Ep. 76: Employees: What to Do When It Isn’t Working Out
This isn’t the most fun topic we’ve covered, but it’s something that almost every business owner encounters needs to deal with at some point. So in this episode, Jeff provides a checklist to cover all your bases when letting an employee go and discusses how to handle these situations professionally while minimizing stress for both the employee and the rest of the team.
Topics:
:23 – When is the right time to let an employee go?
12:48 – Checklist for letting an employee go.
Links:
Checklist for Staff Leaving the Practice - https://mgeonline.com/checklist-for-staff-leaving/
Learn more about MGE - https://www.mgeonline.com
Sample Employee Checklists - https://www.mgeonline.com/sample-employee-checklists/
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Questions From This Episode
If you've decided a problem employee has to go, why not wait until you've found a replacement first?
A genuinely destructive or underperforming employee is often worse than having nobody in the role at all, similar to a tug of war teammate who's pushing instead of pulling. Practices frequently see their statistics improve immediately after letting go of someone who was quietly holding the position down, so waiting for a replacement before removing them usually just prolongs the damage.
How should a two week notice actually be handled, accept it or not?
It depends on why the person is leaving. A long tenured employee moving for a spouse's job or a family situation beyond their control is worth keeping through the notice period, since their head is still in the game. Someone leaving purely because they found a position they'd rather have has already mentally checked out, and Jeff's own practice is to move that person out within 24 hours rather than keep them around for two more weeks.
Why does the doctor need to personally hold administrative access to every piece of software the practice uses?
If an employee is the only one with login credentials to something like a Facebook page or QuickBooks account, losing that employee can mean losing real, sometimes damaging, access to practice assets. In one case a doctor lost control of the practice's Facebook page, in another an employee with sole QuickBooks access was actively embezzling and the doctor couldn't get in to fix it for days.
Why is it important to have a witness present when actually letting someone go?
Without a second person in the room, a termination can turn into a pure he-said, she-said dispute later. Jeff describes a real case where a terminated employee turned out to be pregnant, unrelated to why they were let go, and later claimed the termination was pregnancy related, having a witness present would have given the practice something concrete to point to in response.
What should the team actually be told once someone has left, and what should be avoided?
Keep it simple: the person is no longer with the practice, and here's who is now handling their responsibilities. Avoid trashing the departing employee to the rest of the team, even if the split was a bad one, since it serves no purpose, can alienate coworkers who were close to that person, and can actually provoke exactly the kind of public retaliation, negative reviews, comments to remaining staff, that staying professional was meant to avoid.
Episode Transcript
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We've done a lot of episodes regarding employees, and most of them have normally been directed toward how you find and hire employees, how you get them onboarded quickly, and how you get them trained. For this week's episode, we're taking a bit of a different direction, specifically what you do when things just aren't working out, or your employee has given notice. In other words, we want to talk about the firing process a little bit, because while it's obviously extremely important to fill a position and hire somebody when needed, not letting somebody go, or messing that process up somehow, can have just as severe an impact on the practice as messing up the hiring process. When someone's going to leave, you also don't want to mess up that process either, because that can be extremely damaging to the practice too. And that includes not just how you've let them go or how they leave, but how long they stick around after they've decided to leave, or how long you let them stick around if they've turned out to be an actual problem.
So that's what I want to talk about in this week's episode, what to do when it isn't working out. My name is Jeff Blumberg, and I'm your host. I'm going to start this episode off with a disclaimer. I am not an employment attorney, and this podcast, or any of the information in it, does not constitute legal advice. I'd recommend having an employment attorney you can rely on, because employment law, while not quite as wildly complex as you might think, does vary significantly depending on where you practice. I know this much: employment law in California, where we have an office, versus here in Florida, where we also have an office, is widely divergent. So you want to at least be aware of these differences, or have someone you can call to talk through them.
What I'm going to cover in this week's episode is what happens once someone's given their notice, or you're letting them go. I also have a checklist you can download that walks through some of these ideas. You can take pieces of this and bring them to your own employment attorney to make sure it's properly customized to fit your specific practice.
