Termination Series:

Making the Decision. Should I Fire My Employee?

This series will go over how a termination decision should be made, how the organization handles problems before making a termination and how to convey the news for a constructive face-to-face termination. There are specific guidelines when terminating because all of these factors will impact strongly on the employee’s perceptions, their consequent motivation to act on their emotion negatively and the way your current employees will view how you handle these and following situations. It’s up to you to make a termination something that is going to aid you and your practice or something that could collapse it.

Of the many responsibilities of managing staff, having to terminate an employee is one of the most troublesome and difficult. Termination is the final step of investment protection, one in which the return on investment is wholly inadequate, justifying the ending of the investment. However difficult, it is part of the job and must be done in as timely and humane a manner as possible.

Making the Decision to Terminate

Deciding to terminate an employee is serious business for all that are involved. Considering the increase in litigation over terminations and the losses incurred by employers who have made unwise decisions, the termination must be based on a reasonably thorough assessment of the employment relationship. After all, that is what is being terminated, not merely the employee or the position.

Work is an investment relationship. However different or lopsided, the employee has invested something in the job and practice, and the practice has invested in the employee. Termination ends that investment. People don’t abandon investments unless the return is unfavorable. Remember, the employee’s investment is more risky (bills to pay; life to support), so he/she will have a hard time understanding why the company’s “investment” is being withdrawn, and this will present a greater challenge to the office manager to communicate.

Basic Guidelines to Be Aware of in Making the Decision to Terminate:

  1. Protected Group: If the employee belongs to a protected group (minority), the likelihood of legal action is increased. Have all your documentation and facts clearly prepared.
  2. Defensible Paper Trail: Make sure that the decision to terminate is backed in writing by specific, detailed documentation.
  3. Risk Potential: Is the law clear or fuzzy regarding the facts of your case? Second opinions from labor lawyers are advised.
  4. Public Image: Can your practice withstand any adverse public exposure through the spreading of the bad news in the community?
  5. Organizational Culpability: A “failed relationship” usually has plenty of blame to spread around. To what extent has the practice “failed” the employee? Does the practice have a clear definition of its responsibilities to marginal or unsatisfactory employees?
  6. Continued Damage Potential: Assuming the employee is not terminated and situation doesn’t improve, can you stand continued “repeat performances?” What is at stake if improvement is not forthcoming?
    1. Remaining Morale: Management credibility is really on the line in termination cases:
      What impact would failing to terminate have on morale?
    2. What impact would terminating have on morale?
  7. Twelve Strangers: How would 12 people completely unfamiliar with you, your practice and the employee judge the termination? With the record you have, would they conclude the action was reasonable?
  8. Consistency: How have similar situations involving other employees been handled? If differently, what differences justified such treatment?
  9. Shooting from the Hip: Are you just trying to get rid of someone that you don’t like or does the evidence justify a dismissal?
  10. Procedural Consistency: Have published guidelines for company disciplinary procedures been followed to the letter up to this point?
  11. Skeletons and Pretext: Sometimes companies try to cover up the “real” reason for termination and offer something that sounds plausible. Cover-ups usually unravel at very inopportune times, like with investigators and judges.
  12. Motivation to Organize: Terminations can impact on seeking representation for employees. Do all the factors guiding your decision and your company’s termination policies provide adequate “protection” against the perception of unfairness?
  13. Receptivity to Help: To what extent has assistance been offered and how has the employee responded? Has he demonstrated willingness to cooperate and improve? Is there evidence?
  14. Influence of Personal/External Difficulties: Are there any off-job problems which, in not being resolved, create or add to on-job performance?
  15. Track Record: Why consider termination now? Does the employee have a history or track record of problems or is this something new?
  16. Undeveloped Potential: Does the employee have potential for success in another job or part of the company? Working for a different supervisor?
  17. Pre-termination Conference: Having followed the pre-termination warning and gotten nowhere, have you talked with the employee and given full hearing to his/her side of the situation? Assuming the stories differ significantly, have you accounted for why the differences exist?

The above are guidelines intended to help you in this area. It is not intended to be, nor is it, legal advice. You should consult an attorney on any specific legal problems that might come up with employee discharge.

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The Underrated Business Card

Business cards don’t seem to be in vogue as of recently, however they are still a highly effective tool for getting your name out there. Everyone in the practice should be attentive to any and all opportunities to promote the practice. One of the easiest methods for doing so is handing out business cards. This is a successful tool and is also a commonly accepted practice in the business world.

Initially, each staff member could be given some of the doctor’s cards to distribute. Advise the staff to keep an ample supply of cards in their purse or wallet. Opportunities to hand them out will present themselves in a number of various situations. For example, when a person asks, “What line of work are you in?” The staff member (and doctor) could answer the question, say a little about the practice, and offer a business card or two.

One can take advantage of every day situations to hand them out, e.g., while at the grocery check-out counter and engaged in social conversation with the clerk, at the beauty salon, at the gas stations, the bank, etc. The list could go on and on. The idea is to keep a flow going all of the time. Many practices have been built and expanded in just this fashion.

As your budget allows, print business cards for each of the staff with their names and positions on them. This instills in each staff member a feeling of importance and professionalism. They will also experience a heightened sense of pride when handing out one of their own cards.

A staff meeting should be held during which the significance of new patients/clients is discussed. Impress upon the staff that as each person takes more initiative for building the practice, everyone will experience the increased benefits. Establish “games” for the staff wherein the staff who distributes the most cards and brings in the most new patients/clients is rewarded with cash or some other valuable prize.

The most successful method of using cards to attract new patients/clients to the practice (and to determine whose card they came in on) is to have an offer printed on the back of the business cards which extends to the recipient either a complimentary initial visit or a substantial discount on the first visit. The prospect should be informed to bring the card in with them to the first appointment. The receptionist could then record the name of the staff member as the referring source.

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Reactivating Patients: How to Get Them Back

If you were to calculate the value of each patient or client visit and multiply that by the number of patients or clients you have not seen for 6 months or more, you would begin to get the idea that you are losing significant amounts of income by allowing these patients to slip through the cracks. The reactivation of patients or clients who have discontinued care can be a major source of increased activity and income. Although they aren’t new patients or clients per se, the reactivation of these persons can produce a significant increase in activity for you. By simply concentrating on reactivating those persons who have visited you in the past, you can increase office visits and income notably.

People drop out of treatment for many reasons. It is possible that a person decided to discontinue care due to financial difficulties. By contacting them, you might find that their situation has improved, and they may be quite willing to re-establish their visits with you. It is also possible that a patient/client may have stopped coming for services because they didn’t have a full understanding of the importance of regular visits. This is a matter that could be cleared up through communication and education. Lastly, don’t rule out the idea that your former patient/client may be upset with your office, which again could simply be handled with communication. The important thing to be aware of is that communication, a caring attitude, and good follow-up can encourage people to come back to the practice.

Set aside some time to go through your inactive files and find those patients/clients whom you have not seen for at least six months. Look through the chart to determine what services they might be in need of. Compose a letter which addresses the specific service indicated.

Keep a log of letters sent out and, through the use of a reminder file, target a follow-up phone call to the client/patient within one week of sending out the letter.

When placing a phone call, make sure that you are specifically familiar with whom you are calling. Have it clearly in mind exactly what it is you are calling for. Keep a record of your phone calls which would include:

  • the date and time of the call,
  • whom you spoke with,
  • the reason for the call, and
  • the results of the call.

Request the second part of this article to get an amazing sample call script and the four most important things to focus on during a reactivation call. Request “Reactivating Patients: How to Get Them Back – Part II” (highly recommended). Scroll to top


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