This Human Resources (HR) section provides practical advice, tools and templates to help you understand and implement HR processes to effectively run your business.

Your Recruitment Process and Checklists

You’ve had success running your practice and see the opportunity for growth. To take advantage of this opportunity, you’ll need to hire people to work with you. Who you hire will have an enormous impact on the continued success of your practice, so it’s important to get it right.

The people you hire are a direct reflection of you and your practice. That’s why it’s important to use a solid recruitment process to ensure you make good hiring decisions.

Your recruitment process includes the following steps:

  1. Examine your needs and determine which position(s) you need to hire. Define the job and identify essential responsibilities
  2. Identify the skills and attributes you’re looking for in your candidate(s)
  3. Create job posting(s) or description(s) that provide an accurate representation of the role
  4. Post position(s) and give candidates an application deadline
  5. Screen resumes
  6. Interview
  7. Check references

1. Define the Job and Responsibilities

Receptionist/Administrative Assistant:

The role of your Receptionist/Administrative Assistant is an important first point of contact for your clinic. Exceptional patient experiences begin with a warm greeting when employees are registering new patients, answering phone calls and scheduling appointments. A Receptionist or Administrative Assistant will also look after patient intake forms, explain clinic policies and collect medical information and payments.

Chiropractic Health Assistant (CHA):

Your Chiropractic Health Assistant (CHA) will assist you with patient examinations and diagnostic imaging, such as X-rays and EMG scans. Your CHA will also help your Receptionist/Administrative Assistant with other administrative duties in your clinic.

Office Manager/Director of Operations:

The role of an Office Manager or Director of Operations is to oversee the management of your clinic or clinics (in the case of multiple locations).

Responsibilities include:

  • Supervising and managing staff
  • Securing and negotiating contracts with vendors and suppliers
  • Organizing training and professional development


You know better than anyone the kind of chiropractor you want working in your clinic to deliver exceptional patient experiences. Below are sample job postings for: Chiropractor, Wellness Chiropractor and Associate Chiropractor.

Other Health Care Professionals: 

To offer patients a full range of services, you, like many chiropractors, may join forces with other health care professionals in an interprofessional clinic. These other health care professionals may include:

  • Physiotherapists
  • Registered massage therapists
  • Athletic therapists
  • Naturopaths
  • Nutritionists

2. Identify the Skills and Attributes You Need

You’ll need to identify the right skills and attributes required to perform the role, once you’ve defined the essential responsibilities of the job. This information will help you know what to look for when you hire. 

Let’s say you’re hiring a Receptionist/Administration Assistant. Their responsibilities are more patient-focused because they’re often the first point of contact for your patients. 

As a result, hiring someone with patient services experience, including strong social skills, is important. If you’re hiring a health care professional (chiropractor or other), you want to focus on both their technical expertise and their social skills.

To build and sustain your practice, providing excellent patient services begins by building strong relationships with each patient that comes through your door. This is what often keeps people coming back and leads to more patient referrals.

A number of chiropractors were consulted to create this recruitment resource. The primary belief they expressed was the importance of hiring people with strong social skills. 

They told us most successful hires were not necessarily individuals with previous health care or medical experience. Rather, they were people who had worked in hotels, restaurants and retail roles. These individuals had honed strong social skills through experience interacting with customers and colleagues.

Assess Hard and Soft Skills

Hard Skills –

Hard skills refer to a person’s proficiency in a specific area or field. Whether you are hiring a chiropractor, registered massage therapist or other health care professional, you’ll want to hire someone who is good at what they do. 

To evaluate hard skills, assess:

  • The candidate’s degree or diploma in the field
  • Years of experience practising
  • Treatment success rates
  • Feedback from patients and/or other health care professionals

Soft Skills –

Soft skills refer to attributes and personality traits that determine how well someone interacts with people. These may also be called social skills or people skills. They include attitude, customer service, verbal and written communication skills.

You can evaluate soft skills in a number of ways by reviewing the candidate’s resume, via a telephone call or in a face-to-face meeting or interview.

To evaluate soft skills, look for:

  • Service or customer-oriented experience. Does their resume indicate experience that involves working with people and serving customers (ex. hospitality, retail, reception, social work, etc.)?
  • Tone of voice in the initial phone call. Is the candidate friendly and professional? 
  • Listens and communicates well. Does the person listen to and answer the questions you ask?
  • Communicates a desire to help others
  • Responses to questions about customer service, such as “Tell me about a time you dealt with a difficult customer”

3. Create Job Posting and Advertise

Job postings may vary in the amount of information provided. Depending on how you advertise, you may have a limited amount of space in which to write. As a general rule, keep to the position’s priorities. More is not necessarily better.

