October 1998 Bulletin

When firing an employee is needed

Document the problem, explain standards and exceptions

Firing an employee is a sensitive issue for many physicians-particularly for those whose staff has been around for years. Rather than conducting a new search for an employee, many physicians will tolerate poor work performance, inappropriate behavior to patients and other staff, breach of confidentiality, tardiness and random days off.

"It's never easy to fire anybody," says Vasilios J. Kalogredis, health care attorney and consultant for the Wayne, Pa.-based Kalogredis, Tsoules and Sweeney, Ltd. "There are fears that, 'The devil you know is better than the devil you don't know.'

"If the employee has had longevity, there are a lot of practices who keep people on board….but there are some [employees] who've never done a good job. Sometimes, physicians may not face up to the problem because it's not easy to confront."

Yet, when complaints begin to surface and a pattern of problems stack up, Kalogredis says, "Then, it's time for you to face up to it, address the problem. The key thing is to know 'what do we do about the employee? and 'what are grounds for dismissal?'"

He recommends documenting the problems and confronting the employee. "In most cases, if you document appropriately what the standards and expectations were, what the employee did or did not do-it's helpful to both parties to get a clear understanding," says Kalogredis. "Explain to them that you 'need to have a certain quality of employee,' and define, very clearly, what the standards and expectations were, what the employee did or did not do," Kaogredis says. "Communicate very openly when those expectations are met or are not met.

"Clearly, the warning notice that you give employees will help improve their performance. I think if you've talked to the person a couple of times, not seen any improvement, documented the complaint and conversations, it's time to open the door and let them go. Kalogredis suggests three warning notices prior to termination.

"A lot of times when you're open about these concerns and problems-and the economy is good, hopefully, the employee will leave on his or her own and find another opportunity," says Kalogredis.

Yet, many times a lot of practices are afraid to let someone go because "it's unclear what their risk might be," says Kalogredis, who recommends every practice have an attorney specializing in employment issues or health care law. "Having an office policy manual makes sense. It could take hours to compose, but it defines exactly what your expectations are, what kind of notice would be given to terminate an employee, things like that. Your practice's employment rules are very individualized, as are each states."

Some physicians might think of other ways to handle employee problems such as no merit wage increase, a pay decrease or demotion of an employee. But Kalogredis says, "It's not usually a good idea. The low morale of the office permeates the whole place. Anybody who walks in is going to feel it-if it's not a happy place."

Two weeks written notice should be given to terminate an employee, says Kalogredis-unless there's cause for immediate dismissal such as stealing or breach of confidentiality. "The employee is generally going to get unemployment (compensation) for being fired for 'no cause,'"says Kalogredis. "Generally, the government is pro employee on that one. But if that's their goal-getting fired and being happy living on unemployment for a while, those are the people you don't want to keep anyway." Dismissals often evoke the worst out of an employee who is fired, notes Kalogredis. "They may feel wronged in some way and decide to sue," says Kalogredis. "Whether they're going to win, lose or draw, nobody likes to get sued-even though there may be no basis for it. They may try to argue age, sex or race discrimination…."

Adds Kalogredis, "There's no magic formula to firing anyone. Yet, as good as somebody may be-no one is irreplaceable. If you're not happy with that employee…you're going to find a better replacement, I'm sure."

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