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Terminate the Right Way


“Termination” is an ugly word, and firing employees is awkward and painful for everyone involved.

“Termination” is an ugly word, and firing employees is awkward and painful for everyone involved. Nevertheless, underperforming, untrainable, even criminal employees reduce your ability to care for your patients. And no matter what you do, there will always be some staff members who can’t or won’t do what needs to be done, and so must be let go. Make sure you do it right.

To avoid lawsuits brought by bitter ex-employees based on charges of discrimination, defamation, or anything else allowed by widely varying state laws on termination, follow the general policies and procedures below. Remember: Always check with an attorney versed in your state’s labor laws to make sure your practice is in full compliance.

Rule #1: Document everything. This includes well-written job descriptions, key performance indicators, an employee manual with termination policies, and written warnings for rule violations. Practices that do truthful and constructive performance reviews can avoid the “I didn’t know I was supposed to do that” defense. Plus, you’ll have evidence that the employee was given feedback on performance issues. In one practice I worked with, the internist’s “the less said the better” philosophy cost him dearly in unemployment.

Rule #2: Be fair, even if that means accepting the idea that you might in fact be wrong in a given situation. Listen to your employee’s side of the story before you make an official judgment. Have a policy of progressive discipline to give staff an opportunity to improve. I’m thinking now of another client who mistakenly bought into office gossip and failed to thoroughly investigate allegations before threatening an innocent employee with termination.

Rule #3: Remain calm and in control of your emotions. Focus on the facts whenever speaking with an employee, but especially when telling a dismissed staffer to clean out her desk. The old World War II adage “Loose Lips Sink Ships” applies and can cost you a lawsuit.

Rule #4: Perform an exit interview, if possible. More typically done after a resignation than a termination, sitting down with the outgoing employee allows you to gather information crucial to head off future departures or poor hiring decisions. Here are a few essential tips for the exit interview:

  • Conduct interviews on both voluntary and involuntary terminations, even if you are parting on good terms. One doctor found that departing employees often felt a sense of relief about being able to divulge disturbing goings-on, such as a drawer of unsubmitted claims.

  • Discuss all aspects of the practice to find out what contributed to the employee’s poor performance. Another client learned the staffer had inflated her computer skills on her résumé. The staffer had hoped that once there, she’d be trained. No such training was offered.

Karen Zupko

is a seasoned senior advisor who has been helping physicians to navigate America's healthcare system since 1974. Her perspective stems from more than 25 years of consulting, coaching, and training experience with physicians and those who manage them. She is a member of the American Marketing Association and Women in Communications, and has served on the board of trustees of Chicago's Grant Hospital. Karen is a graduate of the University of Kansas and a Chicago native. You can contact her at

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