What the Hell Just Happened?!

You’re About to Fire an Employee. Then They Reveal a Medical Condition… What the Hell Happens Now?

Episode Season 9, Episode 5Published
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Published on CEDR

You’ve made the decision to fire an employee. You’ve had the conversations, offered coaching, and watched the behavior affect the rest of your practice. Then, just before the termination meeting, the employee tells you something you didn’t know: they’re dealing with a medical condition, a change in medication, or a pregnancy-related issue.

Can you still fire them?

In this episode of What The Hell Just Happened!?, Paul Edwards and CeCe Delgado take on a common, complicated question from healthcare practice owners and managers. The employee may once have been a dependable high performer, but their recent behavior has become disruptive. Now a last-minute disclosure may introduce rights, restrictions, and accommodation obligations the employer cannot ignore.

Paul and CeCe walk through both the legal side and the human side: why consistent coaching and documentation matter, how one person’s behavior affects an entire team, what an interactive accommodation process can look like, and why a new disclosure doesn’t automatically mean an employee can continue behaving the same way without accountability.

They also discuss the significance of the underlying misconduct, including the difference between persistent irritability and a serious incident, plus a real practice example where longstanding performance problems and a later pregnancy disclosure created a challenging termination decision.

In this episode:

  • Why a high-performing employee’s sudden change in behavior deserves a careful conversation and how the rest of the team can be affected.

  • What changes when an employee raises a medical issue, pregnancy, or accommodation need just before termination.

  • Why an at-will workplace is not a substitute for reviewing protected rights and the facts of the situation.

  • How the interactive process, job requirements, and appropriate documentation can help an employer evaluate next steps.

  • Why reasonable accommodation does not mean ignoring performance, attendance, patient-care needs, or serious misconduct.

  • What a practice owner can learn from a termination case involving years of uncollected revenue and a later pregnancy disclosure.

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CEDR members: Have a difficult employee or termination question? Submit an HR request through backstageHR® so the Solution Center can review the facts and help you determine the right next steps.

Not a CEDR member? Explore CEDR HR Solutions: https://www.cedrsolutions.com/our-products/overview/

RELATED LINKS / RESOURCES

  • Employees with Disabilities: Understanding the Interactive Process

https://www.cedrsolutions.com/blog/employee-disability-interactive-process/

  • Reasonable Accommodations in the Workplace Explained

https://www.cedrsolutions.com/blog/reasonable-accommodations/

  • Pregnant Workers Fairness Act: What You Need to Know

https://www.cedrsolutions.com/blog/understanding-the-pregnant-workers-fairness-act/

  • Employee Protected Classes Explained

https://www.cedrsolutions.com/blog/protected-classes-explained/

  • Mental Health in the Workplace

https://www.cedrsolutions.com/blog/mental-health-in-the-workplace/

  • Explore CEDR HR Support for Your Practice

https://www.cedrsolutions.com/our-products/overview/

View transcript

Roundup 2 Episode

00:04 -> 00:13

Narrator:  You’re about to listen to an episode of What the Hell Just Happened? Join Paul Edwards and his guests as they discuss interesting topics and solve some of our listeners submitted questions.

00:14 -> 00:24

Paul: And occasionally I’ll go off topic to talk about whatever I want. Think barbecue, space exploration, growing your business, and things that interest all of us. 

00:27 -> 00:57

Paul: Hey, I want to welcome everybody to the show today on What the Hell Just Happened. We’re going to cover a couple of round up questions. CeCe and I are going to kind of go back and forth and talk about the intricacies of solving an HR problem. It’s not always easy. We bring the round up questions in from some twenty, twenty five thousand people that are in our community. Right, CeCe? We’re all about health care. We’ve got dentists out there. They’ve got urgent care. We’ve got physical therapists. Do I sound exhausted today?

00:57 -> 00:58

CeCe: A little bit.

00:58 -> 01:28

Paul: I feel a little exhausted today. But we’re going to get the energy up for the show. Round up questions are real questions. Now sometimes we reframe them a little bit, but they’re real questions. And the reason why we pick them is either they’re incredibly interesting. So we’re in HR. So some things are more interesting or less interesting than others. Or they’re common. They keep coming up. And this is a very, very common question. Super common or I should call it a scenario.

01:29 -> 01:37

CeCe: Yeah. Yes. Because we get varying questions that sound similar, but the details might vary a little bit, but really common theme.