So, with the disclaimer out of the way, let's get into it. Generally speaking, when you're having trouble with something in an office, it's usually due to a lack of procedure. Look at the things that go smoothly in your office. If I call in as a patient of record to get a crown you already diagnosed for me, there's not a lot of confusion about how that's going to go, I get on the schedule, the tray gets set up the way you want it, you've already picked the lab, the assistant knows exactly what to do, and the lab case gets tracked. When these things do go wrong, it's usually a big deal precisely because you already have a procedure and something deviated from it. The same logic applies to case acceptance, hiring, management meetings, anything. When there's no procedure, things get confusing. So I want to go over a few ideas specifically on this concept of what to actually do if someone's not working out, or they've given notice.
Let's start with an employee who just isn't working out. Say they're your scheduler, and you've got huge, persistent openings in the schedule. Your previous scheduler had no problem filling those same openings, but this new one just isn't cutting it. How long you spend trying to correct this person is really up to you, and depends on how problematic it is for the office, but let's say you've already done the correcting, I've covered ideas for that in other episodes, you've practiced with them, tried different approaches, and it's simply not improving. So you've decided it's time to part ways. Or maybe it isn't a long track record of mistakes at all, maybe they've done something genuinely egregious, called a patient something horrible, and you know immediately this person has to go.
So you've made the decision, they have to go. Now what? Do you wait until you've found a replacement receptionist first? I'd say no, and here's why. Picture your team like a tug of war team. Say it's you and five staff, six people on your side of the rope against six on the other side. Everyone's pulling to whatever degree they're capable of, some people are naturally stronger or more skilled than others, but you'd at least expect everyone to be exerting real effort in your direction so the team can win.
Now imagine someone on your team who, instead of pulling toward victory, is either not pulling at all, or actually pushing the other way, actively working against you. There's a whole explanation behind why this happens that we get into in the MGE program, but I won't dig into that here. The practical reality is, I've seen this constantly throughout my career, if that person were simply gone, there would genuinely be less to deal with than having them there at all. Take an extreme example: a receptionist who accidentally hangs up on every third caller because they never fully learned the phone system. If you simply removed them and put nobody in that seat, even someone doing something else entirely part-time, it would be less destructive to the practice than paying that person to be there hanging up on a third of your calls. It's literally addition by subtraction. I've seen this play out repeatedly, where letting someone go, or having them leave, is followed almost immediately by the practice's statistics going up, because that person had actually been holding the position down.
So if you've decided this isn't working and the person has to go, our policy here at MGE is that when someone needs to go, they're gone immediately. There are exceptions worth considering depending on where you're listening from, we have listeners across the US, the EU, the UK, Australia, and parts of Asia, so employment laws vary considerably. You might have a contracted employee, an associate for example, where specific contractual obligations have to be met before they can actually leave. Most employees, though, are under an at-will arrangement, especially here in Florida where I'm based, meaning there's no contract governing the separation.
So if I've decided someone needs to go, in an at-will situation, they're going to be gone, because it's simply no longer worthwhile keeping them in the business, and they've proven to be at least somewhat destructive. In those cases, I'm genuinely better off with nobody there at all. Here's the thing about having someone in a role, even doing a poor job, it creates the impression that something is being handled. But if you're already seeing things they're messing up, I can nearly guarantee there's a lot more happening that you're not seeing. So what you think is getting done often isn't actually getting done. You're better off with the position empty until you can properly fill it. I would not wait until I'd hired somebody else, especially if the person is genuinely destructive, keeping them around any longer is asking for trouble, and it sends a bad message to the rest of the team too.
But what if someone comes to you and gives two, three, or four weeks notice? This is worth talking through, because in a lot of at-will states, and again, I'm not an employment attorney, two weeks notice is really more of a courtesy than an obligation. You don't have to accept it. In certain cases I will, in many I won't, so let me walk through the differentiating factors.
Say I've had an employee for five or six years who's done a genuinely good job, and their spouse is relocating out of state, so they're moving too, and they give two weeks notice. Or they've got a family situation, needing to care for a parent, requiring a move. Would I accept that notice? Most likely yes, every situation is different, but I'd generally keep them on for those two weeks, because they're not leaving because they had a problem here or decided to go do something else, they're leaving due to circumstances essentially beyond their control. That person hasn't necessarily checked out mentally.
