The great dilemma: Should she stay or should she go?

2013 05 29 10 37 53 47 Knowles Lisa 200 20130529173836

Agony. It's pure agony when we have to fire someone. No one wants to make the wrong decision when it comes to firing a team member. Ironically, I believe agony is what triggers a change; I have to be in some kind of pain to overcome the natural tendency to do nothing. Sometimes it's my pain that forces my inaction into action, and sometimes it's the team's agony that forces me to do something.

Regardless, this "do something" part is the dilemma dentists hate to consider. Often, an employee just stalls on the tracks. If we leave the stalled employee on the track, a wreck is sure to occur at some point. So, we must help the stalled employee off the track -- one way or another.

When trying to decide what to do with a stalled employee, I recommend these guidelines:

Consider where the employee is struggling

Is it a lack of training or a lack of resources? If the answer could be yes, revisit training and review job expectations from all angles of learning.

In other words:

Lisa Knowles, DDS.Lisa Knowles, DDS.
  • Talk it through: Have a one-on-one conversation about expectations and/or procedures in question.

  • Chalk it through: Write down the needed information and expected changes for the employee. This helps the team member and it serves as a paper trail for future discussions. This also prevents he said/she said situations.

  • Walk it through: Actually do the procedure with the team member. There is nothing like hands-on learning. Encourage questions along the way, and ask the employee to repeat back the information to ensure mutual understanding.

Many employees are reluctant to ask questions for fear of looking incompetent; some lack the confidence to speak up and ask questions. A three-step approach (talk, chalk, and walk) helps identify hidden learning aspects and gives the employee one more chance to prove himself or herself. It also gives the dentist or human resources manager (if so lucky to have one) one more time to be a better teacher and trainer.

Early on, I did not consider learning abilities, and I did what I knew best: tell someone how to do something. Worse, I expected the person to do it exactly how I pictured it in my head. Writing it down and actually going through the motions with the team member proves to be a much better way to help an employee succeed and understand expectations. It is more time-consuming in the short term, and that is often the enemy of complete learning. However, in the long term, a more thorough learning method helps retain employees. Also, if the time comes for employee termination, the dentist assuredly makes a final decision.

Go into data-gathering mode

Observe the interactions between team members. Privately ask one or two key team members for their advice on the situation; they see their teammates in action much more than dentists do. They will know how the employee got stuck on the tracks. Cautiously take the recommendations of the person's peers. Underlying personal issues might make it difficult to get an unbiased opinion. Complete careful observation of the employee's behavior and attitude with patients. This is a healthcare profession. If something interferes with consistent care for patients, the employee cannot be a part of the team.

Act on no-brainer behavior

If an employee lies or steals, fact-find first, and then address the behavior with swiftness. In several cases, I thought one thing was occurring, and in reality my overparanoid mind led to premature conclusions. Hence, let me emphasize the fact-finding part again. Ask questions versus immediately blaming someone. When time is short, it is harder to fact-find and easier to blame. It is worth taking the time, however, to ensure proper conclusions are being drawn.

If one person is left on the tracks, an entire pile up can occur behind the stalled employee. If no action is taken on true, inappropriate behavior, other team members will become discouraged and possibly leave the practice. Help the employee off the tracks; this will allow others to flow through the bottleneck again.

Inevitably, dentists have to deal with the great dilemma of, "Should she (or he) stay, or should she go." Human resource management is not familiar to most of us. We struggle to make next-step decisions when it comes to an underperforming employee. With basic guidelines, however, even the most stuck employee can be helped off the tracks --sometimes this is done through training, and sometimes this is done by helping an employee find a better fit with a different employer.

Completing proper protocols and careful documentation cannot be overemphasized. We certainly do not want to derail our goals and progress because of unfamiliarity with human resources knowledge.

Lisa Knowles, DDS, is the founder and CEO of IntentionalDental Consulting. For more information, contact her at or 517-331-3688. Visit her blog site at or website at

The comments and observations expressed herein do not necessarily reflect the opinions of, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.

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