When an Employee Isn’t the Right Fit—and What to Do About It

Every independent practice owner has experienced it at least once. You are short-handed and desperate for help, and you have a great interview with a new candidate. They are punctual, their resume checks all the boxes and you convince yourself that, with training, this person will be perfect for the job.

But over time, something feels off. They show up on time, they do their job (for the most part), but you find yourself micromanaging, double-checking their work and feeling that sinking in your belly. The question you’ve been avoiding becomes impossible to ignore—is this person the right fit for my practice?

The first question we have to ask is whether this is a skills issue or fit issue. Skills can be taught, if the person is willing to learn, of course. Fit is harder—it is about alignment with your practice as a whole. Does this person have the same values, work ethic and expectations as your current team? It is normal for someone to have to learn how your practice works, even with experience. However, if an employee avoids responsibility, clashes with your culture or values or resists constructive feedback, it is likely something that can’t be changed.

WHEN EXPERIENCE ISN’T ENOUGH

This happened to me when I opened Look New Canaan in 2024. We hired an optician with a lot of experience, especially in the luxury market. A dream come true, right? She interviewed well, had experience with the brands we were carrying and I counted my lucky stars to have found her. However, as soon as she came on board, I knew it was not going to work. I went home the first day she started and told my husband, “I made a mistake. She is not a good fit.” It might be new-job jitters, he said—but it wasn’t. The real issue was a huge clash in values and culture. I had a clear vision for our patient experience, and she did not have buy in.

A useful question to ask yourself is this: If this person was perfectly trained tomorrow, would the problems I’m experiencing disappear? If the answer is no, more training isn’t the solution. It may actually increase frustration on both sides because expectations rise but behavior stays the same. In our case, she had experience with the systems we were using but had no interest in learning “the Look way.”

TEAM PLAYER OR TOXIC INFLUENCE?

It’s also important to look beyond the individual and pay attention to how they affect the team. An employee can appear “fine” by themselves yet affect the entire energy of the practice. We have all had a team member like this—their negativity or poor work ethic starts to infect the entire practice. These are subtle warning signs that something is wrong.

Culture, to me, is more than a buzzword. It is essential in how a team functions efficiently and effectively. If culture starts to degrade, patients can feel it too. Have you ever walked into a medical office and could sense something was off? You could feel the tension in the air? How different is it to walk into an office where the team seem to genuinely like working together? The cost of a rotten apple can be significant in your patient revenue and growth.

MAKING THE HARD CALLS

As someone who is conflict averse, it could be easy to let things go and hope they work themselves out. However, the most important thing you can do (and this is hard for me!) is to address conflicts early and clearly. Avoiding conversations, as tempting as it may be, rarely improves the outcome—it just delays the inevitable. A conversation focused on specific behaviors and expectations is important. Plus, employees deserve to know where they stand and what they can change for the better (make sure this is all documented!).

If this employee is worth investing in, make a true effort to help them grow. Set clear expectations with a timeline and specify the behaviors you want to see improved. And then sit back and observe. Those who are a good fit will take ownership and look to improve.  Those who aren’t will continue on as they have been, and that response tells you all you need to know.

Letting someone go is one of the hardest leadership moments in as an independent practice owner, especially when relationships are close and the team is small. But holding on to the wrong fit often creates more long-term damage, and the team often bounces back with renewed energy once the person is gone. Ending employment doesn’t signal failure. It’s a sign that you’re paying attention to your business and lead with intention and clarity.

Read more on staffing here.