Key job points include:

  • Essential job responsibilities
  • Attributes/qualities desired
  • Description of the clinic (e.g. rehabilitation, sports injury, spa/wellness, etc.)
  • Scope of services provided
  • Equipment provided – treatment rooms, tables, laser, ultrasound, etc.
  • Resources provided – assistant, receptionist, online calendar, etc.
  • Hours required – full-time, part-time, evenings, weekends, etc.
  • Payment arrangement – salary, split percentage of billings, partnership, etc. There is no right or wrong, but the industry standard is to indicate the split percentage (i.e. 60/40, 70/30, etc.) on the posting.
  • If the rate of pay is hourly or salary, a figure is usually not provided. Instead, the posting says “this is a full-time salary position.”
  • Bonus – Is there a bonus plan in place?
  • Benefits – health benefits, discount on services, professional development/training, etc.
  • Contact information and instructions on how to apply

Sample Job Postings

4. Post the Position

Most chiropractors experience great success advertising positions online. You can start with our Classifieds (formerly Marketplace). There are also a number of free websites where you can post positions, including: Chiropractic and Naturopathic DoctorKijijiCraig’s ListCMCCIndeed and Jobbank.

Other avenues to consider include local newspaper advertisements, LinkedIn and recruitment agencies.

5. Screen Resumes

Once you advertise your posting and receive numerous applications, the process of resume screening begins. The best way to start the screening process is to eliminate the resumes you don’t want to consider.

Watch for these potential ‘flags’ when you screen a resume:

  • Spelling mistakes – These mistakes can indicate the care and effort put into the resume, the person’s attention to detail and the quality of their work. If there are mistakes on the resume, there will likely be mistakes on work-related documents.
  • Gaps in employment – People may have gaps in between jobs on their resumes. Gaps can occur for several reasons, such as being a stay-at-home parent, looking after an ill relative, illness, injury or disability, going to school, unemployment or travel. They are not a guaranteed flag, but you want to consider how many there are and their duration. Numerous gaps might indicate the person can’t hold a job for a steady period of time.
  • Long gaps (5+ years) may indicate a decline in skills and speed. When someone has been out of the workforce for long periods of time (no matter what the reason), they may not transition back in very well. *Note that the message is to be mindful of employment gaps, not to dismiss someone because of them. One suggestion is to conduct a telephone interview where you can ask the person to explain the gap(s).
  • Overqualified – Some applicants may have more experience than what’s required to perform the job. This isn’t always a negative thing. Like gaps in employment, this is something that can be explored in a telephone interview. The reasons why hiring someone overqualified might be a problem include –
    • Salary expectations are too high
    • The person may eventually become demotivated and disengaged
    • Retention is difficult. The person leaves if/when they find an opportunity more aligned with their experience

But keep an open mind. Sometimes a more experienced person has a reason they’ve applied for the position you’re hiring for that may make them just the right fit.

Here’s what you should look for in a resume:

  • Relevant experience (particularly if it’s important to you that the person has worked in a similar environment)
  • Evidence of technical expertise (see section above on assessing technical expertise and soft skills)
  • Customer service experience and/or experience working with people (regardless of industry)
  • Duration of employment – People change jobs for several reasons and movement is to be expected.  Nevertheless, be wary of people who change jobs every one to two years. You want to hire someone who will stay, not someone who is likely to leave soon after joining.

Resume Screening Checklist

  1. Eliminate the resumes you’re not going to consider.
  2. Create two piles of resumes: a YES pile and a MAYBE pile. It’s good to have backups if the YES candidates don’t pan out.
  3. Refer to best practices (above) to determine if a resume is YES, NO or MAYBE:
    • Spelling errors and typos on the resume are non-negotiable
    • Gaps in employment warrant exploration, especially if the applicant has the skills and experience you are seeking (call the applicant for a brief conversation to explain any reservations)
    • Select the top resumes in your YES pile and contact them for a telephone or face-to-face interview. Keep the number manageable – five or six people is recommended to start.

6. Interview

Telephone interviews are a useful and time-efficient way to perform an initial screening. They can reveal a lot about a candidate, such as their professionalism, communication skills and telephone demeanor. They can also reveal a candidate’s skills, motivations and overall ‘fit’ for the position, if you ask the right questions. 

Face-to-face interviews offer an added dimension and allow you to assess a person’s body language, maturity, professionalism, communication skills and ‘fit’ with the rest of the team. You do not need to do both; however, it is recommended.

Interview techniques can differ depending on the person’s style.

Interview Formats

The two most popular ways to interview are through:

  • Open-ended questions 
  • Behavioural interviewing

Open-ended questions allow the candidate to speak freely and select the information that they want to share. Examples of open-ended questions are 

  • “Tell me about yourself” 
  • “Why are you interested in this position?”
  • “What are your strengths and weaknesses?”

