The First Time I Had to Fire Someone

I had never fired anyone before I owned a practice.

I had been an associate. I had employees quit. I had been on the giving end of a raise and the receiving end of a review. But I had never sat across from someone and told them the job was not theirs anymore.

Six months in, I had to. The version of me who walked into that meeting was not the version who walked out.

Here is what I did wrong, what I did right, and what nobody teaches you about the conversation itself.

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Part 1 — Why I Waited Too Long

It was the assistant I wrote about a few months ago — the colleague from a previous job I hired because she was familiar, and who ended up with blood running down a patient's shirt in month three.

After that, I did the things you are supposed to do. I documented. I coached. I sat her down twice with specific, written feedback about suction technique, room setup, and turnover time. Both times she agreed with me in the room and defended herself the moment she left it.

By month five I knew. I waited another six weeks anyway.

Not because I thought she would turn it around. Because firing someone felt bigger than everything else on my plate, and the practice was still fragile — a loan payment due, a schedule that was not full, and a team of four including my brother. Removing one of four people felt like pulling a wall out of a house I was still framing.

Here is what I did not understand at the time. Every week I waited, my team was watching me tolerate it. My front desk had quietly started re-checking her room setups before I got in. Nobody complained to me. They just absorbed it.

That is worse than complaining. When people stop complaining, it means they have stopped expecting you to fix it.

The cost of a slow firing is not paid by you. It is paid by the people who stay.

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Part 2 — The Conversation

A Tuesday. 7:40 in the morning, first patient at 8:30.

The office manager was in the room. Her final check was printed and in an envelope on the table before she walked in.

I had rehearsed it in my car. I had three paragraphs ready. I got through about one and a half.

She asked if this was about the extraction. I told her the truth: it was not one thing. It was that I had asked for the same change four times and it had not happened, and I could not keep asking.

She cried. Then she got angry. Then she said the thing I still think about.

"You never actually trained me."

She was partly right. That was the hardest part of the whole morning — the fairest criticism I received that entire year came from the person I was firing, in the middle of firing her. I had hired someone into a practice with no protocols, no senior assistant, and a doctor who could not watch every move, and I had assumed she came pre-assembled.

It did not change the decision. She still could not do the job in front of her, and no amount of my regret was going to make her able to. But it changed what I did next, and it changed how I onboarded every person after her.

She was out of the building by 8:15. I saw my first patient at 8:30 and I do not remember one thing about that appointment.

That was the moment I understood ownership differently. I was not only responsible for the outcome. I was responsible for the conditions.

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Part 3 — What I'd Do Differently

Three things I wish someone had told me clearly:

1. Have every piece of paperwork done before you open your mouth.

Final check printed, exit paperwork filled out, and a written list of keys, badge, and software logins to collect. Remember to document everything. In California the final paycheck is due at the moment of termination, not at the end of the pay period. Having it already in an envelope turned a conversation I had been dreading into a professional transaction with a clear ending. Improvising the admin afterward is what makes these drag on for days.

2. Do it early in the morning, early in the week.

I almost scheduled it for Friday at 5:00, after the last patient, because that felt like the kindest version. It is not kinder. It is only quieter for you. A Friday-evening firing hands someone a weekend with nothing they can act on — no unemployment office, no calls returned, no next step. Tuesday morning meant she could file that same day, and it meant I was reachable if she had questions instead of disappearing until Monday.

3. Tell the team the same day, in person, and say nothing unkind about the person who left.

I told my team at lunch, in four sentences: she was no longer with us, I was not going to discuss the details, the schedule was covered, and here is what changes for each of you. What your team is actually measuring in that moment is not whether the person deserved it. It is how you talk about someone who is not in the room — because that is how they assume you would talk about them.

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Part 4 — The Honest Frame

Owning a practice makes you an employer. Being an employer means that sooner or later you will tell someone their job is not theirs anymore. There is no version of ownership where you get to delegate that.

For a long time I thought the goal was to get good enough at hiring that I would never have to do it again. That is not a real goal. Even good hires stop fitting the practice you are becoming. I have since had to end roles for people who did nothing wrong at all.

The question is not "can I avoid this?" You cannot.

The real question is this: when the moment comes, will I have already done the work that makes it fair — the training, the documentation, the direct conversations while there was still time to fix it — so that the person across the table is hearing the last of several conversations instead of the first?

The first time is the hardest. It does not get easy after. It gets more honest.

Reply and tell me where you are in this — pre-first-hire, mid-management, or already had to make that call. I read every one.

— Jennifer