But say instead I had a dental assistant who saw a competing practice across town advertising, thought it looked like a cooler opportunity, accepted the position, and gave me two weeks notice. Would I accept that notice? No. If someone tells me they're leaving to go work for a competing practice simply because they wanted to, what they've essentially told me is that's where their head is now, they're mentally already building something else. So I'd rather move them out of my practice as quickly as possible, ideally within 24 hours if I could manage it.
I know that might sound like a controversial approach, and you may land differently on it, but this is genuinely how I've handled it. If someone gives notice purely because they don't want to work here anymore and have decided to go do something else, why would I keep them around for two more weeks? They've already checked out. I don't run people with threats, that's simply not my style, but there has to be some understanding that boundaries exist. Beyond loving your job and taking professional pride in it, part of why someone follows the rules or shows up on time is that there's a real consequence to not doing so, eventually you're let go. But if someone's already decided to leave, what consequence is actually left to motivate them for those final two weeks? They're already checked out, their head is out of the game. Why would I want someone like that around? It's not personal, I'm not upset with them, I don't feel any ill will, they're just no longer a fit for the organization. Why would I want them sticking around telling the rest of the team about this exciting new place they're headed to? It's a strange dynamic. If someone isn't leaving because they have to move or because of a genuine life circumstance, but simply because they don't want to be here anymore, they should just go. Wanting to actually be there should be one of the basic requirements of the job in the first place.
So in those cases, I'd move them out within 24 hours. Do I have a replacement ready? No, but I'll figure out coverage. If it's a dental assistant, bring in a temp. If it's the receptionist, the rest of the front desk pitches in until someone new is hired. Most of the time the team rallies and makes it work, and I've seen plenty of cases where things actually improve, because that person had already checked out and wasn't fully engaged anyway. That's simply my own view on it, and how we practice it here at MGE, again, this may vary depending on where you practice, and it's worth a conversation with your employment attorney. If the person is longer tenured and leaving for a reason they didn't necessarily choose, I'll likely keep them around. If the person wanted to leave, I get them out, there's no real reason to keep them any longer.
One other point worth raising as we get into the actual process of someone leaving, and again, this is something to run by your own employment attorney: always make sure you have a witness present. If the office manager is letting the receptionist go, it's worth having a doctor or another senior staff member there too. Here's why: if you let someone go with no one else present, it can become a pure he-said, she-said situation later. I actually saw this happen once, someone was let go, and it turned out the person was pregnant, something the person letting them go genuinely didn't know, and it had nothing to do with the actual reason for the termination, there were other pregnant employees who stayed on, had their babies, and returned to work without issue. But the terminated employee later claimed the real reason was the pregnancy. Had there been a witness in the room, there would have at least been someone able to speak to what actually happened.
This brings us to the actual process once someone's leaving, whether they've given notice you've accepted, given notice you haven't accepted and are moving them out, or you've simply decided it's not working out. This is exactly the part of the process that tends to get messed up, things get forgotten or mishandled in ways that create real backlash later. It can be as serious as an employee holding your social media passwords that you never had. I actually saw this happen with a new client, an employee they let go had every social media password, and the doctor had none of them. I'd never recommend that setup, no matter who's actually managing your accounts day to day, the doctor needs administrative access to everything the practice signs up for. I know that can be logistically annoying, since the office manager or a PR person might be the one actually creating these accounts, but the doctor still needs administrative privileges regardless. I've seen a doctor lose control of the practice Facebook page entirely and it took ages to recover. I've seen it worse with QuickBooks, where an employee with sole access was actively embezzling, and the doctor couldn't get into the account for days to even address it.
So you want to make sure you're covered on this well before any of it becomes urgent. It can also just be a mild annoyance rather than a genuine crisis, a lead assistant leaves and there's no checklist capturing all the steps that should happen, so nobody can find anything for weeks because no one knows where things go. This is exactly why, when something isn't figured out or there's no clear procedure, it becomes difficult. A checklist genuinely helps here.
I have a sample for you, set up so you can customize it, we call it a leaving staff checklist. It includes the relevant disclaimer language at the top, and you'd pull it out once you've had the actual conversation, whether it's a termination or a resignation, and run through every step, adding anything specific to your own office along the way. You should have a similar checklist for onboarding too, we've covered positional onboarding checklists in past episodes and I'll likely put together a dedicated one in the future. Checklists matter because there are a lot of small steps involved in this process, and it's easy to forget some of them. Pilots use a checklist before takeoff for exactly this reason, forgetting something can get genuinely dangerous. I'd strongly recommend having something similar for your own office, customized to fit, and reviewed by your employment attorney.