Behavioural interviewing, on the other hand, asks for specific examples of something (situations, skills, abilities, problems, approaches, etc.). The premise of behavioural interviewing is that how one behaves in previous positions and situations will indicate how one will behave in the future. Behavioural questions always ask for an example.

Here are some suggestions for how to structure a behavioural question: 

  • “Tell me about a time when…” 
  • “Can you describe a situation where…” 
  • “Provide an example of…” 

Look for the following in the candidate’s response:

  • A description of the situation, problem, challenge or task at hand
  • The action or approach the person took
  • The end result

There is not a single ‘best way’ to interview. A best practice is to use a combination of open-ended and behavioural questions, as someone may be stronger in one method than another.

7. Check References

Always conduct reference checks. They will validate your hiring decision or save you from making a mistake.

Reference checks are the final stage in the recruitment process and should not be undervalued. In most cases, checking references validates the intuitive feeling you have about a particular candidate and their abilities to successfully perform the role. It confirms information you’ve received through the resume and interview. It’s also an opportunity to hear the experience and perspective of someone who has worked closely with the person and observed their performance. 

Please note, if a candidate doesn’t want to give their current manager as a reference because they are still employed by them, you can speak to previous employers. If the current employer is the only one the candidate has had, you can make an offer of employment contingent upon a reference from their employer after the candidate has resigned.

What if the reference is negative?

Occasionally, reference checks reveal that the candidate is NOT the right person for the job. The person may have lied about their education or had high absenteeism, in which case it’s good you find out before rather than after hiring them. No matter what information is discovered, the process of checking references gives you added information to help you make an informed hiring decision.

Other Ways to Learn About a Candidate

You can also use Facebook, Instagram, LinkedIn and Twitter to find out more about a person. It’s natural to want to see what a person looks like. You hope to find someone that appears likeable and smiling in their pictures. 

You may also get more insight into a person by learning about their previous work experience or extracurricular interests. Perhaps someone worked overseas for a year or practises martial arts. This kind of information gives you a window into the person you’re hiring and can help validate whether they’re a good fit for your practice. Check social sites, such as Facebook with the objective of confirming your decision to hire, not looking for reasons not to hire.

After Recruitment: Offers of Employment

There’s a lot to keep track of when you make the move from being a sole proprietor, who does everything related to your business on your own, to hiring others to work with you. And, you’ll have a number of obligations and responsibilities to any employees or independent contractors you hire. 

This is why documentation is essential in the hiring, firing and performance management process. Take the time to do things properly with the correct documents, such as an offer letter, termination letter, performance reviews. These documents will save you time, frustration and money in the long run.

Agreements and Responsibilities

You should follow a verbal offer of employment with a written employment agreement that clearly outlines the terms and conditions of employment. You can easily open yourself up to a lawsuit without this agreement in place. 

A documented employment agreement doesn’t only protect you as the employer. It also protects the employee from unfair treatment. The new hire should sign the employment agreement and any other documentation required, before starting work. We also recommend that you have new hires sign a confidentiality agreement.

Employee versus Independent Contractor

Your employment agreement will look different and cover different areas depending on the nature of the employment relationship. In most chiropractic clinics, administrative and support positions, such as receptionist, chiropractic health assistant (CHA) and office manager are hired as employees. 

With employees, you’ll ordinarily make a verbal offer of employment followed by a formal letter of offer, once your verbal offer has been accepted. However, you’ll typically use an independent contractor agreement when you hire other health care professionals.

Both types of employment arrangements have advantages and disadvantages. You’ll need to decide which arrangement to use based on your circumstances and assessment of what’s best for your practice. 

The information that follows includes considerations, examples and recommendations. We recommend that you also speak to an employment lawyer for optimal advice on employment agreements and the terms to be covered.

Hiring an employee

Here’s what the typical employer/employee arrangement looks like in both large and small businesses.

Generally speaking, employees:

  • Hold a permanent position (full-time or part-time)
  • Perform a specific role that contributes to business operations (receptionist, CHA, office manager, etc.)
  • Receive a fixed and regular wage (hourly or salary), as well as benefits, pension and paid vacation
  • Work according to hours and rules set by the clinic owner
  • Use the clinic’s tools and equipment to perform the job (computer, telephone, office supplies, etc.)

In most cases, particularly in the case of full-time employment, employees do not work for anyone else. An employee is trained by the employer and assumes no financial risk in performing their duties.

In this kind of arrangement, the employee works for you. You control the functions and responsibilities the employee performs and have the flexibility to modify the role to suit your needs. You direct the employee on how you want their job functions carried out and are very much the decision-maker. 

There is a defined reporting relationship between you and your employees. As part of that relationship, you’re responsible for evaluating performance and accountable for imparting discipline. You also have the right to terminate with or without cause. 

