Who Should Fire Medical Practice Staff?

Physician owners need not personally be present when staff members are dismissed. Depending on the size and structure of your practice, it may make more sense to have the office administrator or an immediate supervisor deliver the news, with a second manager present to witness what was said.

Regardless of whether they are physically in the room, however, it's up to the physicians to ensure that the language used is professional. "The goal of a successful termination session is to make it as least defensive as possible," says Roer. "Many people are so uncomfortable with the act of firing someone that they turn it into a blaming session. 'You did X, Y, and Z and you are the most awful person and you have to get out of here immediately.' That's completely unnecessary."

Her suggestion? Simply tell the employee you've decided to terminate their at-will employment, thank them for their service, and let them know you've decided to go in a different direction. "Make it as simple and straightforward as possible," says Roer.  Specifically, avoid details about their infractions, she adds, which encourages your already emotionally charged employee to challenge the decision or consider avenues for legal recourse.

And unless the security of patient records, your staff, or office property is in question, don't humiliate dismissed employees by escorting them out of the building. "I strongly recommend against escorting them out," says Roer. "I cannot tell you how many years of depositions I've heard from employees who said that being escorted off the premises, and being made to feel like a criminal, was one of the most damaging scars of the process. What you will gain will be so minimal compared to what you may lose."