The old Silicon Valley adage “hire slow, fire fast” is actually apt for any type of small business, including medical practices. The smaller the team, the more powerful this idea is, because as team size shrinks, each member’s contribution becomes more critical to success. Moreover, a single poor performer or “bad apple” can disrupt a smaller team much more effectively than a larger one.
Medical offices are generally small operations where everyone knows a lot about each other, and sometimes it can feel like a family. And firing a member of your family … now that’s hard! You want to be that nice person who supports someone who’s having a tough time. That crabbypuss who comes in late every day, “forgets” to do the insurance checks that are her primary responsibility and never seems to notice when charts are lying around waiting to be re-filed has a family to support after all. Oh, gosh, do we really have the heart to fire her?
Well, the problem with that “nice” thinking is that while you’re being very, very “nice” to the poor performer, you’re being decidedly NOT nice to everyone else on the team. They’re all picking up after her, correcting her mistakes, putting up with her lousy attitude and starting their full work-day on time — without Ms. Crabby, who’s late again. Left unaddressed, this situation kills the morale of the good performers — who may start performing poorly themselves or just leave for a job where they feel good work is recognized.
Here’s a nice essay on the subject from the CEO of Gilt in Inc magazine — Gilt is an internet shopping site, seemingly with little in common with medical practices, but Kevin Ryan’s observations are instructive for any sort of business.