The only reason you would NOT hire someone as an employee is if you need them to:

  • Fill a short-term need 
  • Provide a specific service on an irregular or flexible basis

Hiring independent contractors

Generally speaking, you hire an independent contractor to perform a specific service and receives a fee for that service. When chiropractors hire other therapists or health care professionals that work independently outside of the business, this constitutes an independent contractor arrangement.  

Independent contractors are not on payroll and do not receive benefits, pension or paid vacation.  However, you must pay HST on the compensation an independent contractor receives. 

Keep this in mind from a budgeting standpoint because it can be a substantive amount at the end of a year. Compensation is usually a percentage of billings (60/40 or 70/30 is typical), but could also be an hourly rate or fee per patient. 

Independent contractors usually have autonomy in how they do their job and manage their own schedules. They rely less on the clinic owner to provide training, equipment and support, compared to an employee. 

Independent contractors may work irregular hours and for several clinics at the same time. In this kind of arrangement, the clinic owner has little control over them.

Hiring Process

It’s critical for you to lay out all terms of the arrangement and clearly define who is responsible for what when you draw up an independent contractor agreement. For example, the contractor may be responsible for scheduling their own appointments, collecting payment, marketing themselves and cleaning their work area. Alternatively, the clinic may be responsible for scheduling and billing.

Whatever the arrangement, it needs to be spelled out. This division of responsibility is very important because there is a fine line between being an independent contractor and an employee. As a clinic owner, you don’t want to find yourself knee-deep in legal complications.

Orientation and Training

Once you have recruited and selected your new employee, you need to properly orient and train your new hires. This step is an essential part of human resource management, especially for a small business. 

If you don’t provide adequate training, it can lead to poor performance and/or job dissatisfaction – both of which lead to staff turnover. You have likely spent a great deal of time and effort on the hiring process.  You don’t want to repeat this process time and time again to replace someone who doesn’t work out.

The orientation and training an employee receives also has a major impact on how well they perform.  A well-planned and executed training and orientation program sets the stage for employees to have a positive and productive experience. 

Think about your first day on a job before you were a chiropractor:

  • Were you confident about performing well or were you nervous about meeting expectations? 
  • Were you provided with information and given the tools to succeed or did you stumble along the way and learn for yourself? 
  • Did you know where everything was located or did you feel embarrassed asking where the office supplies were kept?

Don’t assume your new employees come to work on the first day understanding all that needs to be done and how to do it. Do not take the perspective of “they’ll catch on quickly.” You’re only going to do yourself and the employee a disservice. 

Investing time in orientation and training is guaranteed to decrease confusion, expedite learning curves and increase productivity and satisfaction for both you and your new employees.


Orientation is not the same as training. Training is specific to the job being performed and will be different for each position. Orientation is the delivery of more general information about the practice and how it’s run. It provides an overall picture of the business and covers basic information that usually applies to everyone.

Orientation should include:

  • History and background of the business; any vision, mission statement, etc.
  • Acquainting the new hire with the clinic layout – location of washroom, kitchen, office supplies, etc.
  • Introduction to other staff
  • Review of all policies and expectations, including hours of work, breaks, dress code, safety and any other expectations
  • Review of any benefits, such as vacation, sick days, health care benefits and any discounts on services
  • Review of pay and pay schedule
  • How to operate technology and equipment (alarm, photocopier, computer, telephone, etc.)
  • Set up any access cards, logins, passwords, etc.
  • Performance Management – Discussion about how performance will be measured and evaluated; frequency of performance reviews (usually annual), eligibility for salary increases, bonus potential, etc.
  • Invitation to ask questions. It’s important to answer any questions and develop open communication from the start
  • A manual or handbook that captures all of the above in addition to important terms, administrative procedures and best practices. 

Ask existing staff for their input. What information would they have found useful when they started?

The clinic owner or whoever runs daily operations should be the one to conduct the orientation. Being clear about what is expected from the very beginning reduces the potential for misunderstandings and sets both you and the employee up for a smooth transition.


Training is essentially teaching someone how to do a job. No matter how well somebody performs in an interview or how great their references may be, it’s unrealistic to believe all new employees have the abilities and skills necessary to do the required tasks to your standards. 

What you have hired in the candidate you selected is skills, qualities, attributes and work experience that will help the person learn the job and perform it well once they know it. However, you need to ensure they are taught the job.

One-on-one Training

One-on-one training is the most effective way to teach a new employee a job. Keep in mind that people learn differently. Some people learn best by hearing (i.e. verbal), some by seeing (i.e. watching) and some by doing (i.e. hands-on). A best practice approach to training integrates all methods.  

