January 30, 2014



Am I ready to fire my medical assistant?  She has been a problem for some time now and this morning I came in to her printing personal materials, inappropriate for the office.  I think I'm ready to part ways.  What now?

Thanks, Dr. G


First, I definitely cannot answer whether emotionally you are ready to terminate an employee. Most employers do not take such a decision lightly, especially given the job market, with the exception being a certain hospital system responsible for many year-end terminations (by letter).   Second, the emotional component is certainly not the only component to whether or not you are ready to terminate.  Additional considerations include, but are not limited to:

  • practical implications of terminating an employee - what will the work load be once the employee is gone?  Do you need to hire a replacement or have someone trained to step in prior to terminating?  Does the employee have company property?  Laptop at home?  Keys?  Does the employee have access to secure patient information? 
  • legal exposure - have you classified/paid the employee properly?  Have you paid the employee proper wages?  Overtime? Sick days?  Does the employee have "the goods" on you, knowing what your practice may or may not do perfectly?  Have you planned separation properly (documented appropriate) so there is a mitigated chance for a successful claim of unlawful termination?
  • severance / release - is the employee entitled to any contractual severance?  Would you feel more comfortable parting ways with a release in place?  Are you prepared to pay severance in exchange for a release? Be advised any employment law release from a terminated employee must contain a provision (for NY) authorizing the employee to consider the agreement for 21 days - creating a delay in separation.
  • benefits - are you ready to present the employee with his/her benefits coverage and options post-termination?
  • restrictions - is the employee a party to a contract prohibiting solicitation or competition?
  • patient retention - if the individual practicing is looking to work elsewhere, will the practice agree to  provide patients with forwarding contact information, as required by the AMA ethics opinions?

Answering yes to some of the above, no to others, certainly does not result in a definitive, yes, or, no; that you are ready to fire.  The above list is not meant to be all-inclusive, but examples of areas of concern when terminating.  Each situation is different; with different circumstances and different people involved.  If you are questioning the termination process, separation or factors to be taken into account when making such decisions, do not hesitate to reach out to discuss.  An easy way to invite exposure into the practice is by terminating an employee hastily, without proper documentation, support, witnesses or process, all of which can be avoided with assistance and preparation.