Abstract:
No one enjoys dealing with a toxic employee. However, medical practice managers must manage toxic employees effectively to protect their medical practices, employees, and patients. This article explains what kinds of employee behaviors are toxic, as well as what will happen if the manager allows toxic behaviors to go unchecked. It suggests strategies for observing and documenting suspected toxic behaviors and urges managers both to identify patterns of behaviors and to consider possible causes. It also suggests that managers prepare to confront toxic employees by anticipating their six most likely responses. This article further describes a strategy that managers can use for meeting with and following up with toxic employees. It discusses when and how to fire a toxic employee. Finally, this article suggests how medical practice managers can spot toxic employees before they hire them, and strategies for dealing with five of the most common types of toxic employees.
Have you ever had an employee who complained a lot? Gossiped? Bullied? Backstabbed? Procrastinated? Made excuses? Played the martyr? Toxic employees come in many varieties such as these. However, they share one thing in common—left unchecked, they can and eventually will destroy the culture of a medical practice. As Pavlou(1) suggests, a good workplace is founded on “mutual respect and psychological safety.” Unfortunately, respect and safety will fly out the window when a toxic employee has time and space in which to spread his or her poison. No organization is immune to this toxicity. As Pavlou warns, toxic employees can undermine even the best culture initiatives and degrade the best kinds of HR programs.
Clearly, toxic employees must be stopped, and it is up to the medical practice manager to stop them. However, this is a challenging task. As Gallo(2) warns, “Oftentimes the [toxic] behavior doesn’t run against anything legal so you can’t fire them if others in the organization don’t agree that a line has been crossed.” Fortunately, there are several strategies managers can use to disarm the toxic employee.
The Pitfalls of Toxic Employees
Toxic employees are not simply difficult employees. As Muller(3) suggests, “Toxic workers are more harmful because their behavior spreads to others. They’re not just rude; they can create a negative, highly stressful work environment.” Toxic employees often create patterns of de-energizing, frustrating, and putting down their coworkers. The whole team suffers because of the toxic employee’s behavior. As Muller explains, “Toxic employees are a drain on your organization. They deflate morale and hinder performance, their own and others’, and bring down productivity.” Perhaps worst of all, an employee’s toxicity can be contagious. As Gallo suggests, they are much like a bad apple that spoils the barrel. A single toxic employee, left unchecked, can encourage and reinforce toxicity in an entire workforce until every member of the team is infected with the poison. When this happens, the organization’s work culture itself becomes toxic and very difficult to cure.
Even the smallest amount of toxicity is not good for your medical practice.
Toxic employees can range from being mildly annoying to being outright intolerable. However, even the smallest amount of toxicity is not good for your medical practice. As Houlis(4) suggests, “Toxic employees can quickly spoil your company culture if you don’t do anything about them.” They can be distractive and prevent others from doing their work, she says. As well, they can be a drain on medical practice managers. According to Houlis, “Toxic employees are horrible for managers. They [toxic employees] often don’t get their work done on time or on par with expectations, they may demotivate managers’ teams, they’re often disengaged and they’re usually only out to help themselves. This is not the type of employee managers will want to have under their wing.”
Finally, toxic employees can end up hurting your medical practice’s bottom line. As Houlis warns, their behavior can lead to poor retention rates among other employees who cannot stand working with them. As well, toxicity can lead to negative performance and productivity standards that can have a domino effect in your medical practice. And just imagine what happens when the toxicity spills into your patients’ attitudes. Patient satisfaction, loyalty, retention, and referrals will most certainly plummet once patients get a whiff of toxicity, and with good reason. No one wants to spend time in or refer others to a toxic environment.