For example, the employee can watch the trainer as they demonstrate the steps to perform a task and explain how each task is used and relevant to the business. The employee then has the opportunity to perform the task, ask questions and receive feedback from the trainer.

To achieve maximum effectiveness, the clinic owner should be involved in the training process. In some cases, the owner may be the trainer. 

In other cases, the owner will select someone to do the training. When this happens, considerable time must be spent training the trainer. Don’t assume because someone has been with the practice a long time or is a high performer, they are a good trainer. Invest the proper time in training and you’ll be sure to reap the rewards.

Eight-Step Plan

Follow this eight-step plan for an efficient and effective training program that sets your staff up for success:

1. Define learning outcomes

Identify what tasks or skills the new employee should be able to perform once the training is complete. Include factors like speed, volume and any other measure of success. For example, you may expect them to schedule a minimum number of appointments each day. 

Also, think about how you are going to measure patient service. Are you going to solicit feedback from patients and staff or are you simply going to observe? If you choose to observe, what behaviours will you look for? This determines what and how you need to train. 

Once you determine the learning outcomes, document the steps or procedures that you need to communicate and have any materials ready for training.

2. Prepare

Prepare the new employee. Explain why the skills/tasks being taught are important. Discuss common problems they are likely to encounter and how to deal with them. This information is also good to have in a training manual.

3. Select the right trainer

Selecting the right trainer is critical to the new employee learning the job the right way. Employers don’t often do this. They often select anyone who is available, accessible or convenient. Be sure to select someone who intimately knows the job or the tasks being taught, as well as how to communicate their knowledge. You may have different people train on different areas if that makes sense. Invest time in training the trainer so you only do it once.

4. Instruct

Explain each task thoroughly and break them down into small parts or steps. Most new employees find learning several small tasks easier to digest. Document this information in a training manual.

5. Demonstrate

Demonstrate the task or skill to the new hire. Then engage the new hire. Ask them questions and have them explain the process or skill back to the trainer.

6. Do

Give the trainee the opportunity to perform the task or practise the skill. Make sure the new hire performs each step correctly and avoids shortcuts or bad habits.

7. Feedback

One of the most important parts of the training process is feedback. This is an opportunity to assess how much of what has been taught has been learned and understood. It’s also a chance to praise what the person has done well and correct and identify areas that still need work. 

In addition to verbal feedback, you can monitor progress by developing a check sheet with each of the job tasks listed. On a regular basis (weekly, bi-weekly or monthly), go over the sheet with the new hire and update their progress. 

This is valuable feedback for you on how long the learning curve takes when someone new comes on board. It is also good information to have when evaluating the employee’s performance.

Remember that feedback should be a two-way process. Encourage new hires to ask questions and share their feedback on what has been taught. A new employee brings a fresh perspective. Their feedback also helps you make continuous improvements going forward.

8. Follow-up

The last step in the training process is follow-up. From selecting and hiring to onboarding and training, you have invested extensive time and effort in your new employee. It’s easy to make the mistake of thinking your job is done once your new hire is trained. 

It’s important to stay connected through post-training check-in meetings to assess how the employee is performing and how comfortable they are feeling in the new job. Once the employee is settled, you can consider cross-training or introducing additional responsibilities.

Be sure to document the individual’s progress along the way. Since the person is new, you have no measure of previous performance — only how well and quickly they have progressed since their start date.

Training and Best Practices

Training –

  • Develop a written training manual, which includes the job description, reference information and specific steps on how to perform the job. Ensure you have a sustainable training resource when the trainer is no longer there.
  • Select the right person to do the training, not necessarily the person who is most convenient.
  • Appoint a ‘buddy’ who can be a resource for information and questions. Starting a new job is overwhelming and it’s hard to retain everything learning during orientation and training.
  • Provide a friendly and relaxed training environment that is conducive to learning.
  • Allow some latitude in the pace of learning new tasks, especially when different people are teaching different tasks.
  • Integrate a variety of methods to teach information. Some learn by hearing, some by seeing and some by doing.

Best Practices –

  • Don’t micro-manage. It may seem like it expedites learning but it decreases confidence and fuels frustration. Give the person time to learn properly and don’t have unreasonable expectations regarding time frames.
  • Don’t compare new hires to previous or existing staff. Remember that other employees have been there for months or sometimes years. They’ve had way more time to learn how things work.
  • Postpone any cross-training until the person has demonstrated they can effectively perform their job.
  • Engage in some personal discourse. Ask the new hire about their hobbies, interests, family, etc. This helps promote an inclusive workplace and makes a person feel welcome.
  • Provide feedback, both positive and constructive. Positive reinforcement leads to confidence.

Managing Staff

You’ve invested in recruitment, hiring and training new employees and independent contractors. Now you need to implement a process to keep your new hires engaged and motivated,  so they become brand ambassadors to help your practice thrive. 

