Reality check: When Physicians Practice magazine asked some of the country’s busiest practice management consultants which mistakes they see repeatedly in practices, one of the major ones they identified was retaining incompetent employees.

“Practices intuitively know something is wrong but don’t act on it,” says consultant/speaker Elizabeth Woodcock, based in Atlanta, Ga. Staff members who come in late, do nothing, or simply aren’t doing a good job ruin the morale of everyone else, Woodcock says.

Those who do arrive on time, for example, need to cover for the employee who is always late. Worse than the extra work, everyone on the staff begins to feel like management doesn’t care. If the physician-owners don’t seem emotionally invested in the practice, you can be sure no one else will.

The only solution, Woodcock adds, is to tackle under-performance head on. (“Management Mistakes: Dodging Bullets,” Physicians Practice, March, 2006.)

Hard learned lessons about “bad apples:”

“Employees don’t want to work with low performers,” says Quint Studer, former hospital president and author of Hardwiring Excellence. “Nothing makes employees as discouraged and resentful as having to co-exist with people who don’t pull their own weight. In fact, low performers usually drive high performers out the door. (“The Magic of Rounding,” Successful Meetings, February, 2006, 19-20)

Employees who are not performing up to par are expensive in terms of payroll and in terms of alienating, possibly endangering, patients.

THE MOMENT OF TRUTH

How should you handle the unpleasant firing task?

• Always fire someone face to face. The job can’t be delegated anymore than it can be postponed.

• Get to the point fast. Come to the point of the meeting within the first two or three minutes and make the reasons for termination clear.

• Remain firm in your decision. Do not relent, no matter the bargaining the employee may do.

• Focus on fit. Adopt a low-key approach that the employee is just not right for your practice in that job. Don’t dwell on the person’s shortcomings. Simply express disappointment that things have not changed since the last performance review and that you have no alternative but to terminate employment. Acknowledge the person’s capabilities and strong points.

• Have a witness. “Consider having a witness,” advises Paul Preston, PhD, author of Employer’s Guide to Hiring and Firing. “In most firings, a witness is unnecessary. If, however, there is any chance that hostility will turn into a physical threat, or if there is a chance for legal action by the employee, a witness is good protection.”

Should you tell the employee the reasons for your decision or gloss over them? Most personnel managers advocate an explanation somewhere between the two extremes. Give the employee enough information to show your decision was not arbitrary — but not so much detail as to destroy the person’s self-esteem.

Bob Levoy is a seminar speaker and writer who focuses on the healthcare industry. His most recent book is 201 Secrets of a High Performance Dental Practice Elsevier/Mosby (January, 2005). He can be reached by e-mail at b.levoy@att.net