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When An Employee Makes You Nuts


What do you do with an employee who is driving you crazy and causing premature baldness? Most dentists have a conversation with that person – sooner or later—but see varying results. Sometimes, they have multiple meetings which also lead to very little change. I’m working with a dentist who’s facing this issue and who asked me for advice on how to approach her employee. In this article, you’ll get an inside look at a real situation and what I recommended the dentist do.

The Background

Laura is the financial coordinator in a medium sized practice. She’s worked there for 6 years after transitioning from being a DA. Her performance has had some challenges and lately has gotten worse.  The dentist has been told by her front desk team that Laura, “Doesn’t want to answer the phone or do treatment plans” and that she is cranky and uncommunicative. One employee described her as a “Negative Nancy” due to her constant complaining.

The dentist has observed that Laura shunts phone inquiries to other staff and sighs and looks annoyed even when the dentist asks her questions.  She believes Laura only wants to verify insurance and avoid any patient interaction.

Laura can be critical and dismissive of others. At huddle, she rolls her eyes when her least favorite colleague talks. When Laura speaks about patients, it can sound disrespectful. For example, Laura will declare, “This patient is a deadbeat who never pays.” Or predict, So-So is probably not going to show up today.”  When asked why she didn’t discuss the balance before the appointment or why she reappointed the chronic no-shower Laura gets defensive and argumentative. 

Curious about what the dentist should do? Here’s what I advised.

Tip #1: Identify your goals for the conversation

Before you enter into a feedback conversation, identify your desired outcomes first. I asked the dentist to describe her goals, what she wanted to happen as a result of the conversation.

She said she wanted Laura:

  1. To agree to a process of answering patient financial queries instead of deflecting all calls to someone else
  2. Change her attitude at huddle
  3. Be a better team player
  4. Stop complaining about everything and help others without the attitude

Review those goals for a moment. If you’ve worked with me for a while, you’ll notice a problem with how those goals are phrased. The first goal is good: it’s specific, action-oriented and can be measured. But the other goals are about attitude. Changing someone’s attitude is going to be a long, uphill battle. Focus instead on behaviors. If you want an employee to change, you need to spell out what the employee needs to do differently. And those actions need to be phrased as something to DO, instead of what to STOP doing.

Working together, the dentist and I crafted new goals for her conversation. Her new outcomes are:

  • Laura will meet with the OM to write down which calls she will respond to and which calls she needs to forward to someone else
  • At huddle, Laura will use non-judgmental language when describing patients. “This patient has had a history of…”
  • Laura then needs to describe her actions to change patients’ behaviors. “This patient has had a history of late payments, so today I will ….”
  • Use more neutral non-verbal communication and respond to others requests and questions with a way to help.

Tip #2 Describe the consequences of the negative behavior for the employee

When asked, most bosses describe consequences in terms of punishment. “If you don’t do X, then I’ll have to do Y.” This has varying success in changing behavior. It creates a parent/child dynamic where the employee avoids doing wrong, simply to avoid your wrath. That completely misses the point. You want the employee to change because she sees the benefits to changing. And you want her to see that the biggest drawback to her current behavior is that it damages herself.

Most employees do care about two things: their reputation and their relationships. (If you have an employee who really doesn’t give a sh** about those things, then you have a bigger problem.) During your conversation, describe how the employee’s behavior is negatively affecting her relationships with you and her teammates and how her reputation in the practice is suffering.

The dentist and I created a script for this. It’s very direct.

“Laura, when you roll your eyes at someone or gossip and complain, the other team members realize that if you do that to one person, you can do that to them too. This leads them not to trust you. When you arrive in the morning, don’t say hello and then bang your stuff on the table, your colleagues get the message that they should avoid you. When they ask you for help and you get annoyed, then in future they are not going to want to help you out either.  Is this truly the relationship and reputation you want to have with them?”

Tip #3: Document the conversation and the agreements

Every HR person will tell you to document your performance improvement conversations in case you need to defend a dismissal. Another good reason is because it creates a work plan for the employee to refer to. Before you end the conversation, outline how you will measure and evaluate the employee’s changes.  Create specific milestones and schedule your next meeting to evaluate the employee’s progress.

The Plot Twist

Nearing the end of my call with the dentist, I asked a question which changed everything. It was a plot twist!   I was wondering why the dentist had been putting up with this for so long.

I asked, “If Laura has worked for you for 6 years, has she always been like this?”

The dentist shared that in the last 18 months Laura’s husband was jailed for a fatal DUI. She is now divorcing him.  Two weeks ago, Laura’s car died and she is struggling to afford another.

Laura’s personal life is likely a major factor in explaining her behavior at work. It doesn’t make it any more appropriate but it does put it into a larger context. We scripted the dentist’s opening lines for their conversation to acknowledge this. 

“Laura I am so appreciative of your work here in the last 6 years. Until recently, you’ve been reliable and dedicated. I recognize that things have changed in your personal life lately and I feel a great deal of compassion for your situation. I recognize that it can be hard to leave your personal troubles at the door and perhaps you haven’t realized how your interactions with us have changed. We need to talk about how to turn this around so that your colleagues and I can again rely on you.”

This opening acknowledges Laura’s circumstances but still holds her accountable.

 If you have similar staff troubles, let me know and we can create a strategic conversation.

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“As an Office Manager, I’ve seen a great difference in my practice since starting with Sharyn. Three years ago our staff was in turmoil with a lot of infighting and gossip and some jealousy directed towards me.

I had given up because everything I did was judged. Now I have learned to have more one-to-one communication and by being more vulnerable with individuals I found my leadership voice. As a team, we’re all focused on the same goals.

Last year, in August we produced $88,000. This year we’re on track to produce $111,000 this month. I know it’s because we learned how to follow through with patients and communicate our expectations while building our systems.

Sharyn has gotten us out of our comfort zone and inspired us to dream bigger and it works.”

–Sharon St Pierre, Sperbeck Dental Care

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