Ep883 | What To Do With A Difficult Staff Clinician

What To Do With a Frustrating Employee In Your Clinic

In this episode, Doc Danny breaks down one of the hardest parts of owning a clinic: dealing with a talented but frustrating employee. You know the type. Great with patients, solid outcomes, but sloppy with systems, notes, and follow through. Danny walks through the three real options you have, why “letting it slide” destroys culture, and how to use a performance improvement plan to either turn things around or coach someone out.

In This Episode, You’ll Learn:

• The classic pattern of the friendly, high-output clinician who struggles with systems
• Why tolerating mediocrity from one person lowers the standard for your entire team
• The three options you have with a frustrating employee (and the one most owners avoid)
• How to build and run a simple, effective performance improvement plan (PIP)
• Why leadership and standards matter more than any one hire
• How “coaching people out” protects your culture and your A-players
• Questions to ask yourself about your onboarding, training, and systems

Claire: Get Your Attention Back on Patients

Danny opens with a reminder of how fast documentation can pull your attention away from patients. As PTs, we pride ourselves on building rapport and relationships, but it is hard to do that when you spend half the session staring at a laptop.

Claire, the AI scribe built specifically for physical therapists, lets you give patients 100% of your attention while it writes your notes for you.

• No more “split attention” between EMR and patient
• Better engagement and outcomes because you are actually present
• Notes drafted for you based on the session so you can review and finalize

Try Claire free for 7 days: https://meetclaire.ai

The Talented but Frustrating Employee

Danny describes a very familiar pattern in service businesses. You hire someone you like. They are a good culture fit. Patients love them. Outcomes are strong. But behind the scenes, they:

• Drag their feet on notes and documentation
• Ignore or half-follow systems and processes
• Show up a little late, miss small details, or respond slowly to emails and Slack

They are not a disaster. They are not a clear liability. But they are not meeting the standard either. That gray area is exactly where most owners get stuck.

First, Own Your Part as the Owner

Before you blame the employee, Danny challenges you to look in the mirror. Have you:

• Actually trained them on your EMR, project management tools, and communication systems?
• Explained why those systems matter (data, tracking, meetings, outcomes, marketing)?
• Given them clear expectations, examples of “done right,” and time to practice?

Most owners are busy and rush onboarding. They throw people into the deep end with a few screen-share videos and hope they figure it out. Then they get mad when the systems are not followed.

Your Three Options With a Frustrating Employee

Once you are honest about your own role, you really have three options:

1. Let it go. Accept that this person is just this way. They are good with patients, weak with systems, and you live with it.
2. Let them go. Fire them for not following processes and creating extra work for others.
3. Create a performance improvement plan. Sit down, define what needs to change, and track progress over a set period.

Danny explains why the first option is the most dangerous. When you tolerate one person ignoring standards, everyone else sees it. Your A-players start to wonder why they are working so hard. Support staff quietly resent the extra work. The real standard becomes “we say we care about systems, but we do not enforce them.”

How to Build a Performance Improvement Plan

The go-to approach in Danny’s companies is a structured performance improvement plan (PIP). It usually looks like this:

• Define the specific problems (late notes, missing CRM updates, slow responses, etc.).
• Clarify why each behavior matters to the business and the team.
• Decide what is truly necessary for the role and remove anything redundant.
• Set clear, measurable expectations for the next 4–6 weeks.
• Meet weekly to review progress, answer questions, and coach them on better workflows.
• Make it clear this is a non-negotiable standard if they want to keep the role.

This is not about punishment. It is about support, clarity, and accountability. The PIP gives the employee a real chance to succeed with your help.

What Usually Happens Next

Once you run a real PIP, you tend to see one of two outcomes:

• They turn the corner. With training and clear expectations, they improve their systems work, become more efficient, and turn into a strong long-term hire.
• They opt out. They resist change, make excuses, and realize this is not a place where they can do whatever they want. They often resign on their own.

Either way, you win. You either save a good clinician by giving them structure or you protect your culture by making it clear that standards are real.

Leadership, Standards, and A-Players

Danny points out that your best people are always watching how you handle situations like this. A-players want:

• Clear standards and consistency
• Leaders who follow through, not just talk about culture
• Teammates who pull their own weight

When you avoid hard conversations and let someone slide, your A-players lose respect and start looking elsewhere. When you hold the line, they respect you more and see your clinic as a place worth investing their energy.

The Hard Work of Real Leadership

Leading people is often the limiting factor in whether a clinic ever scales. It is not manual skills. It is not marketing hacks. It is your willingness to:

• Have tough, honest conversations
• Take responsibility for training and support
• Set standards and enforce them consistently
• Spend time coaching people, even when you feel “time poor”

That work is uncomfortable, but it is the difference between a team that drifts into mediocrity and one that grows with you for years.

Want Help Navigating This as a Clinic Owner?

If you are facing a frustrating employee, wondering how to hold standards, or trying to grow from being the only producer to running a real team, Danny and the PT Biz advisors can help you work through it.

Talk through your situation with an advisor: https://vip.physicaltherapybiz.com/discovery-call

Try Claire free to buy back documentation time: https://meetclaire.ai

Still part time and trying to go full time in your own practice? Join the free 5-Day Part Time to Full Time Challenge here: https://physicaltherapybiz.com/challenge