Get the Latest News FASTER - View Digital Editions Now!
Operate Your PracticeSupport Your PatientsExpand Your CareEquip Your Clinic

April, 2016

Building the Right Team: Hiring and Firing Do's & Don'ts

By Noel Lloyd, DC

Dr. Nick loves practice, but this morning he dreaded his drive to work. For months, he's known he needs to fire his front-desk CA, but still hasn't. This isn't the first time Nick has found it difficult to let someone go. In fact, he has a pattern: He hires in a hurry and scrimps on training. If he's lucky, the new employee catches on and hangs in there.

It gets worse: Nick also has trouble giving employees encouragement or correction. Eventually, their mistakes make him angry and he ends up stuck: hating their work, but unable to fire them. He tells himself one or more of the following to excuse his lack of decisive action:

  • "It's my fault. I haven't trained her properly."
  • "But my patients are crazy about her!"
  • "She used to do great work."
  • "Who'll do the job if I fire her?"
  • "Can't fire her today, we're too busy."
  • "Maybe I'll give her one more chance."

Deep down, he knows these are just excuses, but he doesn't have the skills to face the problem.

The Challenges

Nick's not alone. This story is repeated every day in practices around the world. Why is firing so hard? Just hire people when there's work to do and say goodbye when they can't or won't do the work. Sounds simple, doesn't it? It isn't.

In fact hiring, managing and firing people is the biggest stressor in an established practice. Furthermore, as a practice owner, you'll always be hiring or firing someone – so my advice is get used to it and get good at it. Here's how.

My Epiphany

hiring and firing - Copyright – Stock Photo / Register Mark Years ago, I owned five busy practices, a marketing company and my current business. We were literally hiring and firing on a weekly basis. I remember suddenly understanding that the coming and going of employees was normal. Letting someone go wasn't personal; we just weren't a good fit.

Firing wasn't fun, but if you fired well, everyone felt better – maybe not immediately, but soon. This realization allowed me to hire and fire with a clearer head and little negative emotion. Let's review the guidelines I still use today to make the process of hiring and firing easier on everyone.


  • Define the work you want done in a clear job description with a complete checklist of each task for the position. This will make it easier to find your next superstar.
  • I hire CAs in a group process. I save time by explaining the job and team standards to 4-12 prospects at a time. We administer written tests and follow with a private interview to select finalists.
  • We invite the top 1-2 applicants back for a working interview. They observe and participate in a paid job audition. Do they engage? After two hours, are they still excited to step into the position? How will they work with us and our patients?
  • I check all references, Google them, check their Facebook profile and run a formal background check.
  • As a final selector, I use Nordstrom's axiom: "Hire the smile, train the skill."
  • I never hire the long commute, the person who used to earn more than I'm offering, or someone who's had three or more jobs in the past two years.
  • I look more for potential, not just experience, and seek to hire the rising star I can train in my systems and procedures.

Hot Tip: I'm convinced too many chiropractors don't train enough, but that's another article. You can increase your chances of a good hire by putting your new employee into a comprehensive training program.


I'm guessing you're better at staff development than our fictitious Dr. Nick, but sooner or later, you'll need to let someone go. Here are my best tips for disengaging.

When should you fire? I've never met a person who felt they fired too early and everyone I've asked usually fires too late. If you think it might be time – it usually is.

  • Example #1: The nice person who can't do the work and you're giving them their 12th chance. Not all people can do this work and if the job is beyond their capability, let them go. The right person can do the work easily.
  • Example #2: The person who won't do the work – the one with the attitude. It's time to bid farewell. Life's too short to work with people looking for an argument. You'll be amazed what patients will tell you about "that one" after they're gone.
  • Example #3: The employee you catch telling lies, cheating or stealing. They need to be let go ASAP. You may even need to contact the police, but check with your attorney first.

In examples #1 and #2, I try to make the relationship work with extra training, verbal warnings and written warnings. However, when you know it's not going to work, let them go. Keeping bad employees, even if they're nice people, can demotivate your team and make the practice miserable for everyone.

When It's Time to Fire, Use These Guidelines

  • Fire when the time is right for you: end of the month, week or shift; typically after work.
  • Have a witness: a staff person at the termination to protect your position.
  • Never make firing personal: If you're angry, you've waited too long. Never give a fired employee a reason to seek revenge.
  • Set the termination meeting: "Gina, at the end of your shift, meet me in my office, please."
  • Keep it short and sweet: "Gina, I need a different result in our marketing and I've decided to rehire your position. I'm letting you go, effective immediately. Would you like me to explain why?" (They usually know why.) "I'm sure you'll do well elsewhere and I wish you the best. Brittany will take your key and help you with your things."

Hot Tip: Before they're out of the parking lot, change all their passwords and never – and I mean never – hire them back. No exceptions. And never badmouth a fired employee to remaining staff. It's beneath you.

You may need to scramble to fill a position, but that's a smaller problem than a bad employee, and I promise your drive to the office will be pleasant again – except for the traffic. Now get out there and find the right employee to fill their position!

Dr. Noel Lloyd graduated from Palmer College of Chiropractic in 1971 and became the youngest practicing chiropractor in Washington. He is the founder and head coach of Five Star Management, a professional training, coaching and consulting service based in Seattle, Wash.

Complete Company Directory Articles:


Other DCPI articles by category:


Chiropractic Events
  • Seminar
  • Online


Operate Your Practice Support Your Patients Expand Your Care Equip Your Clinic