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Prevent toxic employees from poisoning your practice


No matter how long you have been in practice, chances are you have encountered a toxic employee who poisoned the atmosphere of your workplace. If you don’t take action fast, such an employee can threaten your relationships with your patients and your staff, affecting your income in many ways.


No matter how long you have been in practice, chances are you have encountered a toxic employee who poisoned the atmosphere of your workplace. If you don’t take action fast, such an employee can threaten your relationships with your patients and your staff, affecting your income in many ways:

Staff defections. When one employee treats another one poorly, says Keith Borglum, a consultant with Professional Management and Marketing in Santa Rosa, Calif., “often, the other staff members are reticent to say anything, so they quit.”

Mr. Borglum

And it happens more than you might think. Twelve percent of workers have left jobs because of poor treatment.  When that happens, an employer will spend an amount equivalent to one to five times an employee’s annual salary to recruit and train the departed employee, depending on his or her position.

Those statistics come courtesy of research conducted by Christine Pearson, Ph.D., professor of global leadership at the Thunderbird School of Global Management, and Christine Porath, Ph.D., associate professor at the Georgetown University McDonough School of Business, authors of The Cost of Bad Behavior: How Incivility Is Damaging Your Business and What You Can Do About It.

Decreased productivity. More than 95 percent of Americans say they’ve experienced rudeness at work, according to Drs. Pearson and Porath. Among workers who decide to remain in their positions despite their bad experiences, a toxic employee frequently becomes the focus of the workplace, causing a time-wasting distraction. And teamwork among staff members may become a thing of the past.

“The productivity of the toxic individual can slow, because nobody wants to be around (him or her),” says Mr. Borglum. “One bad player on a football team can cause the whole team to lose.”

Also, office morale will take a hit if your dependable, hardworking employees think you condone poor behavior. They may see you as an ineffective manager who does not know the difference between workers you should value and those you should fire.

Lost patients. If a patient has a run-in with a problem employee - or even witnesses one staff member treating another one poorly - he or she may be compelled to seek medical care elsewhere and to spread the word about the negative experience in your practice.

Given these threats to your livelihood, only one solution works when it comes to a confirmed problem worker, experts advise, and although it may seem extreme, you can’t afford to put it off: Fire the employee. But first you must properly identify toxic activity, and you’ll also want to handle the situation fairly for all involved.

Heed the warning signs

A toxic employee is not necessarily an ineptly skilled one. He or she may even be making positive contributions to the practice, but the person’s net effect on the practice is negative.

“Sometimes your toxic employee is doing a really good job; she is just a jerk,” Mr. Borglum says.

What are the warning signs? Watch for unethical, inappropriate, or unprofessional conduct. Toxic employees often exhibit passive-aggressive behavior, spread gossip about their co-workers, and are rude to patients and colleagues.

“They stimulate a sense of discord in the workplace,” Mr. Borglum says.

They also may be uncooperative, exhibit a flagrant disregard for office rules, and seldom take responsibility for their actions. “It’s everybody and everything else that’s wrong, not themselves,” Borglum says.

Many have negative attitudes. “Almost never do you have a toxic employee who is a happy-go-lucky, positive person in the rest of (his or her) life,” he adds.

Because you are a busy physician, your staff members may recognize the telltale indicators before you do, so take their complaints about a co-worker seriously, and try to be aware of staff dynamics.

Remind your employees that you can’t fix a problem you don’t know about, says Kenneth Bowden, C.H.B.C., president of Berkshire Professional Management in Pittsfield, Mass. “Tell them they can come to you with any issues whenever they need to.”

Take action right away

When you realize your staff members or patients have a problem with an employee, take action immediately. Don’t wait.

Call the problem employee into your office for a private meeting. Ask questions to determine whether the behavior is permanent or temporary. Your employee’s actions may be a symptom of something else, such as marital troubles or a personal financial crisis.

“You have to have an accurate diagnosis before you start treating,” Mr. Borglum says. “Once you’re clear in your diagnosis, it’s usually best to work out the issue in a straightforward manner.”

Clearly state the problem and explain that you are going to document his or her behavior in writing. Emphasize that any slip-ups will be noted in his or her personnel file. This point is important, Mr. Borglum says, because physicians rarely can change a toxic employee.

“It’s different from a work-oriented problem,” he explains. “Toxic employees tend to have deeper problems.”

Tell the employee how you expect him or her to behave from that point forward. Offer specific examples. Tell him or her what he or she did wrong, and clearly explain exactly what you expect instead.

Provide a detailed improvement plan, which will make it easier for you to terminate the employment of your toxic worker if he or she continues to exhibit bad behavior. For example, you may choose to offer 30 days or three chances to change. Explain that any subsequent violations will result in termination so he or she knows the consequences of not following the agreed-on plan.

Regularly meet with the employee to make sure the plan is being followed. Above all, make sure you both stick to the agreement (the employee needs to alter actions, and you need to acknowledge performance improvements and inappropriate behavior).

Stress that if the behavior occurs again, you will fire the employee. Stick to the terms of the plan. For example, if the employee slips up after the third try, do not give him or her one more chance. Or, if you give 30 days to show improvement but the bad behavior continues, fire him or her on day 30.

“If they do it again, bring them back into your office and tell them you have in writing what they just did and what they did before,” says Mr. Bowden. Let the employee know that documentation exists.

Invite another person to the meeting. “Having two people in the meeting can validate that nothing inappropriate happened in that room,” Mr. Borglum says. If that’s not possible, leave the door open a crack.

The only way to deal with a confirmed problem person? “Get rid of a toxic employee as quickly as you can,” Mr. Borglum advises. “Toxic people don’t change.”

He adds, “No firing should ever come as a surprise.” However, employment termination may come as a shock to someone who is in denial about his or her behavior. If the employee gets defensive and protests with a list of workplace accomplishments, acknowledge his or her abilities and explain, once again, that the problem was with his or her behavior. Do not argue or listen to excuses. Tell the employee that you agreed on a plan, you made your decision, and you are sticking with it.

“Docs aren’t good at firing people,” Mr. Bowden says. “They are people persons and very soft-hearted.”

After the termination has occurred, inform your staff members that a co-worker was let go. Do not go into detail; the less said, the better. They probably know what led to the firing anyway.

“There are two kinds of employees,” Mr. Bowden says. “Those with 20 years of experience, and those with one-year of experience 20 times. You’ve got to get rid of those one-year experience folks.” DT

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