How to Fire Staff in a Medical Practice

Terminating an employee is one of the most challenging aspects of running a medical practice. Over my 15 years as a clinic owner, I’ve had to let several staff members go. It never gets easier, but I’ve learned ways to handle it professionally and compassionately. Here are my top tips for firing someone smoothly.

The Lead Up: Setting the Stage

Before letting someone go, you need to create a paper trail and give them opportunities to improve.

• Document issues – Keep detailed records of tardiness, errors, disputes, etc. This provides evidence if legally challenged.
• Communication – Have direct talks explaining problems and expectations. Outline specific steps for improvement.
• Performance evaluations – Use formal reviews to address deficiencies in writing. Signs off by employee shows acknowledgement.
• Final warning – If problems persist after chances to correct, give a final written warning that they’ll be terminated if issues continue.

Planning the Termination Discussion

Once you’ve decided letting them go is the necessary call, plan the conversation carefully:

• Timing – Avoid busy clinic times and ensure you have adequate time for a thorough discussion. Don’t rush it.
• Location – Use a neutral private room away from staff. This allows discretion.
• Witness – Consider having another manager present to corroborate if legally needed later.
• Box for belongings – Provide a box for them to pack personal items later to avoid uncomfortable scenes.
• Script – Write talking points highlighting positives about their tenure before explaining reason for termination. Stick to facts.

During the Firing Meeting

Your goal is to have an earnest yet rational conversation:

• Stay calm – This is a business decision for the good of your patients and practice. Don’t get emotional.
• Listen – After sharing your perspective, let them share their side. You may hear new information.
• Answer questions – Be prepared to address severance terms, insurance, job search resources, etc.
• No arguing – If they become angry or defensive, reiterate this is not open for debate. Stay professional.
• Express well wishes – End by sincerely wishing them the best in future endeavors. This maintains humanity.

Aftermath: Ensuring a Smooth Transition

Your priority is now preserving clinic morale and minimizing patient impact:

Pros of Thoughtful Transition

• Retains team loyalty and optimism
• Avoids logistical headaches with staffing gaps
• Upholds practice reputation

Cons of Botched Transition

• Plummets staff morale due to resentment or skepticism
• Scheduling confusion leads to cancellations or delays
• Patients lose confidence in practice’s stability

Learning for the Future

Every termination, while difficult, provides lessons for improvement:

Parting ways with a staff member is a last resort. But occasionally vital for upholding standards of care. By approaching it professionally, you can often turn it into a growth experience. While letting someone go is hard, it reminds us of our greater duty to do right by our patients and practice.