Firing an employee is one of the toughest decisions a dentist can face. No one likes to be in that position, and no one likes to do the firing either—unless you're the type of person who enjoys making others uncomfortable. But hopefully, that's not the case.

As healthcare professionals, we understand that terminating an employee is a difficult situation that requires careful thought and handling. In my 40 years of practice, I’ve had to let go of some employees, but in almost every case, the reason wasn’t poor performance. If someone isn’t performing well, it’s often my fault for not hiring the right person or not providing the right training. More often than not, the issue comes down to a crisis of integrity.

The Importance of Integrity in Your Practice

One of the core values in our practice is integrity. Integrity is inviolable—if someone doesn’t have strong integrity, they cannot be part of our team. We cannot have people working for us who are dishonest, who lie, or who fail to show up when needed. For instance, if someone calls in sick and doesn’t show up, it hurts the rest of the team.

The most critical area of integrity involves actions that break the law—such as stealing or drug use at work. Unfortunately, these situations can happen, and when they do, I do fire the individual. However, these circumstances are rare.

Not All Performance Issues Lead to Termination

In most cases, it’s not a lack of performance that leads to termination. Sometimes, not everyone on the team is a good fit for the practice. It’s a reality today that people don’t tend to stay in one job for decades anymore. The average length of employment in the United States is around 1.5 to 2 years. This is a far cry from when I started my practice, back when General Electric was the largest employer in town, and people stayed for 30 years to earn their pensions.

These days, people are much more likely to jump from job to job. But despite this trend, I’m fortunate to have a lot of long-term employees. In fact, over 25 people in our practice have been with us for double-digit years, with a few approaching their 20th year. I’m incredibly proud of that, as it shows that people enjoy working here and want to stay.

How to Handle Firing Without Directly Doing It

When it comes to firing someone, I rarely have to make that call directly. If someone isn’t working well with the team, it starts to affect the rest of the group. The saying goes that a chain is only as strong as its weakest link, and the same is true for any organization, including a dental practice.

Employees are volunteers. They don’t have to be there; they can go somewhere else for a paycheck. But most employees want to do more than just collect a paycheck—they want to contribute to something greater than themselves. People seek work that provides them with a sense of value, purpose, and fulfillment.

I know this is true for me too. While making a living is important, what I value most is being able to provide tremendous value to others and make a positive difference in their lives. It’s what Darlene Kane and Ken Waters talk about—providing high value and doing meaningful work.

How Employees "Fire" Themselves

If I have an employee who isn’t giving their best—someone who is lazy, dishonest, or unkind to the patients or the team—I don’t need to say anything. The rest of the team will notice, and they will respond to that person accordingly. Life is a reflection of who you are being, and if an employee is not living up to the practice’s values, it becomes apparent in how they interact with others.

This kind of employee will eventually feel uncomfortable in our practice. They might start showing up late, not engaging with the team, or showing signs of disengagement. Over time, they will often decide to leave on their own. They might seek a job elsewhere where they can behave in ways that don’t align with our values.

I’ve found that this happens more often than not. Employees usually "fire" themselves. They stop coming to work, or they arrive late, and before long, they realize that the practice isn’t the right fit for them. I’ll help them find another job that might be a better match. I always wish them the best because, at the end of the day, I want everyone to have the best possible life they can—whether that’s in our practice or elsewhere.

Firing Due to Integrity Issues

There are, however, times when firing someone is necessary due to integrity issues. Whether it’s theft, drug use, or inappropriate behavior, these are the types of issues that require immediate action. Fortunately, this type of situation is rare. When it does happen, it’s a clear decision and one that can’t be avoided.

But for the most part, the employees who aren’t a good fit for our practice will eventually find their own way out. It’s not about making an uncomfortable decision to fire someone—it’s about creating a culture where everyone knows what’s expected and values integrity, honesty, and teamwork.

Conclusion

In my experience, firing an employee is a last resort. If someone isn’t performing well or causing issues within the team, it usually boils down to a lack of alignment with our core values. The key is to create a positive work environment where everyone is motivated to contribute their best. When someone isn’t aligned with those values, they typically recognize it themselves and move on.

By focusing on maintaining a team that values integrity and collaboration, you can avoid having to fire employees. But if the time comes, handling it with professionalism and empathy will ensure that both your practice and your team continue to thrive.