Observe, Document, and Assess the Toxic Behavior
The first step to take when managing a toxic employee is to observe and document the employee’s precise behaviors. Record what you see and hear—words, nonverbal utterances, voice quality and volume, gestures, facial expressions, and posture. Also record the circumstances surrounding the behavior, including when and where in your office it occurred, how long it lasted, and who was present. Finally, record what you see and hear others doing in response to the toxic behavior. For example, if the toxic employee engages in a long, chatty conversation with a coworker during work hours, record the time the conversation began and ended, what it was generally about, where it took place, who else could overhear the conversation, and the body language of the coworker being detained and kept from working. Your precise record of behaviors such as this will be an invaluable tool when you discuss the matter with the toxic employee. Although a toxic employee can take exception to your opinions about his or her behaviors, it will be very difficult if not impossible for the employee to argue with your accurate, documented records.
Could insecurity, jealousy, or fear be at the root of the new behavior?
Next, consider whether the toxic behavior was an isolated incident, or part of a larger pattern. If you detect a pattern, document at least three separate instances of the behavior. Also document any complaints you receive about the toxic employee’s behavior, along with what has resulted. For instance, did your employees generally become quieter when around the toxic behavior? Did they avert or roll their eyes? Give each other knowing looks? Scowl? Did they take steps to avoid or get away from the person? Or, did they get swept up in the toxic behavior themselves, resulting in more mistakes and lower production?
Finally, consider whether the toxic behavior has occurred for a long time, or if it is new. If it has been there for a while, is it more frequent or worse now than it was before? If it is new behavior, can you identify any possible reasons for it? For instance, was the employee recently passed over for a promotion? Is he or she going through a divorce? Or, have you brought a new employee into your medical practice who has changed the dynamics in your office? Could insecurity, jealousy, or fear be at the root of the new behavior?
Meet with the Toxic Employee to Share Your Observations
Choose a place and time for meeting with the toxic employee where your conversation won’t be seen or overheard. As Muller suggests, “Toxic employees who feel they’re being treated like a spectacle aren’t likely to be cooperative.” Ideally, choose to speak to the toxic employee at the end of the day, or even the work week. That way, he or she won’t be able to complain to coworkers and patients immediately after your meeting, or act in ways that cause them to speculate about your conversation.
Explain to the toxic employee that you asked to meet with him because you are concerned about some of his behaviors that you have observed. Then, review your record of his behavior, sticking to the facts. Describe, too, the effect the behavior is having in your medical practice. Be specific but not judgmental. If others have complained to you about the behaviors, say so. If you’ve observed physical responses to the behaviors, describe what you’ve observed. And if you’ve observed declines in productivity and believe that it is linked to the behaviors, share this too.
Be Prepared for the Toxic Employee’s Response
At this point in your conversation, allow the employee to have an opportunity to respond. Although you won’t know exactly what he will say or do, it’s best to be prepared for the most likely responses. Specifically, be prepared for the employee’s:
Surprise: A toxic employee may be surprised that you’ve been observing him so closely as to have kept a record, and he may be shocked that you have done so. He may also be surprised to hear your account of the various things he has done and said. Many toxic people speak their mind without filters and without realizing just how negative they are. As Gallo suggests, “In many cases, toxic people are oblivious to the effect they have on others.” They may be so focused on their own behaviors and needs moment by moment that they are not aware of their overall behavior and its broader impact. Your observations may serve as a mirror for the toxic employee, who has never confronted that image of himself before.
Denial: A toxic employee may deny that she’s done and said the things you’ve observed. She may tell you that you’re mistaken or accuse you of making things up. She may tell you that you’ve misunderstood her. She may even lie to you.
Confusion: A toxic employee may see nothing wrong with his behavior and feel that it is not necessary for you to make such a big deal out of it. He may not understand what is wrong with his behavior and wonder why you are describing it to him. Or, there is a remote possibility that he won’t remember saying and doing the things he has.
Deflection: A toxic employee may compare her behavior with that of her coworkers. She may argue that you’re unfairly singling her out and try to divert your attention to them. She may blame you or others for her behavior. Or she may suggest that the problem was not her, but the circumstances she was in, such as bad traffic on her morning commute, a headache, an overbooked schedule, or a hurtful remark from a patient or coworker.