01:38 -> 01:46

Paul: So this question paraphrase and then I’ll ask the actual question. CeCe is can I still fire this person. And what’s your answer to that.

01:46 -> 01:46

CeCe: It depends. It depends.

01:47 -> 01:54

Paul: It depends. I mean rarely does something happen so clearly that you you’re just able to say you’re fired. Right.

01:55 -> 01:58

CeCe: Yeah. And that’s one of the most risky actions you can take with your employees.

01:59 -> 03:15

Paul: Things just unfold. And it sometimes it takes a while, like a watching a slow wreck happen. In this particular scenario, the office has a long term high performing employee who has, you know, uncharacteristically kind of and recently become irritable. They’ve been combative, they’re not cooperating. They are even somewhat disruptive to the team. If you’ve done a good job, you’ve documented some of this, these conversations that you’re having. And at some point you’ve either made a final decision that they don’t know about, or you have told them that you’re about to make a final decision. And for me, I can’t change you. I can’t force you to change this behavior. But I can tell you, if you continue to do this, I choose who I work with carefully, and I will no longer choose to work with you. That’s my final warning to somebody. So for everybody, when we answer a round up question. We look at it from the legal and from the human point of view, from the human point of view. One thing I feel like we’ve done is we’ve given them time. We’ve given them a warning, we’ve talked to them and tried to figure out what’s going on.

03:15 -> 03:29

CeCe: And if this is somebody who’s in the past performed for you really well, they’ve been with you a long time. You’re probably giving them already a little bit more time or a little bit more space than you might someone else, I’m guessing.

03:29 -> 03:46

Paul: Yeah. I think regardless of who it is, unless it’s an immediate needs to be fired, like they’re yelling at a patient or you’ve discovered they’re stealing from you or, you know, something like that, you want to give everybody a shot. You want to tell them what the issue is, the impact that might help them identify where they need to improve or get realigned.

03:46 -> 03:47

CeCe: Of course. Yes.

03:48 -> 04:12

Paul: You know, I’m trying to think of how I receive this stuff, particularly in my younger days and being coached and stuff. This is coaching for me in sports or in band. You know, you never would say to a band teacher, well, I have this figured out. If a band teacher says, you know, you’re just not on the beat or you’re just not playing this right, or you’re out of key, or you’re not hitting the same notes we’re hitting or in marching band. I don’t know if you know that or not, but I used to be in marching band.

04:13 -> 04:14

CeCe: I don’t think I knew that.

04:14 -> 04:19

Paul: It was a pretty big deal. First chair in the marching band. Just want to say, you know, you want to know the reason I left the marching band.

04:20 -> 04:20

CeCe: Why is that?

04:21 -> 04:29

Paul: Because the cheerleading squad asked me to be there. And so the question was, would you like to be in the marching band with all the other guy drummers, or would you like to be on the cheerleading bus.

04:30 -> 04:32

CeCe: I was going to just ask what instrument you played?

04:32 -> 04:38

Paul: I was a drummer. Yeah, I was a drummer. Where were we? We were talking about high performers.

04:38 -> 04:39

CeCe: It’s all coaching.

04:40 -> 05:14

Paul: Yeah. Oh thank you CeCe. That’s why she’s the CEO now. And I’ve been demoted to whatever it is that I do here. Oh, I was reflecting on how I felt about being coached. And I think it’s a little more high stake when you get to be an adult and someone’s telling you you’re not doing something that we want you to do, or you’re not doing something right, it doesn’t feel good to receive that coaching. And then typically when someone becomes disgruntled at work, there’s something going on there. Yes. Right. It might not have anything to do with work. And it might have everything to do with work. So setting all that aside.

05:15 -> 05:40

CeCe: Well, I think there’s one more human element we should, we should address, though. Well, it impacts the whole team. Right. So, we’re focused on one person. But typically there is a and especially if it’s a long term person because there’s some built in leadership. You know, people think of that person as a leader if they’ve been there a really long time. And so now they’re all probably impacted in at least some way too.

05:41 -> 06:48

Paul: Yeah. It, it. Yes. Yeah. Because especially if disruptive means they’re not treating the people around them well, we’re not being accountable around things and we have to protect culture. I know that word gets used a lot. It can mean a lot of things. I guess it’s fairly subjective. But in a very objective sense. Culture is the ability to run your business with some sense of peace between everybody and to be able to get things done. If you want to ruin a team, let someone who’s slid from the culture just stay there. It’s time to let the person go. CeCe, you taught a course on this, and I love what you did with that course. Because on one day, you gave everybody all these HR scenarios and kind of told them the laws and told them the rules and told them what to look out for. And you kind of presented without them realizing it, a fairly standardized rosy picture. Without a human being involved on the other. Or the the twists that come in share with them some of the twists.