Sometimes, despite your best efforts, things just don’t work out with someone you’ve hired. Having a process in place that addresses this scenario is just as important.

As with recruitment, hiring and training, it’s important for you to document your performance management process. We’ve put together some useful resources to help you do this.

Leadership Assessment

When you’re planning how to manage employees consider how your leadership style will impact your workplace culture and performance management processes. How do you currently make decisions? Do you know what your practice will look like three years from now? 

Develop a strategic plan for your practice.

A plan can help you:

  1. Define your unique features
  2. Prioritize your financial needs
  3. Communicate your strategy to your staff 
  4. Provide direction to staff

To start developing your plan, answer these key questions:

  • What is your mission statement?
  • What is your vision statement?
  • What can you and your clinic do better than anyone else?
  • What are your short-term goals and priorities?

Answering these questions on a regular basis, whether annually or quarterly, will help you and your staff stay on track.

Engaging and Motivating Your Staff

It’s important to engage and motivate your staff. One way to do this is to acknowledge their accomplishments and contributions. 

Whether it’s a “job well done” or a physical reward, positive reinforcement goes a long way in making people feel appreciated and wanting to contribute more. Research shows that engaged employees are more loyal, satisfied and productive than disengaged ones.  They also show more initiative and make greater team contributions.

The more motivated an employee, the more they strive for excellence and the better they perform. 

Employers who make an effort to keep their staff engaged and motivated get the best out of their people and increase employee retention. So what’s the secret to engaging and motivating your staff? Believe it or not, financial compensation is not one of the top drivers.

Primary drivers for employee engagement are:

  1. Relationship with one’s manager
  2. Enjoyment of the work
  3. A belief or pride in the organization and what it stands for and does

Communicate, stay connected and provide frequent feedback. These are the essential building blocks to strong, trusting and productive relationships with your staff.

Other factors that drive engagement and motivation at work include:

  • Pay
  • Rewards and recognition
  • Career opportunities
  • Professional development opportunities
  • The business or clinic’s reputation

Each of the chiropractors interviewed to develop this resource had employee engagement strategies in place. These included performance-based bonuses, professional development opportunities, opportunities to work on special projects and ad hoc rewards, such as gift cards and a day off for a job well done.

Tips to Engage and Motivate your Staff

Create a harmonious and inclusive work environment through team activities and outings.

  • Recognition –

Recognize employees for a job well done or contribution made. You can do this through verbal feedback. Praise from one’s manager makes an employee feel appreciated and valued. Don’t underestimate this non-monetary form of recognition, as it has a great impact.

  • Professional Development

Allow and encourage employees to attend conferences, such as OCA workshops, Thrive or other professional development courses on various relevant topics, such as Microsoft Project, Excel, business planning or communications.

  • Team Spirit

Small activities and rituals, such as team lunches and taking turns bringing donuts or refreshments into the office can promote team spirit and make people feel good. Celebrate birthdays with a cake or a group lunch and do something in the summer (picnic or BBQ) and during the holiday season to show your appreciation for your teams’ hard work and contributions throughout the year.

  • Rewards –

Physical rewards also go a long way in making people feel appreciated. They can come in the form of money (e.g. bonus), gift cards, movie passes, time off, etc.   

These kinds of rewards are discretionary and usually reserved for contributions or tasks that require significant time and effort or are above and beyond the scope of one’s regular work. An example is an office assistant who took the initiative to research different telephone and internet providers and secured a contract that saved the clinic $200 per month.

Career/Development Opportunities

A promotion may not be realistic given the needs and structure of your practice, but you can be creative with development opportunities that still support business needs. These could include assigning special projects, cross-functional training and filling in for someone more senior as a backup.

  • Frequent Feedback –

Delivering feedback once a year in the form of a performance review does not keep employees motivated. Research shows employees are more engaged when feedback is delivered on a frequent basis

A best practice is to hold weekly meetings to review the previous week and plan for the upcoming week. This is a great way to stay connected with your staff and understand what’s happening on the ground level of your practice.

  • Effective Relationships

Communicating and connecting with your staff is critical. Demonstrate respect, honesty, integrity and trust. 

Show that you care and value each employee’s input and opinions. You need ongoing communication to achieve this. Be accessible to your employees and listen to their questions and concerns. Offer your support as a manager and work with them to achieve professional success. 

Ask questions about your employee’s personal life, such as family, personal interests, etc. Most employees appreciate this and it often strengthens the relationship. However, navigate this area carefully as there are always some individuals who prefer to keep their personal life separate.

  • Bonus –

    Bonus incentives are great motivators when they are achievable. Setting bonus targets that are largely unattainable has the opposite effect and disengages employees.

