The adage is true: A chain is only as strong as its weakest link. Most medical practices have at least one weak link. It may be an overly negative employee or a chronic underperformer, but even one toxic staffer can dramatically affect the bottom line and cause resentment and unrest among other workers. Here are five types of problem employees and what to do about them.

Problem Employee No. 1:
The Snarky Staffer

Do you have one employee who continues to disrespect your authority in front of others? You know the type: Someone who mouths off, rolls their eyes, or just seems to do as they please. This type of behavior can be contagious, and soon your whole staff may start to follow suit.


If any problem employees are terminated, make sure to protect yourself and your practice by:

• Consulting with an attorney in your state who specializes in human resources in advance. Employment law differs from state to state.

• Immediately changing the locks and security codes to the building if the ousted staffer knew them.

• Changing computer logins and passwords immediately.

• Walking them to their office, watching them gather their belongings, and walking them out of the building. Most practices opt not to allow the employee a chance to say goodbye to other employees.

• Holding a staff meeting immediately to let the team know that the terminated employee is no longer a part of your team.

What To Do: Address the issues immediately. Make sure to put a warning in writing. Let the employee know that if the behavior continues, they will be terminated.

Problem Employee No. 2:
The Bungling Burglar

Are your office supplies leaving the building faster than they should be? Have patients reported things missing from treatment rooms? Does your ledger show checks written to unfamiliar companies? If so, it could be an inside job.

What To Do: Adopt a zero tolerance policy for theft. Proof of theft is key. Consider a lie detector test if necessary. There are degrees of theft. If a trusted employee took a box of pens when their kids went back to school, place them on written warning. If it is something more serious, like theft of cash or pricey equipment, terminate the employee immediately upon discovery.

Problem Employee No. 3:
The Addict

Is your once crackerjack office assistant now consistently late? Does s/he take less pride in his or her appearance and work? Is s/he calling out sick more regularly? Substance abuse is a disease and it doesn't discriminate. Alcohol or drug abuse can cause an employee to take risks that will put your practice and patients in jeopardy.

What To Do: While some states allow drug testing of a single employee with a valid reason, others urge you to conduct drug testing across your company. Make sure all employees are aware of your drug policies upon hiring and acknowledge said policy in writing. Also, let them know that help is available, and that they will have a job when they get clean and sober. The Substance Abuse and Mental Health Services Administration ( offers listings of residential, outpatient, and hospital inpatient treatment programs for drug addiction and alcoholism throughout the country and the National Institute on Alcohol Abuse and Alcoholism ( offers information on alcohol, alcohol use, and treatment of alcohol-related problems.

Problem Employee No. 4:
The PTO Enthusiast

It starts with one day off for a migraine and then leads to days at a time. It could also be a chronically sick employee, a pregnant staff member, or someone who is just milking your paid time off (PTO) policy, but when an employee abuses sick days, it can affect the bottom line.

What to do: All employees should be clear about PTO policies upon hiring . The ailing employee may want to consider short- or long-term disability if needed.

Problem Employee No. 5:
The Square Peg

Sometimes a new employee just doesn't gel. It's not that they are late, incompetent, or rude, they just may not fit in and this can cause discord in the office or exam room.

What To Do: Team-building exercises may help. Also, consider assigning the employee a mentor to help them better acclimate to the ways of your practice. If the situation doesn't get better after several months and efforts, it may be time to part ways with the employee. n

Jay A. Shorr BA, MBM-C, CAC I-VIII is the founder and managing partner of The Best Medical Business Solutions, assisting medical practices with the operational, financial and administrative health of their business. He can be reached at

Mara Shorr, BS, CAC II-VIII serves as the Vice President of Marketing and Business Development for The Best Medical Business Solutions. She is a Level II - VIII Certified Aesthetic Consultant utilizing knowledge and experience to help clients achieve their potential. She can be contacted at


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