Famous last words that can heal your practice

Don't let that employee go before finding out why they want to leave

By Theo Sands

Rita C had been with the Guelph group practice for eight years, for the last three as office manager. In her mid-30s, she had two kids, a good husband and, as far as the group's doctors knew, a happy home life. Her work was exemplary though she was a bit of a loner and didn't do much socializing with the rest of the staff. Still, she appeared an even-handed supervisor, respected by those who worked for her. "Unflappable" was a word more than one of the eight-doctor group had used to describe her. She had a low-key manner, did her job well, had neat habits and was pleasant to have around. She gave no sign she was unhappy with her job, so it came as a shock when she handed in her notice one Monday morning.

Her formal resignation was typed on her own stationery and simply read:

"Dear Dr M...,
Thank you so much for the opportunity of working with the practice.

I have accepted another position and will be beginning there on Xxxx 17, 2006. Please consider this my two weeks notice.

I've learned a lot while working here and wish the practice every success in the future. Please let me know if there is anything I can do to help prepare for my replacement.

Yours truly,
Rita C."

The physician who was acting head of the group called her into his office and asked the usual questions: Why are you leaving? Who's your new employer? Are they paying you more? Rita gave him polite but curt answers. She was leaving, she said, because she'd grown bored with the job; her new employers had a bigger practice located closer to her house; and yes they were paying her more. He knew the group and his stomach tightened at the nerve of them for stealing his office manager. He asked her if she would consider staying if he increased her salary. No, she wouldn't.

SAY YOU'LL STAY
Over the next two weeks, she continued to do her work efficiently but seemed even more subdued than before. Her attitude disturbed the physician and he realized he resented her for leaving him in the lurch without an adequate explanation. On her second-to-last day there was a brief respite in his schedule and he decided to ask her to go across the street to the local café for coffee.

Once they were seated in the booth and had ordered he said, "So tell me why you're really leaving?" She looked at him for a moment with a half smile and then unloaded: "Where do you want me to start? I've supposedly been in charge of the office but frankly I gave up on trying to work cooperatively with the bookkeeper and the receptionist a year after I arrived. They both have their own way of doing things and were completely closed to trying new ways of working. They've been with you a lot longer than I have and used that right from the start as an excuse for doing things in the same old way they always had. They fought me every step of the way and I finally just gave in. The office was running to the extent that the door was getting opened in the morning and patients kept coming and going but that was about it. The bookkeeper should have been replaced years ago. The practice has changed and grown and she hasn't. You've talked about moving to an electronic system — which you should have done four or five years ago — and it's never going to happen with her around. The receptionist is more interested in her pet birds and keeping up with the latest gossip than she is in your patients. She spends as much time goofing off as she can get away with. The worst part though is that you've got eight employees and three cliques. Janis won't talk to Ellen and Ellen has no respect for Craig and Craig and Sonya detest me and Gloria. I could go on and on. It's the pettiest thing, like being in high school again. You know weeks go by sometimes when Jean and I don't exchange two words. It's the most dysfunctional office I've ever worked in. The pay's not very good either."

The doctor slumped back in the booth and took a gulp of coffee to recover. He managed a wan smile and said, "Is that all? Why didn't you tell me?"

They both laughed and, with the ice broken, got down to an honest exchange. No, she wouldn't consider staying but she had some good suggestions on how he could fix the social morass that had settled over the practice. One place he might start was a salary review. Other clinics were offering more. She revealed that she'd be getting almost $5,000 more at her new place of employment — about a 10% increase. She said that other staffers had resented her since the day she walked in the door. At first she said she thought she could handle it and get around it. When she found she couldn't, she simply made sure the work bases were all covered and shut down.

BYE BYE
The following day was her last. The staff bought a cake for her and they shared it in a cheerless goodbye ritual around 4:00pm on Friday, and then she was gone. The doctor never heard from her again.

She was gone but not forgotten. Before even advertising for a replacement, the doctor plunged in and tried to sort out some of the problems Rita had highlighted. Meetings were held; exchanges encouraged. Job descriptions were written; a yearly evaluation process begun. Salaries were reviewed and increases were granted when deserved. The whole process took six weeks, but when it was over the physicians had a much better fix on what it takes to run a smooth operation and felt they were closer to the staff than they'd ever been.

Losing Rita turned out to be a blessing in the long run, not for what she did while she was working there but for what she told them when she left. A more structured exit interview such as the one here would have given them even better results.