Let me walk through a few of the key points on it, roughly sixteen steps total that walk you through the whole process once someone's leaving. First, you'd indicate whether the person quit or is being let go. This matters in certain regards related to unemployment, again, not legal advice, but generally if someone quits, you don't pay unemployment, versus if you let them go, you typically do.
Next, if they're voluntarily leaving, you'd ask them to put their resignation in writing. Say they've told you they're leaving to work at a competing practice, you'd simply ask them to put something in writing confirming that. If they later file an unemployment claim, that documentation showing they resigned, rather than were terminated, matters.
The next step covers their final paycheck, whether it's direct deposit or a physical check, and when they'll actually receive it. In certain states, if you let someone go or they quit, you're required to hand them their final check before they walk out the door, that's worth confirming applies correctly to your own state. This should all be spelled out clearly so the employee understands exactly what's happening, including anything you've worked out separately, some employers provide a week or two of additional pay depending on the circumstances, but that should be settled and communicated before they leave.
Next, you'd have the person do a turnover, and how that actually looks depends heavily on who this person is and why they're leaving. If it's someone I've accepted two weeks notice from because they're relocating out of state, that turnover might include a real writeup, updating the office manual, and helping train the person taking over their responsibilities, so I lose as little institutional knowledge as possible. If instead it's someone I'm moving out quickly after they gave notice for a job elsewhere, the turnover looks different, say it's my financial coordinator, I might just have them write up a brief summary of anything currently in progress, three open insurance claims they were mid-conversation on, or patients they'd promised a callback regarding billing questions. I'd get that summary into the hands of whoever's picking up their responsibilities in the interim, even if that person is also juggling their own existing role. The goal is simply avoiding dropped balls that create problems or upset patients.
Once that turnover is handled, the next step is checking for any passwords they hold that you don't already have. Ideally this situation never arises, but sometimes it does, particularly with cloud-based software rather than something installed locally on your own hardware. If this departing employee has administrative privileges, meaning the ability to add or remove users, on any of your software, you want that transferred immediately. As the doctor, you should be an administrator on every piece of software the practice uses, regardless of who else manages it day to day, otherwise you're always at risk of being locked out of something that actually belongs to your own business. You can usually get access back eventually, but why put yourself through that at all? So before the person has actually walked out the door, you're collecting all of that access, making sure you're not left dependent on passwords only they knew.
From there, check for any company property or equipment they might have, keys, manuals, uniforms, a printer they took home once, whatever applies to your specific practice, and make sure it all gets returned, especially keys.
Next on our sample checklist is health insurance. Depending on how your plan works, you may or may not be covering part of the premium. On our own version, we let the employee know their final premium contribution will come out of their last paycheck, that they'll receive information in the mail regarding COBRA continuation, and that if they're enrolled in any other practice-sponsored insurance, life or disability for instance, we'll be notifying those carriers that they're no longer employed, giving them a defined window to take those policies over personally if they choose. We actually have the employee sign off at this point, confirming they understood this would happen, so there's no later claim that they were never told a policy would be canceled.
Once most of that's been handled, whoever's running this process, typically the office manager, or an HR director in a larger practice, should let the departing employee know that any future questions, about their employment, their last paycheck, or anything else related to leaving, should come directly to them, rather than being routed through other staff. They may still talk to coworkers regardless, and there's not much you can do about that, and that's fine. This is also why I've mentioned before that losing a job is inherently degrading for the person going through it, so if I'm letting someone go, I keep the tone upbeat and professional throughout, not falsely cheerful, but polite and respectful. There's no reason to make an already difficult moment worse, doing so just creates an adversary where you didn't need one, and there's nothing to be gained from that.
So I'd let them know I'm their point of contact for anything related to their departure, confirm they don't have other outstanding questions, sick pay, final details, whatever it might be, hopefully most of that is already spelled out in your written policy, and then move to the next step: their personal belongings. Assuming they're leaving the office right then, I'd walk with them to their workstation, get them a box, and help collect their things, making sure nothing belonging to the practice leaves with them, and checking any other spots where personal items might be kept, lockers, the staff lounge, and so on.