06:48 -> 07:21

CeCe: The day before the termination meeting your employees can always sense it, right? Whether you’ve told them this is the next step, or they can just sense that something’s changed. Something in them goes, I probably should tell them what’s going on if there’s something bigger going on. Oh, yeah. And so they come to you and you’re about to terminate them, and they tell you I’m suffering from depression or some sort of mental health thing. I’m working with my doctor. I’ve adjusted my medications, and it’s having these side effects that are causing the behavior that I’ve been displaying.

07:21 -> 07:33

Paul: So this goes back to your answer when I said, hey, can I still let this person go? And you said, well, it depends on what you meant was it depends on what happens between when you ask that question and when you execute on the, on the thing.

07:33 -> 08:05

CeCe: Yeah. Commonly we’ll see somebody with poor attendance issues and all of a sudden they come to you and they tell you that they’re pregnant and you are like, but all of those issues before may have had nothing to do with this. Maybe we don’t know. Right? Because we don’t know, how long they are yet all of those details. But, but regardless, now they’re telling you I’m, I’m pregnant and I’m going to need some accommodations with my schedule because of it.

08:05 -> 08:36

Paul: I mean, you get a new piece of information?  Some of those pieces of information will explain what’s going on. And may actually help you say, you know what? I’m not going to let this person go. But honestly, by the time you get to the end of this kind of track, the chances of them giving you a new piece of information that’s going to make everything better is less likely. I don’t want to say highly unlikely, but it’s less likely to explain away, the issue because the damage is done.

08:37 -> 08:40

CeCe: The damage is done. Uh, especially with the team.

08:40 -> 08:52

Paul: Oh, by the way, can I just interrupt? You can’t go tell the team. No you can’t. You can’t go to the team and say, oh, her meds. It’s not something you can share with the team.

08:52 -> 09:01

CeCe: And rarely is the cause of why they’re behaving like this. Something that you can now fix. Just because you know about it. Right.

09:01 -> 09:09

Paul: So we have some we have they could tell you something that’s not protected. What do we mean when we say protected? When we define.

09:10 -> 09:23

CeCe: That protected by something in the law. So the law says that you now have an obligation to do something. We’ll just say broadly, something because you know about what’s going on with the employee.

09:24 -> 10:17

Paul: Before we were in an at will employment situation, and we could just let someone go at will with or without reason, with or without notice. And, now we have it depends. It depends on what happens or what you learn. Now we’ve learned something. Could be under protected, could not be protected. But a lot of these things that come to light – my medicine, depression doctor and a lot of cases, a divorce might not be protected, unfortunately, however, domestic violence could be, could be protected in a lot of states now, as it should be,, pregnancy, all the things that you learn now you have to factor it in. So when you taught the course that we were talking about and you brought him in the second day and you said, okay, everybody, we’re going to run through the scenarios and you start firing things at them.

10:18 -> 10:47

CeCe: Yeah. In almost all of these scenarios, we can’t just still move forward with the termination, right? Partly because the need for an accommodation, whether or not it was the start of the behaviour was triggered by what they’re describing. Right. I mean that’s something that we get asked a lot is well can I find out when she started working with her doctor or when she conceived or.

10:47 -> 10:51

Paul: And can I lean into the behavior that happened before then and say, that’s, that’s what I want to address.

10:52 -> 10:56

CeCe: Exactly. And you can’t it’s it’s we’re past that point now.

10:56 -> 11:14

Paul: When you find out something like this, you enter into an interactive process and you know, CeCe as you well know, it’s an investigation. Does severity matter, like the severity of the what’s going on? Does that does that matter?

11:14 -> 11:43

CeCe: It can. Yeah. It can. Let’s say they just cussed out a patient at the front desk. Right? Yeah. That’s a yeah, that’s a very different thing than just. They’re late a lot. They’re irritable when they’re here and snappy at people. Right. Or if they, you know, they got in a verbal altercation with another employee and ended up punching them or something. Those are just a little bit different scenarios than just somebody who day to day is sort of making things miserable lately.

