Urgent message: An urgent care center cannot afford to retain employees who undermine work, demoralize others, run off patients, or who seek vengeance. But dealing with toxic employees is more complicated than simply firing them; urgent care operators must have a strategy.


Alan A. Ayers, MBA, MAcc is Chief Executive Officer of Velocity Urgent Care, LLC and is Practice Management Editor of The Journal of Urgent Care Medicine.

The “toxic employee” is one of the more dangerous phenomena for the urgent care staff. More potent than any outside circumstance, an inside force undermining work and robbing the morale of others, who will go so far as to seek vengeance against the company, is something that cannot be ignored. Whether they’re a gossiper, a bully, or a slacker, toxic employees come in many disguises. However, at the end of the day their vitriol makes them an “energy vampire,” crippling their teams and businesses.


A tremendous amount of patience and self-discipline is essential when dealing with toxic employees. On one hand, they cannot necessarily be fired for bad attitude alone. On the other, their negative outlook cannot be allowed to spread to the rest of the team or organization. Dealing with these individuals depends heavily on how much damage they’re doing and whether or not they are willing to change.


What is a Toxic Employee?

It’s the urgent care manager’s job to weed out potential toxic employees before they get hired. However, sometimes they slip through the interviewing cracks and find a place within an organization that does not benefit from their poisonous nature.


The difference between an employee who is difficult and one who is toxic is how their poor attitudes and behaviors spread like a disease. If the toxicity is allowed to contaminate others, managers will see deenergizing, frustration, and decreased morale of the entire team. Therefore, it’s important to identify and address toxic employees before their influence is allowed to extend its reach.


There are many types of toxic employees. Some are easy to spot, others are more difficult to identify. The person could subtly gossip around the water cooler about other employees, bringing down team morale and creating conflict. They could be more direct, bullying others on the team and purposely creating a negative atmosphere. Some make the organization their target—constantly harping their disagreement with what the business is or isn’t doing. Or, they could simply be lazy, bogging down projects and disgruntling others who are forced to pick up the slack. All are dangerous and must be dealt with appropriately and swiftly.


The Big Problem with Toxic Employees

So, you’ve identified a toxic employee? Why not just fire him/her? Unfortunately, it isn’t that simple. In many cases, the toxic behavior of an employee does not have any legal implications or provide an explicit reason for firing. Doing so can put the company in a risky position should the employee bring a lawsuit. This often makes ridding your organization of toxic employees difficult. Fortunately, there are approaches that can be used to try to either change the individual’s attitude or prevent the spread of their toxicity.


How to Deal With Toxic Employees in the Workplace

There are three key strategies to remember when dealing with a toxic employee: the carrot, the stick, and the isolation. Putting these into practice can help stop a toxic employee in their tracks and protect an organization from their negative effects.


Provide Specific Feedback: The Carrot

The first step to managing a toxic employee is a direct conversation about their behavior. This includes laying out specific examples of when their toxic behavior has negatively affected the team. In many cases, the individual is unaware that their negative attitude is bringing down the team. Honest, direct feedback can help them understand the problem and give them an opportunity to change.


Establish Consequences: The Stick

People respond strongly to the potential sting of losses, whether this is a promotion, an upcoming bonus, or days to work from home. If a direct conversation does nothing for the toxic employee’s behavior, use leverage as the manager to provide incentive for change. Often, this motivation is enough to force the employee to examine and alter their behavior.


Minimizing Interaction: The Isolation

Urgent care owner/operators should be familiar with the concept of isolation. If you don’t want the disease to spread, you have to separate it from the healthy individuals. In the urgent care center, this means physically separating the toxic employee from other members of the team. This is a great alternative if you cannot fire the individual but need to keep their influence from spreading. By periodically rearranging teams or shuffling schedules, no one is forced to spend too much time around the “infectious agent”; essentially, you immunize the rest of the team from their negative attitude.


Things to Consider

In an interview with the Harvard Business Review, Christine Porath, associate professor at Georgetown, notes that around 4% of individuals “engage in this kind of behavior just because it’s fun or because they believe they can get away with it.” Interestingly, 4% percent is the same estimate given to the number of people in the population who meet the clinical definition of sociopath. It’s important to remember that not all toxic employees are willing to change. Despite a manager’s best efforts, some cases are a “no-win” situation.


What to Do if Firing is the Only Option

If you have tried other methods of handling a toxic employee to no avail, it is time to create a plan to remove them from your team. When preparing to fire one of these individuals, it is crucial that you document everything. This includes specific patterns of behavior, negative effects on the team, and the steps taken thus far to address the situation. Documentation should include supporting material as well. For example, peer evaluations or performance evaluations. Finally, documentation should never be personal. It should focus instead on professional—or unprofessional—behavior of the individual rather than their character. This protects you as the manager and the company while showing the toxic employee exactly why they are being fired.


Stay Focused

Dealing with a toxic employee can be draining for a manager. Throughout the process, it is important to not fall into the trap of “tunnel vision” related to the issue. You should ensure that you stay focused on the projects that really matter and avoid devoting too much time to dealing with the problem. Self-care activities like eating right and exercising, along with surrounding oneself with positive people is another way to combat the stress that comes with managing a toxic employee.




  • Levin M. Harvard research proves toxic employees destroy your culture and your bottom line. Inc. Available at: https://www.inc.com/marissa-levin/harvard-research-proves-toxic-employees-destroy-your-culture-your-bottom-line.html. Accessed March 22, 2019.
  • Porath C. How to avoid hiring a toxic employee. Harvard Business Review. February 3, 2016. Available at: https://hbr.org/2016/02/how-to-avoid-hiring-a-toxic-employee. Accessed March 22, 2019.
  • Porath C. Isolate toxic employees to reduce their negative effects. Harvard Business Review. November 14, 2016. Available at: https://hbr.org/2016/11/isolate-toxic-employees-to-reduce-their-negative-effects. Accessed March 22, 2019.
  • Torres N. It’s better to avoid a toxic employee than hire a superstar. Harvard Business Review. December 9, 2015. Available at: https://hbr.org/2015/12/its-better-to-avoid-a-toxic-employee-than-hire-a-superstar. Accessed March 22, 2019.


How to Manage a Toxic Employee

Alan A. Ayers, MBA, MAcc

President of Experity Networks and is Practice Management Editor of The Journal of Urgent Care Medicine
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