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  • Travis Campbell

    Many of us would say that the most stressful thing about running an office is maintaining employees, especially when it comes to having to discipline or fire one.  First thing to remember, you are not alone.  I have yet to meet anyone that actually enjoys disciplining or firing people that work for them, we develop an emotional attachment to people we work with.  However, there are multiple ways to help make this a better experience for both you and your employees.

    1) Always know the laws:
    One of the main source of discomfort for dentists is not knowing the laws that you have to follow so that you are confident in the choices you want to make.  Every state is a little different, however many states follow similar trends or rely on federal regulations.
    – There are several protected classes that you can never terminate an employee because of, which include sex, religion, gender, culture, sexual orientation, age.  Just make sure you never use these as the reason to let someone go.
    – Most states are “at will” employment, meaning the employer or employee may terminate the relationship at any time without reason.
    -You do NOT have to have step-wise discipline or documentation to terminate an employee.  There is nothing legally requiring them.  If you have a toxic employee, get rid of them fast!  However, if you want to avoid unemployment, it is highly recommended to have documentation of a verbal and written warning.  These should state that you tried to give the employee additional training and or counseling; basically that the employer did everything to retain the employee and show as much proof as possible the employee was the only issue.

    2) Pregnancy:
    This is always a misunderstood section that many employers without knowing the exact rules tend to fear.  So here are some of the most common issues to know so you can avoid problems or getting trapped by an employee.
    – You are required to make special accommodations for pregnant employees IF they are reasonable.  However, the employee must still accomplish their job description.
    -Common example of what you must do: provide opportunity for more bathroom breaks or for nursing.
    – You cannot fire someone just because they are pregnant.  This often leads to employers keeping around toxic pregnant employees because they don't know how to get rid of them.
    – You are NOT required to keep them around if they cannot perform their job description!! But this does not mean you have to fire them either.  Common example is x-rays.  You do NOT have to let someone stay if they don't want to take x-rays for any reason.  If a pregnant employee has concerns about x-rays, absolutely sit down and listen to their concerns.  Gently but firmly tell them evidence does not support their concerns, their job requires taking x-rays, but since you are a kind employer you would gladly purchase an x-ray monitoring badge for them to use if they want peace of mind.  Same goes for nitrous oxide.  These badges are an employer's protection as well as helps employees with legitimate concerns to get over their fears.
    – Medical Leave of Absence.  If the employee still refuses to do their job, their last option is to take an UNPAID medical leave of absence.  To be clear, to keep coming to work, they MUST complete their daily tasks, including all x-rays/nitrous they usually would.  If the employer has less than 25 employees (most dental offices), you are NOT required to save their job when they return.  This allows you to give them a legal way to take off the time they want without having to fire them or paying unemployment, and avoiding all legal issues.
    – Like any other separation, have the employee sign a request for a MLoA that states the start date!

    3) Discipline:
    I don't know many of us that enjoy disciplining or firing employees.  It is just not enjoyable for anyone involved on either side.  However, it is a vital part of being a boss and a leader.  You need to terminate toxic employees to PROTECT your team and patients.  Think about it, who is more important to you….your good patients and team members, or the toxic employee?  Keep the good, trim the bad.
    Now, the biggest part though is avoiding needing to terminate anyone, which is always the ideal goal.  One of the main things to remember is discipline should not be about punishment for doing something wrong.  It should be about training employees to know how to do their job better.  The attitude you go into an employee evaluation means everything.  Go into the meeting pissed off at someone and it shows, everyone gets emotional, it gets out of hand, and no one is happy.  Go into the meeting with a positive outlook that you are just trying to work out how to get everyone working better together and it will go smoother.

