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Termination Protocol

Sept. 1, 2006
I have decided to discontinue a staff member’s employment. I should have fired her before now, but I kept hoping she would change.

Dear Dianne,

I have decided to discontinue a staff member’s employment. I should have fired her before now, but I kept hoping she would change. She has been my employee for two years, which is actually a year and a half too long. The most glaring problem is her absenteeism. My practice is small, and when anyone is absent, it puts added stress on everyone.

I have never fired anyone, so can you give me any protocol? I don’t want to break any laws, etc.

Termination Jitters

Dear Termination,

Unfortunately, this is one of those difficult managerial tasks that you probably do not learn much about in dental school. Every doctor will have to drop the ax and remove an employee one day. Many doctors lose sleep just thinking about confronting a difficult employee with the bad news.

In an informal study conducted by a major practice-management journal, the No. 1 reason for employment termination is absenteeism. Many dental practices are small businesses with adequate but few staff members. Often, no back-up systems exist, so when a staff member is absent, the office is thrown into chaos. One doctor told me that when he hires someone, he tells the new hire that he or she is not allowed to be absent. This extreme mandate seems unreasonable to me. Everyone, including doctors, will eventually miss work for some reason. That’s why it is important to have good back-up systems. (I’m not talking about chronic absenteeism here.) Being properly staffed - not overstaffed or understaffed - and crosstraining controls staffing stress.

I’m assuming your situation involves chronic absenteeism, which can create major stress on other staff members when they must carry this person’s load too often. Your inaction or procrastination can have disastrous effects. For example, you could lose good staff members when the limits of their patience is exceeded with you, your absentee staff member, or both.

First, you must be proactive and make a well-written policies manual for your practice. It should include guidelines about attendance and chronic absenteeism. The following is an excerpt from a policy manual:


Regular attendance and punctuality are expected of all employees. Repeated tardiness or absences will be considered an unsatisfactory attitude toward work. Excessive absences for whatever reasons or excuses will be dealt with in accord with our Disciplinary Procedures outlined in this handbook. Any employee who fails to report as scheduled on three consecutive days without reason or a plausible excuse will be considered to have resigned without notice. If you must be absent because of illness or an emergency, please notify Insert Name Here by 6 a.m. on the morning due to work at Insert Phone Number Here. Employees are expected to call themselves unless extreme circumstances do not permit this.

Your policy manual should also contain information about your dismissal policy. Here is a sample of the disciplinary protocol:

General offenses:

  1. Discourtesy
  2. Two unexcused absences
  3. Two unexcused tardies
  4. Smoking during working hours or on site
  5. Disregard of duty or safe working practices
  6. Poor work habits: abuse of telephone privileges (excessive personal phone calls); excessive “visiting” during work time
  7. Insubordination (neglect or refusal to obey, disobedience)

The following guidelines will be used, but each situation will be handled individually:

First violation: Verbal reprimand (note in file)

Second violation: Written warning

Third violation: Discharge

To my knowledge, most, if not all 50, states are at-will states, meaning that a staff member can be terminated at the will of the employer or employee, as long as the termination does not conflict with federal or state labor standards that prohibit discrimination on the basis of race, gender, color, religion, national origin, or age. Some states also add height, weight, or marital status to the list. Your policy handbook should have the at-will employment status of each employee with his or her signature. Keep that document in the employee file.

Document all dates of absenteeism and tardiness. Should you decide to terminate, you might need to refer to those dates. Document all conversations - telephone and in person - with absentee staff members. Good documentation is critical should you ever be charged with employment violations by a disgruntled staff member.

Most employment experts recommend using a graduated disciplinary protocol of verbal and written warnings before termination. Nevertheless, this is not mandated by law. Further, there are offenses that are egregious enough to warrant immediate dismissal, such as working under the influence of alcohol or illicit drugs and failure to maintain patient confidentiality.

I recommend:

  1. Having a witness such as your spouse, office administrator, associate doctor, or even your accountant at the termination meeting.
  2. Presenting any remuneration due the staff member, including earned vacation pay. Severance pay is not mandatory but shows good will on your part.
  3. Not engaging in long explanations.
  4. Asking for the staff member’s key and requesting that he or she gather any personal belongings.
  5. Maintaining confidentiality prior to the dismissal. Do not discuss this matter with staff members other than an office administrator.
  6. Maintaining the dignity of the staff member by refraining from rudeness, derogatory remarks, or harshness.

Here is a sample termination script:

“I want to thank you for being a member of my staff, but your chronic absenteeism and resulting effects on our daily work have caused me to make the decision to end your employment here. Therefore, your services will not be needed from today forward. Here is a check for two weeks severance pay and any accrued benefits you have earned. I ask that you please gather your personal belongings and leave your office key with me.”

If there were other reasons for dismissal and you do not wish to enter into a discussion with the departing employee, you could use this reason:

“I have plans to move the practice in a different direction, and unfortunately, those plans do not include you.”

Just remember that sometimes terminations must happen for the good of the practice. You cannot work to full efficiency if you are not staffed properly every day. Chronic absenteeism for any reason will negatively affect your productivity.

Hire right in the first place. That way, you might avoid the unpleasant specter of firing someone. Further, when you hire someone and know early on that you made a hiring mistake, don’t wait another year and a half to do something about it. Dentistry is stressful enough without your having to deal with excessive staffing stress.

While the reasons requiring employee termination are many, my advice is to fire with impunity any staff member who does not thrive and grow or who becomes a negative force in the practice. Hiring a new staff member often can breathe new life into practice morale that has been wounded by a contrary, hateful, gossipy, or otherwise negative staff member.

Best wishes, Dianne

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Dianne Glasscoe Glasscoe is a speaker, consultant, and writer for the dental industry with more than 30 years of experience. She is CEO of Professional Dental Management, Inc., in Frederick, Md. You may reach her at (301) 874-5240, [email protected], or visit www.professional