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    How to keep toxic employees from harming your practice


    Judy BeeJudy BeeToxic employees can be a drag on your medical practice, sapping the morale of your staff and impacting how your patients view you. Here are some tips to help you identify and manage toxic employees, and provide these workers a chance to shape up before you have no choice but to ship them out.

    Physicians value technical skill in a worker over almost everything else. Of the three components of employee evaluation—attitude, availability and ability, physicians are inclined to forgive lapses of the first two where the employee has high procedural capabilities. “Yeah, she’s a tough nurse but she’s good.”

    In the operating room, that may make sense. But in the office, tough is inherently bad. An employee who is cool or clipped with patients or co-workers is a public relations or management liability, no matter how skilled. And tolerating it often erodes morale in the rest of the staff and generates turnover. We call workers with reliability (on time, every day) and attitude problems toxic because they poison the atmosphere where teams need to grow.

    On any performance review for office staff we stress three parts of the performance:  Availability, Attitude, and Ability, in that order of priority.  It is true of almost every job in the office: If a worker brings the first two qualities and an average IQ to work, you can teach him or her what to do to succeed. 


    Some practices experience high absenteeism and late arrivals.  That might not be a problem for a hospital with large numbers of workers with flexible schedules and redundant systems for coverage. 

    In a smaller practice with ten employees, having one out for any reason is a problem.  With three employees out it can be a disaster.  Even though there are good reasons to be off work—child care, illness and the like—you depend on the worker. If he or she is not reliable you are not being well served no matter how good she is when she shows up.  The remaining staff gets grumpy when pushed to their limits over and over, and they may also start taking “mental health days” in retribution.  That generates resentment and depresses physician production.


    Most people say it’s too subjective to fairly evaluate employees’ attitudes.  But here are real examples of good attitude that, if not present, affects the practice:

    • A cheerful demeanor no matter how stressed.
    • Courteous and cooperative at all times.
    • A willingness to help the team all of the time, not just some of the time.
    • Clean and professional appearance every day, all day.
    • Considerate of other’s time and feelings.
    • A willingness to give co-workers the benefit of the doubt.

    Remember, attitudes are contagious, both good and bad. 

    If you don’t believe it, go visit a depressing office in your town.  Where do they get all those drones?  They don’t hire them. The office environment helps create them. 

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    • Ms. SJantz
      I really found this article useful. Thanks for putting it in. I'd like to see more Judy Bee articles. I would like to have more regular articles on personnel topics - toxic emp, how to fire someone, how to respond to inquiries regarding past employees, ways to motivate employees, ways to reward good behavior, ways to help a troubled employee. We are a small practice in a small town -- we can't be careless about these things.

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