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Trojan Today Classic: “Difficult Employee? No Problem!” by Tim Twigg and Michelle Allen

Trojan Today Classic | Tim Twigg & Michelle Allen | Difficult Employee? No Problem!

Originally published April 2014 in Trojan Today.

If you are an employer, at one time or another (if not already), you will have to deal with a difficult employee. 

For many practice owners and managers, the question becomes, “How did I get this employee working for me in the first place? Why didn’t I see the signs and how do I get them to correct their behavior?” In many cases, the behavior has been going on for so long you just want to get the employee out of the practice.

You know the employees: Negative Neal, Cell Phone Sally, Bullying Barbara, Know-it-All Al, Confrontational Connie, Better Late-Than-Never Lisa, and her cousin, I-Will-Come-to-Work-When-I-Feel-Like-It Felix.

Maybe you inherited some of them when you bought or took over a practice; maybe you missed signs of their true character when you interviewed them; and/or you didn’t do adequate reference checks to learn difficulties or problems experienced by previous employers. Now, here you are, feeling stuck.

To minimize the emotional stress and financial toll of a difficult employee, you need to proactively deal with the situation sooner rather than later. Prolonging the agony is not fair to your good employees and sends a message condoning poor behavior, bad attitude, and/or lousy job performance. 

Once you find yourself in one of these situations, there are steps you can take to either correct the behavior or, if necessary, end the employee’s employment on more positive terms. This means learning basic management skills and gaining the confidence to proactively address the problems.

Negative Neal

This is the employee who sees the “glass half empty.” Neal constantly complains about policies and procedures; and when you make adjustments to your policies and/or procedures, he complains about those too. He will openly let you know your long-term employees don’t do their jobs right and the new employee you just hired doesn’t have a clue. Neal’s skills are good and meet your expectations, but his negative attitude is poisoning your practice. 

Cell Phone Sally

his employee finds it absolutely necessary to have her cell phone with her at all times. She will text and check her email during staff meetings; or tucked away in a private corner of your practice, she will take calls when she is supposed to be working and give you an attitude when you request the cell phone be put away or turned off.

Bullying Barbara

This employee asserts her will on everyone, even you. She manipulates every situation for her benefit by using condescending language and tone to make people uncomfortable and less likely to express their views, ideas, or opinions. She may even carry herself physically in a way that seems threatening. Ironically, your patients really like her; she does her job well and puts on a pleasant face whenever they are near.

Over time, you find this employee is controlling you and your practice; and your employees are scared to have an opposing opinion. Everyone is avoiding confrontation at all costs. A number of fantastic employees have resigned as a result, and you realize your practice really is run by Bullying Barbara.

Know-it-All Al

his employee knows everything, at least he thinks he does; and he does not hesitate to tell you, your co-workers, and your patients. He questions your decisions at every turn and does not have a problem publicly stating you are wrong in front of other employees and/or patients, causing awkward and uncomfortable moments.

Your employees know he is a self-proclaimed know-it-all; and your patients, especially your new ones, are starting to doubt your credibility and have started looking for a second opinion or have changed providers altogether.


This employee is late more often than she is on time. She always has a major emergency that just happens to come up right before she is due. Sometimes she will call to announce she is running late. Other times no one knows what has happened to her and she is surprised you and your staff are upset she is an hour late and did not even bother to call. You have talked with her on numerous occasions resulting in an immediate change that falls back to old habits within weeks.


This employee truly has no real interest in your practice succeeding. He comes to work when it fits his schedule and makes it clear his personal life takes priority. He may or may not call in his absence and will take time off for doctor and personal appointments to maximize his time away from your office. 

Initially his requests for time off and excuses for his absences seem legitimate, so you worked with him. Now that time has passed, you realize your staff completely resents him and wonders why you keep this guy around. His absences are causing patient care to sink below your standards and you realize a change needs to be made immediately. 

What is the best course of action when dealing with these types of difficult employees?

As you can see, all of these personalities bring great challenges to any practice. Don’t think these challenges will magically go away; they rarely do. The longer you wait to address these issues the more problematic each of these difficult employees becomes, at times creating mass destruction in their wake.

First, make sure “your house is in order.” Namely, make sure your policy manual is current and up-to-date; have signed acknowledgements and employment agreements with each employee; and have comprehensive, up-to-date job descriptions for each employee and position, including essential duties and core attitudinal and performance competencies.

Your policies, coupled with the essential duties and core attitudinal and performance competencies on the job description, form the foundation, basis, reasoning, and/or justification for counseling an employee regarding job performance or poor behavior. These also support consistent, effective, and fair staff management that is objective rather than subjective.

Second, ensure you have appropriately and objectively documented the past poor job performance issues. Focus on performance-related issues, not the emotions that surround them. This may include supervisory notes describing your verbal remedial intervention and the employee’s response or a formal performance evaluation.

Third, have a private meeting with the difficult employee and discuss how attitude, behavior, and/or comments are affecting your patients and the overall operation of your practice. Clearly explain your expectations, referencing your policies and the employee’s job description as needed.

If appropriate, solicit solutions from the employee. Some employees may be more open to assisting with the solution than others. When employees are part of creating a solution to the area(s) of concern, they tend to take more ownership of the situation, which increases the chances for a change in behavior.

Employees who are negative, confrontational, or who like to bully do not always see themselves in this negative light. They may be resistant to what you have to say. This is not the time to back down but rather the time to insist on change and, if applicable, articulate the course of action they should take to make that change.

What happens if the difficulties still persist? Then you meet again with your difficult employee, taking a more formal approach through a written employee-counseling memo. During the meeting, note there has not been the necessary improvement needed to meet your expectations regarding attitudes, behaviors, and/or other issues. Once again, use specific examples on the counseling memo and relate those examples to how their negative attitudes, behaviors, and/or other issues are affecting your practice. This is also the time to let your difficult employee know further disciplinary action, up to and including termination, will follow if changes in behavior don’t occur.

By following the steps mentioned, you not only give your difficult employee the opportunity to change, you also are documenting the legitimate, nondiscriminatory reasons for termination if your difficult employee does not heed your counseling and make the necessary changes to be a productive member of your team. Since difficult employees may be in a protected class (such as age, disability, religion, national origin, or ethnicity), your documentation is key to supporting your decision for termination and keeping discrimination and/or wrongful termination claims at bay.

Do not be held captive by your difficult employee. Take action to create a better working environment for yourself and your employees. No employee is indispensable – especially one that is adversely affecting your practice. There are good employees out there waiting to be discovered.

Tim Twigg is the President and co-owner of Bent Ericksen & Associates, a leading authority in human resources and personnel management in the healthcare industry, helping dentists successfully deal with the ever-changing and complex labor laws. 


Read more from Bent Ericksen & Associates authors:

Trojan Today: “Onboarding and Engaging Employees: Are You Doing Everything You Should?” by Rebecca Boartfield – Trojan Professional Services (

Trojan Today Classic: “The Value of Standard Operating Procedures” by Tim Twigg and Rebecca Boartfield – Trojan Professional Services (

Trojan Today: “Setting the Culture: Negative Policies & Your Team” by Alan Twigg – Trojan Professional Services (


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