The Elephant In The Room: 10 Recommendations Properly Letting Go of a Medical Practice Employee


Firing any employee can be a difficult undertaking for many employers, and requires skill to do it right. Physicians and office managers are often too talkative, belligerent, or even apologetic when telling an employee that he or she is being “let go.” Other times they simply “cave in” if the employee becomes too emotional or threatening, and decide to capitulate under the guise of “giving the employee 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 generally no way to make a dismissal a pleasant experience, an employer can minimize the pain and hostility. Here are 10 tips to make the process a little bit easier:

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, the substance of your comments as well as the employee’s comments. If the desired improvement does not occur after this second discussion, the employee should be terminated without further notice but again documenting the reason for the termination. In addition, do not “candy coat” annual performance reviews. These are often perfect occasions on which to address a problem or a trend before it escalates to a level that requires a specific meeting to address the issue. Again, be certain to document these comments in the employees personnel file.

Don’t delay. Once you make the decision to let the person go, get the termination process completed and the employee out quick. Two weeks notice? No. It is more times than not 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.

Prepare in advance. When the day of dismissal arrives, have well thought-out plan about what you want to say to the employee. Avoid any discussion of the employee’s “attitude.” It’s subjective and open to debate and almost always assures an argument from the employee. Rather, focus your comments upon behaviors and actions that were observed and documented.

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. Stay calm and speak directly on the general actions that the employee failed to rectify or the policies/procedures that were not complied with following the previous meeting(s).

Have a witness. It is strongly recommended that you have someone else in the room for the termination meeting. Often the presence of another can eliminate the risk of the employee later claiming you said things you didn’t actually say. It also frequently has the effect of keeping the meeting from becoming hostile or aggressive. The witness should sign the summary statement of the meeting to confirm the report of what was said by all persons in attendance at the meeting.

Keep it short. The employee will generally have a sense as to the reason for the meeting. Therefore, get to the point as gently as possible and keep it short, generally not more than 7 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 or providing a second chance.

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.

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. Do, however, be aware of the personnel relationships that are often formed between employees and if necessary, address the former employees colleagues in private. Such meetings should remain very brief, direct and without disclosing the specific reasons for the termination.
Reality check. The number of wrongful dismissal cases brought by disgruntled employees has dramatically increased in recent years and many with outcomes that have been extremely costly for employers. When in doubt, consult with your corporate counsel or an employment lawyer in your state to learn the precautions you should take.

Possible reporting requirements. If the reason for the termination of the employee involves violations of federal or state medical regulations, or constitutes a possible crime, you should consult with your corporate counsel or employment lawyer immediately and seek their legal advice of complying with any mandatory reporting requirements.

Inevitably, an employer will need to terminate an employee. By following these 10 steps you can frequently address these unpleasant situations in a more effective manner, thus avoiding employment disputes or lawsuits. Remember, whenever in doubt, consult your corporate counsel or an employment lawyer. An once of prevention is always worth a pound of cure.

Mr. Thomson was born in Madison, Wisconsin. He received a B.S. in Political Science from The Ohio State University in 1979, and his Juris Doctorate from the Capital University in 1985. While pursuing has law degree, Mr. Thomson was the Notes Editor of Law Review and a member of the National Moot Court team.

Mr. Thomson is a member of the Arizona and American Bar Associations, and is a member of the Business, and Litigation Sections of the ABA. Mr. Thomson has been recognized as one of the Best Lawyers in America for business and commercial attorneys from 2001 though 2011 and has long held the prestigious AV® Preeminent™ Peer Review RatingSM from Martindale-Hubbell®..