I have been reading podiatry articles for pointers on how to run an office for the last eight years of private practice. I have adopted the advice of all the practice management gurus in our professional world. They write with ease and enjoyment on the how-to’s of conducting employee interviews, compiling employee manuals, creating job descriptions, how to train, how to treat staff and so on. I have absorbed this advice and feel they provide good tips for facilitating a good working environment.

     I condone open communication with my staff so we can try to resolve an issue or conflict promptly. I express when a good job is done and say please and thank you often. I make staff aware of practice goals and their individual responsibilities upfront, and that they can use flex time on certain days of the week. We have individualized training. Although I have now found a competent staff, I have had my share of misadventures over the years with a few bad apple employees.

     I have had many different types of people as employees over the last several years of practice ranging from the young single, twenty-something staffer to the middle-age employee with a family to the widowed retiree. However, it does not seem to matter what age, what experience, what you explain upfront, what you put in writing or how you communicate. Just when you have a plan in place or think you have spent an adequate amount of time on training, a bad apple employee can sabotage your efforts. With this in mind, consider a few grievances I have had over the years with bad staff.

     Inability to manage the schedule. I once had an office manager who did not know how to schedule. I would come in for a day’s work and have 50 patients on the schedule with one nurse and one receptionist. In an exit interview, I asked what recommendations she may have for the office. She replied, “We worry about you. You need to slow down.” I thought, “I will after you leave. When is your last day anyway?”

     Lying in an interview. An older employee in an interview said she had several good working years left. Less than a year later, she said she was retiring to Florida. A thirty-something employee who claimed she was here to stay worked for six months and then decided to leave for nursing school.

     Failure to understand the manual. Six weeks into work, an employee requested time off with two days’ notice, ignoring the two-week notice request policy. When she was told no, this person proceeded not to show up on those days. I asked her not to return.

     Clueless staff. We trained, retrained and even extended the probation period for one LPN. After a patient said, “She just scares me,” I knew I had to do something.

     Failure to give two weeks’ notice. Did you hear the one about the employee who left on a week’s vacation and never came back? We did receive the courtesy of a message left on the answering machine the day she was to return.

     Multitasking or the lack thereof. An employee related significant stress and felt he could not handle the workload appropriately. In reality, there was trouble multitasking, which he gave as a strong point during the interview process.

     Failure to drive. The interview question was, “Would you have a problem driving 30 minutes to the other office to cover if someone is sick, on vacation, etc.?” The interviewee said no and then quit three days into training for being asked to drive to the other office for a meeting.

     Lack of professionalism. Last but not least, even a long-time associate left on vacation with only two days notice and did not return. Then the associate refused to answer phone calls regarding patient care.

     So what happened to honesty, loyalty and communication? Hopefully, I have finally found my salvation. Currently, I have several staff members that seem loyal to the office, organized, committed to doing good work, go the extra mile and can work through problems together with teamwork. I consider them my friends and enjoy going to the office. To all the practice management writers out there, I commend you on your excellence in the field. Although I have found my salvation, I have vowed to stop reading most of those articles and fend for myself.

     Dr. Allman is a Fellow of the American College of Foot and Ankle Surgeons. She has offices in Dubois, Ridgway and Clearfield, Pa.

     Dr. McCord (pictured) is a Diplomate with the American Board of Podiatric Surgery. He practices at the Centralia Medical Center in Centralia, Wash.