Tips to Conduct a Performance Review

Performance reviews are usually conducted annually and are a more ‘official’ way of providing feedback. If you are providing regular feedback throughout the year, there should be no surprises in the annual performance review. 

Take this opportunity to discuss goals and objectives for the coming year and describe what success will look like. This information provides a benchmark to measure performance at the next review.

Use the following tips to conduct effective performance reviews:

  • Schedule a meeting in advance and hold it in a private place with no interruptions.
  • Give your employee an opportunity to express a self-assessment of their performance, including what they feel they’ve done well and what areas they think need improvement.
  • Deliver positive feedback first, by telling the employee what they do well and provide examples.
  • Collect feedback from peers, patients and others the employee works with on a regular basis. Summarize and communicate that feedback to the employee. It’s good for them to know how they’re perceived by others.
  • Deliver any constructive feedback and discuss areas for improvement. Sometimes these are not areas of improvement, but rather areas you want to grow or develop the person in. For example, you may want your Office Assistant to start doing billings.
  • Provide a concrete rating that reflects the overall evaluation of their performance. This rating can be numerical or verbal (i.e., meets expectations, exceeds expectations, does not meet expectations). Whatever the rating, support it with examples and document it. You may ask the employee to sign off on the review. This is optional.
  • Discuss goals and objectives for the upcoming year. Define what success/achievement will look like and how you will measure the employee.

Best Practices for Developing a Performance Improvement Plan

A solid performance improvement plan should include:

  • An understanding of the performance gap and expectations about what they need to achieve
  • A clear understanding of the responsibilities and deliverables you expect from the employee
  • A clear understanding of the responsibilities and role you as the employer will play in helping the employee improve (i.e. additional training, frequent feedback, check-in meetings, etc.)
  • How you will measure progress and define success (i.e. what milestones)
  • Specific time frames for improvement. There may be one or there may be many, depending on the problem. Be sure to allow sufficient time for performance to improve

Dealing with Underperforming Employees

Deal with an underperforming employee as soon as you notice a pattern or problem. Address it one-on-one and prevent it from turning into something bigger.

Poor performance can manifest itself in different ways. It can be a failure to perform the position’s duties; not adhering to workplace policies, rules or procedures; or disruptive and unacceptable behaviour in the workplace.

Reasons for underperformance can include:

  • The employee doesn’t know what they are expected to do
  • A mismatch between the employee’s capabilities and the job they were hired to do
  • Employee not provided with the skills or knowledge to do the job
  • No feedback on performance has been provided
  • Difficult personality
  • Low morale in the workplace
  • Personal issues, such as family stress or health problems

Note that you can prevent the first few reasons in the above list with an effective hiring and training process, as well as employee engagement strategies at work. 

Address poor performance right away because it’s unlikely the employee knows there’s a problem. 

If someone doesn’t know there’s a problem, there is little chance of them changing their behaviour on their own. For example, if someone is late for work a few days in a row, don’t let it carry on. Have a one-on-one conversation with the person and say you have noticed that they have been coming to work late. 

You can ask if there is a reason ‘why’ – perhaps they are dealing with something at home. Emphasize that you need them to be punctual and arrive at X time every day. If the problem persists, have another conversation and communicate consequences, such as a written warning, documentation in their performance review, no bonus, etc.

Five-Step Plan

When managing an underperforming employee, here are five helpful steps to follow:

1. Identify the problem –

Before you take action, clearly identify the problem. Is it…

    • Attitudinal or behavioural?
    • An isolated incident or a series of occurrences?
    • Specific to one area or is it the person’s overall performance?

2. Analyze the problem –

Explore the possible reasons contributing to the problem. Has there been a significant life event or disappointment at work? Have dynamics in the workplace changed with respect to hours, supervision or the introduction of new co-workers?  

Next, try to determine how serious the problem is.  How long has it been occurring? Is this a departure from previous behaviour? How big is the gap between where performance needs to be and what is being delivered?

3. Discuss the problem –

If possible, deal with the problem immediately (never in front of patients or coworkers). When applicable, schedule a meeting with the underperforming employee to discuss the problem. Let them know the purpose of the meeting so you don’t take them by surprise. Hold the meeting in private (not in front of patients or coworkers) and ensure you will not be interrupted. Explain to the employee specifically what the problem is, why it is a problem and the impact it has had at work. Allow the employee to speak freely and express their opinions, comments and point of view. Finally, communicate the outcomes you wish to achieve.

4. Develop a performance improvement plan –

Where possible, jointly develop a solution to address the problem. An employee who contributes to the solution is more likely to accept it and act on it. 

Refer to this solution as a performance improvement plan. Set time frames for completion and schedule future meetings to review the employee’s progress and performance against the agreed upon plan. Keep a written record of all discussions in case further action is required.