You might wonder why you'd need to personally be there for this if the person's been great. But ultimately, being a great person doesn't guarantee they won't accidentally take something that isn't theirs. This isn't about distrust or paranoia, it's simply a point of professionalism, protecting the practice while making sure the departing employee only leaves with what actually belongs to them. Once they've got their things, I'd make sure they have a way to actually get home, and then walk them out, wish them well, and let them go on their way, keeping the same calm, professional demeanor throughout, no lost temper, nothing unnecessarily harsh, since it's already a rough moment for them, especially if they were let go rather than choosing to leave.
Once they've actually left, there's still internal housekeeping to handle, and this is where things commonly get forgotten simply because people get busy. First: security and passwords. Any credentials the departing employee had, company software, email, social media, get changed immediately, or if the account needs to transfer to another employee, the username and password get updated right away. If they had a practice email address, I'd forward it to whoever's now handling their responsibilities. If they had the alarm code, change it immediately and update anyone who needs the new one. In some cases, especially a genuinely difficult separation, or if there's direct street access to the office, you might even consider rekeying the practice as an added security measure, that's a judgment call based on your specific situation. I'd also remove them from any group text threads or shared email lists, otherwise you end up with small, avoidable awkwardness later, a meeting reminder text going out to someone who no longer works there, followed by an uncomfortable reply.
Next, inform the team. Your staff does need to know this person is gone, and this is exactly where you'll want to loop in your employment attorney on wording, since this varies so much by situation and jurisdiction. But here's the one thing I'd say regardless: never trash the departing employee. It serves no real purpose. Say you had someone who was a genuinely poor performer, really got under your skin, but they happen to be close friends with another employee who's actually excellent. Standing in front of the group and tearing them down accomplishes nothing productive. I might even talk to staff individually rather than as a group, something simple like, John's no longer with the practice, he's moved on to something else, Sally will be handling what John was responsible for, we wish him well. If you're ever uncertain what's appropriate to say, again, that's not legal advice, but I'd never get into trashing the person. What the team genuinely needs to know is that the person is gone, and who's now covering their responsibilities, that's really it.
They may ask what happened, or why the person left, and honestly, as blunt as this sounds, it isn't really their business, that's not meant unkindly, since they're part of the team, but it's simply not appropriate to discuss the details of one employee's departure with another. A simple, we wish John well, he's just no longer here, is enough. I wouldn't elaborate further, even if it was a genuinely bad split and there's a real temptation to explain everything that went wrong, doing so just creates future problems for yourself, with no upside. If John was the treatment coordinator and a patient later asks why he isn't there anymore, the answer is simply that you'll be working with someone new going forward, and you move the conversation along.
Because here's what can happen, especially with a difficult split: the terminated employee goes on social media, leaves reviews, messages your remaining staff, and tells their version of events. If that becomes a genuine problem, you'll need to address it directly when it happens, but I'm not going to hand that person a reason to escalate by trashing them in front of the team first. Staying composed and professional throughout the entire process is partly why. It's also simply the more professional way to handle it, and there's nothing to be gained by fighting that particular fight.
From there, a few remaining administrative items to wrap things up. Remove the former employee's name from anywhere it still appears, an organizational chart, locker labels, notice boards, and so on. Notify your payroll service that the employee is gone. Notify your insurance company or broker of their departure and the date. Transfer any additional user accounts they held with outside vendors the practice works with. If their photo is on your website or team page, take it down. Then take everything from this process and file it in their personnel file, which should be properly secured, and that closes it out.
Doing this thoroughly makes sure you haven't missed anything when an employee leaves, whether you let them go or they chose to leave, because missing these small things is exactly how problems crop up later.
That about wraps it up for this week. I know this wasn't the usual upbeat how do we hire, how do we train topic, but turnover is something every practice deals with, and you want to make sure that when it happens, it's handled as smoothly and professionally as possible. You can download the leaving staff checklist from the episode webpage, along with the positional onboarding checklists I mentioned. A lot of this material also comes from our online platform, DDS Success, which includes additional positional training for your team, I'll link that as well if you'd like to check it out.
That's everything I have for you this week. I hope this helps. If you have questions about MGE or need any kind of help, you can find us online at mgeonline.com or call us at (800) 640-1140. Have a great week, and we'll see you at the next episode.