Terminating My Office Manager

Today’s post is a big learning experience for me. This post will go over terminating my office manager and the red flags that I ignored along the way. We are always learning, especially owning a business and practicing as a physician. I sure learned a lot based off of hiring and firing my first ever office manager.

This post will not get into bashing the manager. Instead, it will be more of a high level post about what is a good manager and what I did wrong or could have done better in this situation.

Why I Needed A Manager

I posted in a previous post about why I needed an office manager. As my practice has grown, it was no longer possible for all tasks in my clinic to be managed or delegated by just me.

A good small business needs excellent talent in each employed position. At first, I thought that I had excellent talent in my manager position. However, in the past 6 months I noticed a trend. I felt consistently more stressed about managerial tasks within my office. I also noticed that the office manager and my business were progressively becoming a worse fit.

What Is A Good Office Manager

A good office manager can effectively lead and coordinate a team or organization towards achieving its goals. A good office manager should possess a range of skills and qualities, including:

  1. Communication: A good manager is able to communicate clearly and effectively with their team, including listening to feedback and providing feedback in a constructive manner.
  2. Leadership: A good manager should have strong leadership skills, including the ability to inspire and motivate their team.
  3. Strategic thinking: A good manager should be able to think strategically, with the ability to plan and prioritize tasks and projects in order to achieve goals efficiently.
  4. Problem-solving: A good manager should be able to identify and solve problems effectively, including being able to anticipate potential issues and take preventative measures.
  5. Emotional intelligence: A good manager should have strong emotional intelligence, including the ability to understand and manage their own emotions, as well as those of their team.
  6. Adaptability: A good manager should be able to adapt to changing circumstances and be flexible in their approach to achieving goals.
  7. Accountability: A good manager should take responsibility for their actions and decisions, as well as those of their team, and be accountable for meeting goals and objectives.

Overall, a good office manager is someone who is able to lead and inspire their team, while effectively managing resources and achieving organizational goals.

What Went Wrong With My Office Manager

It was no change overnight. However, gradually every single one of the 7 points above, my previous office manager continued to become less effective as a leader or perform worse at her duties.

  1. Constant communication issues. For example, I told my manager that we will plan in the coming months to change up all our schedules, but we will talk more about this in our weekly meetings before implementing. The next day she sent out an email about these changes effective immediately.
  2. At the end of her time with my clinic, the office manager was only leading by fear and by being demeaning to our employees. That is not a good leader. The straw that broke the camels back was when she called a new hire “f&#king ret#$$ed” to her face right in front of a patient.
  3. Scheduling lunches or schmoozing with drug reps seemed to take importance over ensuring the practice was running smoothly.
  4. We are moving to a paperless clinic. However, despite this, our office manager instructed employees to print the electronic med refill requests, put them in a pile, and once they go through them to then toss it in the trash. Talk about so many inefficiencies.
  5. In terms of emotional intelligence I think they were pretty good about this until their last day as I stated above.
  6. The manager hated change. Anything that changed, there was a lot of pushback. Our practice is growing, leaning, and adapting. We are not a practice that has been around for 75 years and can just coast by doing things the way they always have been done. There is a lot of constant change.
  7. Zero accountability at the end to the point where they denied yelling at staff, despite it being caught on camera.

Red Flags That I Ignored

The overwhelming feedback from anyone that I talked to was how rude the manager was. I blew this off at first. I mean, sure, patients who don’t want to pay their bill or like our controlled substance policy, she is not going to be best friends with them.

However, employees started to bring up this concern. I tried to rectify this by doing additional training, offering to pay for leadership conferences. Nothing seemed to improve this behavior. She continued to become more abrasive and rude to anyone she interacted with.

I Am Constant Complaining

About 3 months before I terminated my office manager, my wife brought it to my attention. Every day when I come home, I complain about our manager and tell my wife how much harder my manager is making my day.

I started weekly meetings with goals for the week, thinking this would help solve the problem.

Nope, it didn’t help at all.

My office manager should make my life easier. However, I was finding myself waking up at 4:30 in the morning to double check my manager’s tasks since many of them did not get done or were done wrong.

What I Should Have Done As A Medical Practice Owner

Formal Feedback With Consequences Spelled out.

Although at my weekly meetings I gave her things to improve upon, I never spelled out what would happen if she fail to meet those targets. I should have had a well-defined probation period written out for them if she failed to meet my expectations.

Listened More To My Gut.

I felt fatigued, tired, irritable because I was doing my work and my office manager’s work. I should have listened to my gut and just terminated earlier. An employee should bring talent and skills to your job. They should hopefully make your job easier, improve revenue, or improve satisfaction.

Why I Think I Didn’t Terminate Earlier

  1. I felt like I owed them something. When staffing was a big problem, my manager was there to help me out. They never complained about working late. They were also there for half the life span of my practice. In my mind I felt “bad” terminating them since any startup has its rocky moments. Was it the nature of a startup or just my office manger? That is what I kept thinking during some of the last couple of months.
  2. Afarid To Be Without A Manager. How would things go without a manager? She was with me for the last 2 years. This was during a growth phase where we went from about 7k patients to 18k patients. I was worried how we would manage without them. Turns out great since my partner and I basically were doing all the managing anyway at the end. However, I was afraid to make the change and be without a manager.
  3. Is it me or them? I tend to get really into my own head. Starting a business is crazy. As Elon Musk said, “Being an entrepreneur is like eating glass and staring into the abyss of death.” Lots of things go right. Some things could have gone better. I kept thinking to myself, is it me who keeps moving the goal posts in my expectations or is it really them?

How I Feel Now

I feel a mixture of emotions. I’m happy that we are now without any of the negativity that the manager was bringing to work everyday. However, I am also sad that it has come to this. I’m also disappointed in myself that I let it go on as long as it did.

I hate to say I’m also a bit embarrassed that since my office manager has left our practice over a month ago, we are running smoother, more efficient and we haven’t noticed any downside yet. I’m embarrassed because I didn’t realize that my manager was making my office less effective, not as good of a place to work in terms of employee satisfaction, and overall, I should have recognized this earlier.

That falls on me as a leader. I can only learn from my mistakes about leading my office manager and do better for the next manager that we end up hiring.


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