Slow to Hire. Quick to Fire. Easier Said Than Done.

Green "Hire" and red "Fire" buttons next to each otherDoctors don’t always wear the title of CEO for their practice, but if it’s your business, you’ve got the top job. And along with it, you hold the ultimate hire-fire responsibility for the organization.

Command, as the saying goes, is a lonely place. Personnel matters are often tough. Employees can be liked, but perform marginally. And even when the situation clearly warrants releasing an employee, it’s an unpleasant task.

But, as I’ve discovered in healthcare organizations of all sizes, there’s a valuable lesson in the concept of being “slow to hire and quick to fire.”

Slow to hire…

In the interest of confidentiality and sensitivity, I’ll avoid specifics here. But having counseled many medical practices—and being a CEO myself—these observations are well founded. I know from experience that a staff problem can torpedo your best marketing plan. (And sometimes worse.)

The benefits of the “slow to hire” idea are easy to embrace. The challenge, however, is the time pressure to properly fill a need in the organization. When the slot is empty, everyone wants the extra help as soon as possible.

Experience shows that there’s more of a downside to being rushed into making a fast-but-wrong hire. Tough though it is, it’s better to absorb the temporary urgency and pressure and to take the necessary time to recruit and retain a proper fit for the practice.

Quick to fire…

It’s easier said than done, particularly when an organization wants to avoid an unpleasant task, play out a “second chance” or a “wait and see” scenario, or side-step the immediate challenges of being shorthanded during another round of “slow to hire.”

Nevertheless, there are many reasons to take the appropriate personnel steps sooner rather than later. Some of these include:

A “poor performing” employee costs is costly. In addition to paying the salary and related expenses, lost opportunity and/or productivity are added burdens.

Your reputation is at stake. Sooner or later (usually sooner), patients, customers and colleagues are touched by poor performance. One person can negatively influence PR and the reputation of the organization.

Invariably, other staff members are aware and soured. An unresolved “problem” creates an unhealthy environment for teamwork and risks the loss of other “good” employees.

Damage has already been done the time you are aware of a “bad fit.” It may take weeks to discover the negative consequences, and even longer to correct the downside.

Inaction communicates poor leadership. Allowing a personnel problem to linger erodes both confidence and culture.

Personnel and human resource issues can be complex, so it’s prudent to seek legal or professional advice. But regardless of the appropriate course of action, it is a sound business practice to protect the integrity of your organization, your employees and your reputation.

It may be easier said than done, but the slow-to-hire and quick-to-fire concepts have merit for CEOs and managers, and they offer financial benefits worth considering. Keeping a “bad fit” can be toxic for the organization.

Stewart Gandolf, MBA


Stewart Gandolf
Chief Executive Officer & Creative Director at Healthcare Success
Over the years Stewart has personally marketed and consulted for over 1,457 healthcare clients, ranging from private practices to multi-billion dollar corporations. Additionally, he has marketed a variety of America’s leading companies, including Citicorp, J. Walter Thompson, Grubb & Ellis, Bally Total Fitness, Wells Fargo and Chase Manhattan. Stewart co-founded our company, and today acts as Chief Executive Officer and Creative Director. He is also a frequent author and speaker on the topic of healthcare marketing. His personal accomplishments are supported by a loving wife and two beautiful daughters.



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“Despite practicing in a hyper-competitive market, our new-patient counts are double what they were for the same time period last year. Hiring Healthcare Success was one of the best business decisions I have ever made.”

– Jonathan Calure, MD