The decision to terminate someone’s employment is not an easy one, nor one to take lightly. When an employee is underperforming in a specific area but is otherwise a highly skilled and valuable member of the team, the issue is even more complex. Depending on the situation, in a case like this you might offer coaching, require additional training, give verbal or written warnings, or even put someone on probation to try to turn things around and keep the individual on board.

There are times, however, when the need to let someone go is unequivocal. A “zero tolerance” list – offenses that clearly warrant termination – should be spelled out in your employee manual. Below are situations you might include on that list. This is not an all-inclusive list and you should pick and choose what you consider to be zero tolerance situations based on the practice’s policies and philosophy.

Breaching patient confidentiality. Patient privacy is – or certainly should be – a high priority in any type of medical practice. Revealing information about patients to any unauthorized third party, even in a seemingly benign manner, is a serious transgression and must be treated as such.

Dishonesty. This might include actions such as misrepresenting oneself on a resume or employment application, falsifying a time card, stealing money, supplies, or drugs from the practice, or being caught in an obvious lie.

Violence. Any sort of violence or the threat of violence in the workplace is intolerable. This is not a common issue in medical practices, but it does occur. The possession of any type of weapon at work is most likely another zero tolerance situation.

Possession of illegal drugs. Particularly in a place of healing, the possession or use of illegal drugs is a clear violation of policy. Intoxication at work is also an obvious breach of policy.

Sexual harassment. Resist the temptation to look the other way, even if the perpetrator is your most productive medical provider.

Illegal discrimination. Everyone in the office, and particularly those in a position with hiring authority, should be acutely aware that discrimination based on an employee’s (or potential employee’s) race, religion, creed, color, national origin, sex, sexual orientation, gender identity, age, ancestry, physical or mental disability, medical condition including medical characteristics, marital status or any other classification protected by local, state or federal laws is illegal.

Incompetence. No matter how thorough you are when hiring, occasionally you end up with someone who is just not up to the task. An incompetent employee, particularly one in the clinical area, can put patient safety and your practice at risk.

Blatant insubordination. An employee who is disrespectful toward their manager or who simply refuses to follow practice policies is a problem and sets a bad example. Take insubordination seriously the first time it occurs.

Any time you are faced with potentially terminating an employee, be very careful to follow proper procedures as outlined in your employee manual. If you have any doubt or feel that you are on thin ice legally (i.e., at risk for a wrongful termination or hostile work environment claim), consult a labor attorney.