5 signs it’s time to fire a practice employee

Practices are battling the tightest labor market in years, yet every administrator eventually meets the employee who costs more than they contribute – in lost patients, tangled billing and teammates who start polishing résumés. Keeping that “bad apple” on the payroll is not just a morale issue; it is a reputational and financial threat that can ripple through a small office faster than flu season in January.

The stakes are enormous. A single HIPAA breach by a careless front-desk clerk can saddle the practice with six-figure fines. One toxic scheduler can sour Google reviews overnight. And if you misfire on termination, beware: discrimination and retaliation complaints filed with the Equal Employment Opportunity Commission have roughly doubled over the past two decades, making dismissal one of the riskiest moves a physician-owned business can take.

That risk tempts many owners to delay action, hoping another coaching session or a last-chance performance plan will spark a turnaround. Meanwhile, the damage mounts – phone lines jam, invoices slip, patients grumble about rude greetings, and compliant staff wonder why leadership tolerates the chaos. In an era when practices fight razor-thin margins and consumers can book elsewhere with a tap, the cost of inertia is measured in revenue leakage and eroded trust.

Here are five unmistakable warning signs that it’s time to let an underperformer go and how to pull the trigger cleanly, with the documentation and due diligence that protect your physicians, your patients and your bottom line.