Staff Management

How Firing the Bad Apples Can Enhance Employee Satisfaction & Profitability

Dr. Arnold, who is now retired, with his former practice team. Dr. Arnold says that he learned the value of not letting poor-performing employees linger in his office.

Maintaining employee satisfaction in optometry practices

By Thomas P. Arnold, OD, FSLS

Feb. 5, 2025

I freely admit that one of my sophomoric habits is trading funny Facebook memes with a good friend. Another close buddy has said, “We are still emotionally 15 years old, just in a higher tax bracket now.” One such meme turned out to be the inspiration for this article.

Recently, I came across a post that simply said, “Nothing will kill a great employee faster than watching you tolerate a bad one.” While not a “knee-slapper,” this anonymous quote resonated with me.

In my experience of many years in private practice, I can testify to the truth of this simple statement.

The Importance of Employee Dynamics in Practice

As professionals in a healing capacity, I think that, as a rule, optometrists are tolerant and caring individuals. This is largely true in our interactions with both patients and employees alike, especially in a private practice.

We look for employees who have similar characteristics and personalities. Sometimes, however, we can be fooled.

An example is the staff member who interviews well, says all positive things, is generous with praise and complimentary to the doctor. Once in their position, however, they become a “splitter.” That is someone who forms a clique where they are the center. They divide the office between the “in group” and the “out group.”

This can be very subtle at first. Over time, one may notice that a group might band together and exclude others; particularly in cases where teamwork breaks down. Clues may be statements such as, “That is optical’s job (or “Susie’s” job).” Or simply observing that things are falling through the cracks – jobs left unfinished or lacking follow-up.

The Cost of Tolerating Poor Performers: Understanding Revenue Loss

Previously, I have written that our practice routine was to start every week on Monday morning with a one-hour staff meeting. It was an open forum where every staff member could raise issues, voice concerns, share observations and make suggestions for improvement. This is a great opportunity to air concerns in public in a non-confrontational manner.

Ideally, all the staff can see that the doctor is aware of problematic situations. This provides the practitioner the chance to be an arbiter. This is the ideal condition when employees feel confident that they can speak freely without fear of reprisal.

If the problems continue, then the practitioner’s next step is to privately counsel the employee who is creating difficulties.

Hopefully, this can impress on the individual the disruption that their behavior is causing and that the situation must change immediately. My personal experience is that this is successful about 50 percent of the time.

Some personalities are so rigid and so deeply ingrained that the employee cannot help themselves and eventually will leave if the spotlight on their behavior becomes too bright.

Unfortunately, sometimes termination is the only resort. In the early years of the practice, I would often let the problem employee stay too long…. giving them “one more chance.”

As time went on, I became more alert and aware of these situations and less reluctant to confront the person and terminate their employment.

Creating a Culture of Open Communication: The Key to Team Cohesion

Circling back to the Facebook meme, I was concerned that firing someone, even if they deserved it, would reflect badly on me and would elicit sympathy for the terminated employee from the remaining crew.

However, I quickly discovered that this was never the case. I found that if the employee was creating issues for me, their impact on the other staff was much greater.

It was not uncommon to have an employee approach and thank me for finally letting the troublemaker go. I became more attuned to these situations and less reluctant to confront them.

Another behavior that affects employee satisfaction is the responsibility of the practitioner. That is to support the staff as they execute office policy that the doctor has directed.

There is nothing more deflating or discouraging than overruling an employee in front of a patient. Patients will sometimes try to skirt the rule (e.g. co-payment; deposit on materials, etc.) by appealing to the owner. Giving in to them and failing to enforce the office policy may make that one patient happy, but can discourage the entire team.

Once patients know that the “rules don’t apply to them,” it only encourages their behavior.

The Impact of Leadership on Employee Morale: Supporting Your Staff

Over the years I was very fortunate to build a loyal team with employees who all were outstanding at their jobs.

Even though I sold the practice several years ago, and am now fully retired, many of those same employees are still active in the practice.

When asked how I was able to build such a dedicated and motivated group of individuals, my answer is always, “I fired the bad ones.”

Thomas P. Arnold, OD, FSLS, now retired, was a partner with Memorial Eye Center at Sugar Land, now a part of AEG Vision. To contact him: tarnold@aegvision.com

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