    The sandwich technique is a common motivation tactic.  You always want to start and end a conversation on a positive note.  So if you are having to discipline or correct someone's work or behavior, start off first with something they are doing well.
    Next, talk about the issue involved that is NOT what the employee is doing, but how it is affecting the atmosphere/job.  Then ask how YOU can HELP them to resolve the situation.  This will completely change the context of the conversation for the better.   Avoid blaming or YOU statements because they just create defensiveness.
    Last, end on a positive.
    Example, lab issues:

    “Suzie, you are great with patients and working with me chair side.  We are getting some patient complaints though that their lab cases are taking too long to return.  I notice we are not getting things out the day they are done.  What can I do to help you make sure to get these cases out same day or next day, and then make sure we follow up with the patient when the case comes in? (discuss) Okay great, I think we have a good place to start in having x/y/z systems in place so that our patients are taken care of to the best of our ability.  Is there anything else you want to talk about while we are together?”
    Then document the conversation!

    Notice I avoided blaming Suzie.  I avoided saying anything that might overly cause her to get defensive.  And I used WE instead of YOU.  The only people who are going to have problems when you use a method that is more positive overall is the truly toxic employee.  But this can be a good thing as well because what is happening is the employee is basically telling you straight out “I need to stop working here”.

    4) Termination:
    It will happen to all of us multiple times that if we run a business we will need to terminate employees.  Here are a few tips to help make this a smoother process:
    – Always stay short, concise, and limit details.  In most cases the employee already knows it is coming. The less you talk, the less chance someone gets emotional or causes a scene.
    – Always get things in writing.  Like clinical dentistry, employment rules are all about documentation.
    – Always have a witness.  This helps avoid he said, she said arguments later.
    – “Things are just not working out” is a great way to answer the question “Why?”.  You never want to give the employee a reason to come back later and say you terminated them for an illegal reason.  Again, they almost always know why anyway.
    – In your documentation, to avoid unemployment, you need both a log of problems and training that was done to try to solve the issue.  And the stated reason for termination should be something like insubordination or things that are illegal or harmful to patient care.  Something like “employee refuses to follow standard procedure after multiple training attempts, leading to patient safety issues”, will often get the state to side with you if you have supporting documentation.

    5) Resignation:
    Any time you can get an employee to resign instead of being fired, life is much easier.  The absolute most important part about a resignation though is getting it in writing with a date and have the employee sign it!  This will release you from all legal claims and unemployment claims.

    If you ever offer severance pay (1-2 weeks of pay when you let someone go) make your office manual state that only employees that resign in good standing will receive it.  This way you incentivize your employees to resign instead of making you fire them.  You should NEVER EVER give it to someone that you are having to fire, unless you are doing it for purely emotional reasons (you feel bad for them).  And of course most people will tell you that running a business off emotions is a bad idea.  I would say you should never feel sorry for them.  If YOU did your job right as a leader and gave the employee plenty of opportunity to get training and improve, then THEY did it to themselves and you cannot help them with their poor life choices.

    6) Source of toxicity:
    We all can point to patients we see that come in with the concern “I just don't understand why I keep having dental problems”…..and they do minimal home care, consume acid and sugar like they are water, and infrequently see a dentist.
    Another example we see in life is someone who asks why they cannot find a good spouse, but have been divorced 4 times.
    In both scenarios at some point the problem might be internal, not external.  How many relationships have to end before someone realizes the problem is themselves?

    The same goes for running an office.  Unfortunately, often times the problem is the leader.  If you are having a run of toxic employees, it might be time to look at yourself and your office instead of blaming all the people that keep not working out.  Here are a few things to think about:
    – Are you trying to hire the right people?
    – Have you run a behavior test on new hires, and do you know what behavior profile you need for that job?
    – Are you looking for attitude first and skills second?

    – Are your interview skills up to par to ask the right questions and see red flags?
    – Are you hiring people out of desire to find the right person, or out of desperation because you NEED someone NOW?  Are you “settling” for someone?
    – Are there good systems in place that someone can be successful at the job, or are you just winging it?
    – Do you have a solid training protocol for helping new people?  Written with pictures or video?  (No,verbal is NOT adequate in most cases).
    – Are you giving GOOD feedback on performance?
    – Are YOU an easy or hard person to work for?  Are YOU a consistent leader that always wants the same things that are predictable?
    – Are YOU doing everything possible to help your team succeed?
    – Are YOU emotionally stable at work?  (Yes, guys too)

    These can be difficult questions to ask, but they are highly important to help YOU as well as your team function effectively and without drama.

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