Staff behavior
Risk Management

How to Avoid the Impact of Bad Behavior by Your Staff

As a D.C., you're the one providing the direct patient care, so it's easy to underestimate your staff's potential impact on the practice. But consider this: If your practice is like many, your staff has considerable contact with your patients.


Patients will consider your employee’s actions—good or bad—to be a direct reflection on you and your practice. And in extreme cases, if a patient is dissatisfied with your practice, it may lead to a lawsuit.

Let’s take the example of an office manager who was known for openly correcting staff in front of patients. She had been with the doctor since the practice began, and he defended her any time the matter was brought up.

On one occasion, she walked up to the front desk assistant while she was taking down patient insurance information and said, “That’s not how it’s done.” She took over the file and said, “Now, insurance will be billed correctly!”

Though the D.C.’s staff repeatedly complained about similar situations with the office manager, the behavior went unchecked. As a result of the behavior not being dealt with, staff turnover was extremely high and attracting new employees was a challenge.

Weighing the Consequences

When disruptive behavior is allowed to continue on a regular basis, valuable resources are expended as management and staff deal with a host of issues, such as worker anxiety and stress, decreased productivity, and employee turnover.

What’s more, patient care is compromised when there is disharmony. A “not-my-job” mentality may result—files are misplaced and follow-through is neglected.

When disruptive behavior is witnessed by patients, it can have a very detrimental effect on patient confidence, the reputation of the practice and patient return visits. Unfortunately, as the old adage goes, “If a patient likes you, he’ll tell two people. If he doesn’t, he’ll tell 10.” Because no practice can afford dissatisfied patients, many D.C.s have instituted a zero tolerance policy for aberrant behavior by employees. It’s important that the entire staff is committed to eliminating any disruptive behavior. Toward this endeavor, the practice must implement:

  • Office practices. Professional behavior toward all employees and patients should be the expectation. Policies and procedures must speak to what will and will not be tolerated, as well as how noncompliance will be addressed and its consequences.
  • Regular staff training. Effective implementation and communication of office practices is the key to bringing them to life. Regularly scheduled staff meetings can be very beneficial in drawing out issues without internal confrontation. One way to do this is to ask each employee to come up with a “hypothetical scenario” to be discussed at the meetings. After the scenario is presented, the group then discusses how the situation could be improved. Though the scenarios often end up being more fact than fiction, they often bring to light problems the doctor would normally be unaware of and solutions the entire practice can embrace.

By taking steps to help your staff work as a team and follow your practice’s policies and procedures, staff and patient satisfaction are likely to improve. This, in turn, serves to minimize the risk of a malpractice allegation or HIPAA violation. 


The information in the NCMIC Learning Center is offered solely for general information and educational purposes. It is not offered as, nor does it represent, legal or professional advice. Neither does this information constitute a guideline, practice parameter or standard of care. You should not act or rely upon this information without seeking the advice of an attorney familiar with the specific legal requirements of the state(s) in which you practice. If there is a discrepancy between the site and an insurance policy you have with NCMIC, the policy will prevail.