Shut down: A toxic employee confronted by his own behavior may become so upset that he clams up or even cries. Or he may be afraid to say anything for fear of the repercussions.
Confession: The toxic employee may tell you that she knows that she’s been acting in these ways, and that it’s wrong for her to do so. She may reveal to you that she has been dealing with a serious personal problem and taking it out on others, or that she’s unhappy working in your medical practice.
Stand Up for Your Employees, Patients, and Medical Practice
No matter how the toxic employee responds, it is up to you as the manager to make it clear that the behavior won’t be tolerated in your medical practice and that it must stop immediately. Be very specific about what you need the toxic employee to change, and why. Describe the consequences if the behavior continues. Gallo suggests that we all tend to respond more strongly to potential losses than we do to potential gains, so it’s important to show offenders what they stand to lose if they don’t improve. Figure out what toxic employees care about the most, and put that at stake, she says. As Gallo puts it, “For most people, the possibility of missing out on a promised promotion or suffering other consequences tied to the pocketbook will be a strong motivation to behave in a more civil way.” So, too, will the possibility of being fired. Be very clear that continued toxic behavior is grounds for dismissal.
If you uncover a reason that the toxic employee is acting the way he or she is, offer to help. Gallo suggests that a manager can use this information to coach the employee or suggest resources to help address the root of the problem. For example, if the toxic employee is going through a divorce, dealing with a family member’s illness or crisis, or struggling with a mental health issue, you could point him or her to counseling resources or discuss time off that could potentially alleviate the underlying issue. However, be careful not to overstep. As Muller suggests, “Be careful not to diagnose a clinical problem – leave that to the professionals.” Express your concern and offer your support. However, make it clear that regardless of whether or not the employee seeks help to deal with these matters, the toxic behavior must stop immediately. Also make it clear that there will be consequences if it does not.
Follow-up
Record the contents of your meeting immediately after the employee leaves. Clearly describe the toxic behaviors you have observed, the employee’s response, what you’ve told him or her specifically that must be changed and by when (immediately), and any guidance you’ve provided about counseling resources or time off. As soon as possible, ask the employee to sign this document to indicate that you have given it to him or her and that he or she has had an opportunity to read it. Keep in mind that the employee is within his or her rights to write a written response if he or she disagrees with anything in the document. Nonetheless, get the employee’s signature in case you ever need to prove that he has been given this information.
Set a time for a follow-up meeting no later than two weeks after the first. Continue to observe the employee’s behavior closely and to record anything that he or she says or does that is toxic. Continue to document everything and meet with the employee as often as is needed. Be mindful that the toxic employee may behave more appropriately on the heels of your initial meeting, but that in time he or she may revert to the old toxic behaviors. Do not let down your guard. Continue to observe and meet with the employee. Also keep in mind that a reformed toxic employee may slip up from time to time. As Ashford(5) suggests, “Toxic employees probably aren’t going to change their tune overnight.” It often takes time, repetition, and perseverance for a toxic employee to realize that the rules have changed, Ashford says. However, if the employee is progressing well, continue your efforts.
Firing a Toxic Employee
If the toxic employee does not improve sufficiently, be sure that you have strong documentation and that you’ve issued multiple written warnings to the employee before you take action. As Gallo suggests, “You want to establish a pattern of behavior, the steps you took to address it, the information, warnings or resources provided to the employee, and the failure of the employee to change.” Include supporting material, too, such as formal complaints and relevant information from performance evaluations. Once everything is in place, fire the toxic employee who will not or cannot reform his or her behavior.
Of course, it’s best to go into the task of managing a toxic employee hoping that he can change. However, not everyone will. As Pavlou explains, some toxic behaviors can be extremely difficult to change. You may find yourself with a toxic employee who will be unwilling or unable to change. The problem may be too deeply rooted or too complex. As Gallo suggests, it’s important that you do your best with a toxic employee but accept that you won’t always be able to fix the problem.
