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    Shannon Geis
    Shannon Geis

    Most managers have had an experience with an employee who is not performing at the level his or her position requires, either by not completing assigned tasks, disregarding quality standards or ignoring policies and rules. Addressing these issues is difficult and frequently avoided, according to experts. 

    “Discipline is a sensitive issue for many leaders and team members because you are asserting your authority over someone else,” explains Susan Murphy, MBA, PhD, organizational consultant, Business Consultants Group, Rancho Mirage,Calif., and author of Maximizing Performance Management

    The most important thing to remember when terminating a staff member, according to Carolyn Pickles, is to be respectful. “It is an unfortunate situation, but hopefully the employee learns from the experience.”

    However, it is important to address issues in a timely manner to avoid hurting your practice in the long run. “Your practice’s output and morale can suffer because the reluctance to discipline can make you appear to be a weak manager and can hamper productivity,” Murphy explains. 


    Carolyn Pickles, MBA, FACMPE, practice management advisor and consultant, PPMC, LLC, Longmeadow, Mass., recommends putting systems in place to prevent a situation before it occurs. 

    Start by setting expectations and making sure employees know what those expectations are from the start. “Otherwise you don’t give them a chance” to succeed, Pickles says. 

    Consider implementing and communicating counseling and discipline policies that you review regularly, and if you change a policy, make sure everyone gets a copy of the new procedures, Pickles explains. “Don’t just assume they’ve read the employee handbook,” she adds.

    The timely talk

    If you do have an employee who is not performing, address issues as soon as possible. If you wait too long to talk to an employee, he or she will assume the behavior is acceptable and you lose some of your authority as a manager.

    In addition to timeliness, Murphy believes it is important for managers to observe a problem personally to make sure they are talking to the right person about the right problem.  

    When you do talk, try what Tracy Spears, vice president, healthcare, Transworld Systems, Chicago, calls the “Timely Talk,” a short conversation that includes these steps:

    • Explain the reason for the meeting.
    • Convey why the behavior concerns you.
    • Be specific about your recommendation for improvement.
    • Set up a time to review the situation.
    • Clarify your confidence in the employee to do the job.

    Follow up with employees with a short conversation or another meeting if necessary after the conversation regardless of whether the situation improves. If the person takes positive steps, reinforce the good behavior. 

    “People love positive feedback,” Pickles says. “It’s an important part of a manager’s job that can get pushed aside.”
    (Learn more about positive conversations.) 

    If the behavior does not improve, it’s time to talk about next steps.

    Keep it professional

    Murphy and Spears recommend keeping conversations as professional as possible. Spears suggests that managers make concerns evidence-based. Focus on issues that you can prove, such as a failure to complete an assignment or regularly being late to work.

    For example, if an employee mentions a personal problem, it’s better to be supportive than to give advice. Recommend a support group or outside organization, Murphy says. 

    “Beware of your inclination to feel sorry for a team member in such a situation,” Murphy writes in her book. “When managers start to feel sorry for their employees, they often provide those individuals with an excuse for delivering low-quality work.” 

    Focus on the employee’s workplace behavior and the good of the office, which also means not sharing disciplinary issues or personal problems with other staff. 

    Now or never

    If an employee does not improve, consider the “Now or Never” talk, Spears says. “This is the conversation that most leaders never have,” she adds. Spears recommends sitting down with an employee to make your concerns known and emphasize how an employee’s actions moving forward will affect his or her future with the organization. She shares the following suggestions to start the conversation: 

    “We seem to be stuck and we’re running out of options.”

    “You are making a decision about your future with your performance. Do you understand that?”

    “Your potential in this role is still great, but you are at risk.” 

    “This is the moment where things must change.” 

    Pickles recommends documenting these conversations with informal notes or a more formal form if your practice policy requires it. Either way, make sure that the employee has a chance to see the documentation and request a signature to confirm that he or she understands the situation. 

    You should also highlight the positive if possible. “Counseling and discipline can be a stepping stone for turnaround if there’s a positive aspect to it,” Pickles says. 

    If the issue escalates, you might want to consider having another person present during conversations to guarantee you cover all of your bases, she says. 

    The ‘Can’t or Won’t Dilemma’

    After several conversations that don’t result in improvement, consider what Spears calls the “Can’t or Won’t Dilemma.” She believes that when there is a performance issue, it boils down to whether an employee has a “can’t” or a “won’t” attitude, which leads to very different conversations.

    The question you have to ask yourself, says Spears says, is: “Is it the capability of the person you were wrong about or were you wrong about his or her intentions?” 

    If your employee has a “can’t” attitude, it means he or she doesn’t possess a certain skill, and you might consider training. In comparison, a “won’t” attitude in someone refers to interest in changing behavior. The best approach in this situation is to issue a warning to which the employee will comply or not, and you will be able to move forward based on that decision. 

    Understanding the answer to this very direct question will “give you a solid stance for understanding and solving key performance shortcomings,” Spears adds. 


    If an employee won’t improve, you might have to dismiss that person. Letting an employee go demonstrates respect for the employee as well as your other team members and the organization as a whole, Murphy says. 

    Terminating an employee is “a life-altering situation,” Pickles says, which is why she recommends treating every dismissal as a unique situation. 

    According to Spears, if you have followed the steps outlined above, the employee should not be surprised by the action. “Be compassionate but be honest and direct,” she says. “It should be a short conversation. It’s painful but you have to rip the Band-Aid off.”

    The most important thing to remember when terminating a staff member, according to Pickles, is to be respectful. “It is an unfortunate situation, but hopefully the employee learns from the experience.” 

    Shannon Geis

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    Shannon Geis

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