Employee discipline is one of the hardest, but necessary, components of practice ownership and employing staff.
It’s human nature to avoid confrontation. As a leader, it’s important to set the ground rules from the first day of employment. Creating an atmosphere of collaboration, mutual respect and trust early on can reap long-term rewards for the employee, you as the employer and ultimately the practice. Employees who have a sense of ownership and investment will often perform in a manner that enables the practice to flourish and grow. Happiness is infectious! This atmosphere will resonate with your patients and lead to potential referrals. It is important and recommended that you have an established office policy manual. Staying consistent with all employees in establishing clear, reasonable policies makes the difference between a smooth-running practice and one that’s plagued with employee-related angst. If you don’t already have a manual, or it’s out-of-date, you can develop one at no charge using our employee manual resources.
Adherence to the policies in place should be understood by all employees and enforced equally by the employer. Each employee should be familiar with office policies, and the consequences that may occur if they violate a policy — keeping in mind that you should be flexible in the enforcement of certain rules if extenuating circumstances should arise. Any changes in office policies should be posted for all employees to see in advance of the policy effective date. Provide employees an opportunity to ask questions and have each sign an acknowledgement of the new policy and place in the employee personnel file.
If a problem develops with an employee, you should be prepared to have an open discussion bringing the behavior to his or her attention; hopefully, he or she will work with you to solve it. By showing confidence and trust by involving the employee in finding a solution, not only will you likely get your desired result, you will have given the employee an opportunity to grow professionally and personally.
Consider the following tips for difficult performance conversations:
It’s important to convey the difficult feedback while still treating the person with respect and empathy. If you damage the employment relationship, you shut down future opportunities for collaboration and growth. In fact, tell the person up front that the relationship is important to you.
Ambushing an employee creates anxiety and could break down trust. Instead, invite the employee to chat at a specified time. For example: “Amanda, I’d like to chat with you about your attendance. Could we meet this afternoon at 3:00?” This gives the employee time to gather their thoughts and prepare.
It’s usually best not to call the person into your office. This shifts the balance of power to your side and puts the other person on the defensive. A private, neutral space—say a break room with a door—sends the signal that this is a solutions-centered discussion, not an embarrassing, dressing down.
Share up front what the problem is, how it’s affecting others and what must change. Provide specific examples: “You’ve been late 13 days in the past six months, “or “Your falling behind with patients each day creating an excessive overtime issue.” Productive conversations are grounded in facts, not observations.
Results are better when the person feels a sense of ownership for the solution. As positive questions like, “Can you explain what is impeding your ability get to work on time each day?” or Can you provide ideas on how to stay on schedule without impacting patient care?” Listen to the person’s perspective and compromise when you can.
Avoid doing all the talking to assert your point of view or to fill the silence. This is especially important when you are dealing with an introvert who needs time to think before they speak.
Stay focused on understanding what the person is saying, both verbally and nonverbally. Summarize what they say to confirm it with them. Trying to understand someone’s point of view will show empathy. This will help the other person accept what you have to say, even if it isn’t what they want to hear.
Never yell, insult, threaten or bully. If things start to escalate, step away, end the meeting and reschedule when tempers are calmer. A single episode of bad behavior can damage a relationship that took time to build.
Go into the conversation with an open mind. You may not be aware of all the variables causing the issue. You may learn something that totally shifts your perspective – or you may be completely wrong. Knowing this will help you be a better listener.
Ideally, the employee will leave the meeting with specific steps to improve on the topic discussed. Schedule a follow-up conversation to see if things have changes for the better.
If this approach isn’t successful, develop a performance improvement plan that works best for your practice. There are situations in which a performance improvement plan approach may be warranted, as outlined below. However, it is important to emphasize in any written materials that employment remains at-will and either the employer or employee can terminate the employment at any time. Even if you decide to adopt a step approach to help facilitate disciplinary action, there are occasions when the first offense is egregious enough to warrant immediate termination One option for a performance improvement plan is as follows:
While you cannot control an employee’s behavior or what he or she may do before or after a termination, it’s important to have copies of any instances of poor performance or disciplinary forms placed in the employee’s personnel record. If through this process it becomes apparent that the situation is not improving and your decision is to terminate the employee, having a documented record of events showing objective reasoning and the steps taken prior to reaching your decision will be important should you need to have an accurate reference. A hazy account of the details that led up to termination can tip the scales toward the employee if the circumstances surrounding the termination are questionable. If poorly handled, it can be a disaster.
Further, employers should avoid “papering” an employee’s personnel record with documented performance issues – all written in the three weeks prior to termination. An employee can work for years without documented performance problems. Then, once the employer notes issues with the employee’s performance, the employer starts papering the file, and in quick succession the employee is terminated. Employees may be able to contend that the recent file-keeping is nothing more than a set-up. It is therefore important to keep periodic, accurate records throughout the course of the employment relationship.
In the long run, it’s better to try to improve employee performance than to go through the painful process of termination of employment — unless the employee has behaved in such a way that warrants immediate termination such as gross misconduct or theft. Oftentimes, the performance issues are temporary and can be worked through.