First and foremost, you have to protect your employees, patients, and medical practice. You may encounter an employee who is so emotionally damaged that there’s just no coaching him or her to civility or productivity. As Chaffold(6) warns, “Such extremists cause severe loss of productivity, high turnover, lost clients, and charges of discrimination or harassment.” Don’t leave a toxic employee in place to spew and spread his or her poison. As Chaffold suggests, try your best. But if the toxic employee doesn’t reform, let him or her go.
References
Pavlou C. How to identify and address “toxic employees.” Workable. https://resources.workable.com/tutorial/toxic-employees . Accessed September 24, 2019.
Gallo A. How to manage a toxic employee. Harvard Business Review. October 3, 2016. https://hbr.org/2016/10/how-to-manage-a-toxic-employee . Accessed September 24, 2019.
Muller D. Spotting and dealing with a toxic employee. HRAcuity. February 26, 2018. www.hracuity.com/blog/dont-let-toxic-employees-chase-away-the-workers-you-want-to-keep . Accessed September 22, 2019.
Houlis A. Toxic employees: identifying and dealing with them before they poison the office. Fairy God Boss. https://fairygodboss.com/career-topics/toxic-employee . Accessed September 23, 2019.
Ashford K. How to manage a toxic employee. Monster. www.monster.com/career-advice/article/manage-a-toxic-employee . Accessed September 26, 2019.
Chaffold J. Are toxic employees ruining your workplace? Insperity. https://www.insperity.com/blog/toxic-employee-types/ . Accessed September 26, 2019.
Spotting Toxic Employees Before You Hire Them
Some toxic people can be charming when they want to be, such as on job interviews. Therefore, you have to be able to spot them before they end up on your payroll.
During the job interview, test candidates’ civility by asking them how they would handle a conflict or other high-pressured situation. As Muller(3) suggests, “That might reveal whether they’re patient or anxious in high-pressured situations and whether they’re conflict diffusers or enablers.” Toxic employees may cleverly respond with the right-sounding answers. However, by offering up several scenarios during the interview, you’ll likely come up with one or more that will have them struggling to respond, Muller suggests. Some questions to ask in the interview:
What would your former boss say about you?
What would your former coworker say about you?
How did you handle someone who was difficult to work with?
When did you fail at something and how did you fix it?
What would you like to improve about yourself?
Muller also suggests that toxic people tend to let their hair down in informal social situations. Therefore, once you’ve completed your interviews, arrange for your top candidates to have lunch off-site with an employee who is not a member of your hiring team. Ask your employee to note and report to you any cynical, sarcastic, or critical remarks made by the candidates, as well as other behaviors that may suggest toxic attitudes. Also ask your employee to observe how each job candidate interacts with waitstaff and other restaurant patrons.
Finally, when you offer the job to your top candidate, put the new employee on probation before making employment in your medical practice permanent. Then pay close attention to the probationary employee’s interactions with coworkers and patients. Track every incident of discord or concern. These could be signs that you have a toxic probationary new hire who may be better off seeking permanent employment elsewhere.
Five Types of Toxic Employees and How to Manage Them
Is it possible to manage toxic employees to success? It depends. According to Shandrow,(1) “Not every laggard is a lost cause.” The fate of toxic employees hinges on three things, Shandrow suggests: how awful they are to work with; the damage they’ve done; and how willing they are to change for the better.
When you’re thinking of braving the employee rehab road, Yonatan(2) suggests specific management strategies for dealing with five of the most common types of toxic employees shown in the table below.
References
Shandrow KL. 5 types of toxic employees and how to deal with them. Entrepreneur. October 12, 2015. www.entrepreneur.com/article/251614 . Accessed September 22, 2019.
Yonatan R. 5 Types of toxic employees and how to deal with them. GetVoIP, February 24, 2015. https://getvoip.com/blog/2015/02/24/toxic-employees/ . Accessed September 22, 2019.