about it overnight or worse, over the long weekend.

8. Inform staff. Tell other employees of your decision and ask for their support until a replacement is found. Staff members may well be aware of the discharged employee's shortcomings and actually applaud your decision.

9. Reality check. The number of wrongful dismissal cases brought by disgruntled employees has dramatically increased in recent years - many with outcomes that have been extremely costly for employers. To be on the safe side, check with a lawyer in your state to learn the precautions you should take.

Bob Levoy is the author of seven books and hundreds of articles on human resource and practice management topics. His newest book is “222 Secrets of Hiring, Managing and Retaining Great Employees in Healthcare Practices” published by Jones & Bartlett. He can be reached at

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