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The Right Way to Fire an Employee at Your Medical Practice


When you are letting someone from your staff go, you must exercise caution.

The last week in May, I discussed how to hire an exceptional team member. This week I will cover what happens when you discover you don’t have an exceptional team member and it is time to let them go. 

Firing an employee is one of the hardest things to do, and even harder to do it tactfully. The following information is not legal advice, and assumes your employee hasn’t done anything to warrant immediate dismissal (theft, violence, intoxication, etc).  It is important to remember that when you are letting someone from your staff go, you must exercise caution as to not get yourself in legal trouble; employment laws vary from state to state, so always consult an attorney if needed.

First, I would like to start with you understanding that termination is a last resort, after your coaching/counseling methods have failed. Unless an employee has done something that requires immediate dismissal, it is important to use increasingly more intense feedback to the employee regarding their work performance.  Begin with verbal warning and increase to written warnings. When issuing these warnings, make sure that you document time, date, place, and employee feedback. Ask the employee to sign any written warnings.  Make sure you ask the employee for feedback: Remember the point of the meeting is to give the employee the opportunity to take your requests to heart and change.

1. If all else fails, it is time to cut them loose. This is one of the hardest parts of being in charge. Here are some tips when it comes to the meeting to let your employee go.Be straightforward; say it simply, and with compassion.

2. Refer to your notes from your counseling meetings.

3. Include the employees supervisor and a representative from HR (if your clinic is large enough to have one and depending on your state laws), or other witness

4. Many people advise terminating on a Friday, my advice is to terminate earlier in the week and pay them for the remainder of the week, or week and the following week, to allow the employee time to begin the job search.  (again this is given the employee hasn’t done something to warrant immediate termination)

Here is an example of what you might say (assuming your employee’s name is Jennifer and she has worked as your receptionist for six months):

Hi Jennifer, thank you so much for the work and care you’ve given to the clinic over the last six months.  We really appreciate it. As you know I have been evaluating where the clinic is at, and where we see it going over the next year, and I see a lot of growth, change and evolution ahead.  As I have evaluated your performance, I have realized that your work here is not meeting our needs for receptionist. At this time we are going to have to let you go, effective (insert date here or immediately). Here is a list of items we need to collect from you (name badges, keys, etc.).

If Jennifer is the type of employee that would be open to constructive advice on improving, you can certainly give that advice. Some employers will offer advice on job search resources, tips for improvement for future employers, or even a discussion of  the fired employee’s strengths in hopes of providing a little self-esteem boost and some clarity moving forward. You don’t have to do this, and certainly don’t give the advice if you feel it will make the conversation harder. Some people will take your advice as an opportunity to negotiate. Be careful to keep your decision final. 

Don’t engage in any “what ifs” or “how abouts” that the employee might present. Stay with what is relevant: This is the situation, these are the things I need to close out the working relationship, I wish you the best, the end. 

Once you have collected all of the company property or determined its location, allow the employee to remove personal belongings from their work station.  You should offer a choice regarding which one of your meeting attendees will walk the employee to their station to collect their belongings and escort them out of the building. If necessary, a security employee, if available, can be utilized for this task, and in some larger clinics/facilities this may be required by policy.

Once the now former employee has left the premises, it is time to take a deep breath and learn from the mistakes in hiring and training them, be sure and put those into practice when moving forward and hiring your next candidate to make sure you are building your stellar team.

Do you have a question about a practice management issue in your clinic? Would you like some ideas on how to fix a problem? Submit your anonymous questions to Ask Audrey and practice management expert Audrey “Christie” McLaughlin, RN, will answer them in a future Practice Notes blog.

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