 

11:43 -> 13:51

Paul: I have a scenario. Okay, I just remembered a story. We had a doctor call in. This person’s been with me a very long time, a good high performer. And I just figured out that they, have not been doing their job very well, meaning that they were not collecting the way they were supposed to and they were not, you know, they were not doing their job. And, and when we asked how long and he said, well, we’re four years back right now. I’ve got a new CPA and there’s about we started off missing about fifty thousand dollars that we should have collected. And now it’s up to about a half a million dollars. And, busy practice, obviously to be able to miss that money and still be able to operate. But I mean, the first thing we all think was this explains why we’re struggling here. You know, more than a little money missing in the margins. Go to terminate her, you know, know that this is going to be a terminal offense. This person is not even hardly wanting to give him a chance because they’re like, they’re just, we got to get him out. And she reveals that she has a significant health issue. And we believe in in an attempt to actually be able to keep from being fired. And ultimately, this significant health condition is that she is pregnant and she’s having a difficult pregnancy, but this has nothing to do with what’s been going on for the last five years. We move to tell them they need to do a severance agreement with her, and we don’t write severance agreements. We send them to an attorney, their attorney creates a severance agreement for her, and it’s rather generous. She’s been with them for many years and takes it to her. She takes it to an attorney, and that attorney turns around and says, I’m going to sue you over this. I’m coming after you for this. This is pregnancy discrimination. Really didn’t understand that. I don’t think she had the best attorney. I just want to say, having the records of what happened and how long it had been ongoing finally brought that thing to a close, and they finally accepted the severance letter as it was written, and there was no lawsuit. So sometimes you can use the stuff that happened before. But in the scenario that we described.

13:52 -> 13:58

CeCe: Yeah, no, that’s a good point. The power of context, I mean, it all matters so much.

13:58  -> 14:03

Paul: That’s why you can’t just go to, an AI and ask these questions.

14:03 -> 14:20

CeCe: Yeah. It’s one of my cautionary things that I’ve said in many a talk is if you go to somebody for HR advice and they have the answer for you immediately without asking you like ten, fifteen, twenty questions, follow up questions first. Do not take that person’s advice.

14:20 -> 14:36

Paul: Yeah, probably not a good idea. The next question that comes up when I have to say to someone, we’re not going to be able to let her go right now. Well, then am I just going to have to let them keep abusing everybody around him or be late all the time? Or, or, you know, whatever the behavior was that triggered this thing. So what’s the answer to that?

14:37 -> 15:30

CeCe: Well, we talked about the interactive process. We’ve got to get some information from their doctor. But no, certainly the answer isn’t that now they just have carte blanche to keep behaving how they were. Right. But there might be some things that we can do depending on what information we get from their doctor. Maybe it’s that we need to reduce some stress. Maybe we need to give them some flexibility to go cool off in a break room, take a break or something like that. It could be a temporary removal from a certain task. Maybe there’s a task that’s causing extra stress or that puts them too much integrated with other people for right now. And so we remove those duties from them temporarily. Yeah. Sometimes like with pregnancy, maybe there are some schedule accommodations, but it’s certainly not just come in whenever you feel like it. And don’t be here whenever you feel like it.

15:31 -> 16:34

Paul: And call in and don’t call in or call in last minute, two or three times a week when you’re a clinical provider. And that is going to impact the patients. Well, the answer is, is no. They don’t get to continue across these other things. And then the second half of that answer is, is, but you still may have to change some of the stuff that they do. This is not the most exciting thing, but it is one of the most frequent questions that we get. And I just want to be really clear here. This is the exception to the at will rule that governs in forty nine states. If anyone ever tells you you don’t have to worry about it, you’re in an at will state. You don’t have to give anybody any reason. and you can just let people go. That is also someone that you should just ignore.  Yes you should. Just like, you know, unless they’ve got a lot of things to say after that to qualify what they’ve just said. CeCe I like this scenario. I feel like it’s a, um. It’s so common. It’s a good thing that we talked about it.

16:35 -> 16:35

Paul: I agree.

16:39 -> 17:07

Narrator:  Thanks for joining us for this week’s episode of What the hell Just Happened. Do Paul and yourself a favor and please share the podcast with your network. If you have an HR issue question or just want to add a comment about something, Paul said, please record it on your phone and send it to podcast at wthjusthappened.com. We might even ask if we can play it on the show. You can also visit wthjusthappened.com dot com to learn more about the show and join our HR community. Don’t forget to like and subscribe and join us again next week.

Email questions or comments for Paul at podcast@wthjusthappened.com

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