My New Hire Isn't Working Out - What Are My Options
You hired someone with real optimism. The interview went well. They seemed like the right fit. And now, a few weeks in, something is off. Maybe it is their performance. Maybe it is how they interact with patients. Maybe it is a gut feeling you cannot fully articulate yet.
Before you act, take a breath and work through this systematically.
First: Diagnose What Is Actually Happening
There is a big difference between someone who is a bad hire and someone who has not been set up to succeed. Before you draw any conclusions, ask yourself these questions honestly.
• Did they receive a clear job description before they started?
• Did your onboarding process give them the information and training they needed?
• Have you clearly communicated what good performance looks like in this role?
• Have you given them feedback about what is not working, and have they had a real opportunity to respond and improve?
If the answer to any of these is no, the problem may be the system, not the person. That does not mean the hire will work out - but it does mean you owe them clarity before you make a decision.
The Direct Conversation
If you have not yet had a direct conversation about the concerns, that is your first step. Not a performance improvement plan. Not a formal warning. A direct, honest conversation.
The conversation sounds like: 'I want to talk with you about some things I have been observing. I want to be direct with you because I think you deserve that, and because I want to give you the opportunity to understand my concerns and tell me your perspective.'
Then be specific. Not 'your attitude is off' - but 'I have noticed that when patients ask questions at the front desk, the response has sometimes come across as impatient. Here is a specific example.'
Vague feedback does not help anyone improve. Specific feedback gives the person something to actually work with.
What You Are Listening For
In the conversation, pay attention to how they respond to direct feedback. Do they receive it thoughtfully? Do they get defensive? Do they acknowledge the concern and take ownership? Do they offer context that changes your understanding of the situation?
How someone responds to a difficult conversation often tells you more than the original concern did.
Your Options
Option 1: Invest in Development
If the issues are performance-based, the person is otherwise a good fit, and they respond well to feedback, a structured improvement plan with clear expectations and check-ins may be the right path. This only works if you are genuinely willing to invest in the outcome and the person is genuinely committed to improving.
Option 2: Redefine the Role
Sometimes a new hire struggles in one area but excels in another. If the role has flexibility, consider whether restructuring their responsibilities plays to their strengths. This is not always possible in a small practice, but it is worth considering before a separation.
Option 3: Part Ways
If the issues are fundamental - values misalignment, conduct problems, or performance that is not improving despite clear feedback and real opportunity - ending the employment relationship sooner rather than later is usually the right call. Delaying a departure that is inevitable just extends the disruption and is rarely fair to anyone.
The Probationary Period
Many practices have an informal understanding that the first 90 days are a mutual evaluation period. If you have not made this explicit in your handbook or offer letter, consider doing so. A defined probationary period sets clear expectations on both sides and makes early-stage separations cleaner and less complicated.
Whatever you decide, document the situation. The conversations, the feedback, the expectations, and the outcome. Good documentation protects you and creates a record that helps you hire better next time.
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