5. Monitor performance –

Monitor the employee’s performance and continue to provide regular feedback. You’re working to resolve the problem, so foster a climate of encouragement; not one where the employee feels like their head is on the chopping block.

Once you’ve dealt with the problem and performance has improved to an acceptable level, meet with the employee to acknowledge that the issue is resolved. Be prepared to work with the employee to sustain good performance.

If performance does not improve to the required standard and the problem cannot effectively be resolved, you many need more serious action, such as a formal written warning or termination of employment.

To work effectively, performance management must be a participatory process. If the underperforming employee doesn’t take accountability or show a desire to change the situation, their performance is unlikely to improve. 

The above steps may seem like a lot of trouble and effort to fix a problem. You may believe it’s worth the effort for some and in other cases, that termination is truly the best solution for both parties. The reality is our laws heavily protect the rights of the employee. So going through these steps and pursuing corrective action before resorting to termination goes a long way in preventing legal claims.

Terminating an Employee

It’s never easy. Firing an employee is one of the most difficult and unpleasant things for an employer to do. In Ontario, laws largely favour the employee. If you’re going to terminate an employee, it’s critical you do so in a proper and professional manner to avoid aggravation and/or a wrongful dismissal lawsuit.

Termination Process


Terminating an employee comes with a financial cost. The Employment Standards Act, 2000 (ESA) requires employers to provide notice of termination or pay in lieu of notice, which is calculated based on an employee’s length of service. If an employee has worked less than three months, no notice is required. 

Any duration longer than three months requires one week per year of service. For example, someone employed for more than three months but less than one year receives one week of notice.  Someone employed more than one year but less than three years receives two weeks notice. Someone employed more than three years but less than four years receives three weeks notice, and so on. 

You may also owe legal entitlements, such as paid vacation, overtime and statutory holiday pay. It’s important to note that compensation includes entitlements to things like bonuses, commissions and health benefits for the duration of the notice period.

Severance pay is a separate obligation under the ESA. It applies only if the employee has been employed for five or more years and if the employer has a payroll in Ontario of at least $2.5 million per year. Refer to the ESA for more information.

Termination letter

Use this template to develop a termination letter and include the appropriate details, as outlined below.

Working notice

An employer can provide working notice instead of pay in-lieu. Working notice is when an employee continues to work throughout the notice period instead of ending employment on the date of termination. The advantage to the employer is that they still receive the benefit of the employee working. However, the employee’s effort will likely be less than 100 per cent.

Employee Agreement

The first step in conducting a proper termination is to ensure the employment agreement was properly put together. The Hiring section on this page provides information about employment agreements.

All employment agreements — whether in the form of employee or independent contractor — should include a termination clause to minimize the clinic’s potential for liability. Revisit the termination clause in your employment agreement prior to initiating termination. Ensure the clause meets the minimum legal requirements set forth by the ESA.

“Just cause” or “without cause”

The majority of terminations that take place in any business are “without cause.”  You do not have to give a specific reason for the termination other than it is “without cause,” provided the employee is not unionized. 

The terms “just cause” or “with cause” refer to a situation when an employer terminates an employee with no notice or compensation. “Just cause” terminations are usually reserved for significant incidents of misbehaviour, such as embezzlement, assault and fraud. Terminating with cause is extremely difficult to prove and will almost guarantee subsequent legal action. Poor performance is not considered grounds for “just cause.” Employers are encouraged to deal with underperforming staff before resorting to termination (see Managing Staff section on this page).

Termination meeting

There isn’t a legally prescribed way to carry out a termination meeting. However, there certainly is ‘termination meeting etiquette’:

  • Hold the meeting in a private place.
  • Deliver the message in a professional way but be direct and to the point.
  • Do not engage in personal conversation. You are there to deliver a message. If the employee wants to discuss, simply state “the decision has been made.”
  • Deliver the termination agreement and explain the next steps.
  • Give the person an option to collect their personal belongings or arrange another time to come back after hours.
  • Ask the person to return all keys and access cards for security purposes. Terminating access to building facilities and computers can be done after the person has left (or before, depending on the situation).
  • Consider letting the person say good-bye to co-workers.
  • Offer yourself as a reference for future employment (decide on a case by case basis).

Signed release

A terminated employee (without cause) does not need to sign a release to receive the minimum entitlements set out under the ESA. Should the employer offer more than what is required under the ESA, they can request a release be signed for the amount over and above what the ESA entitlements are. If there’s a release to be signed, do not make the person sign it at the termination meeting. Allow them one to two weeks to read the information, sign and return the release.

Walking the person out and saying good-bye

There is no rule that dictates a terminated employee must be walked out of the building or cannot say goodbye to their co-workers. These are decisions that can be made on an individual basis.

Other considerations when terminating an employee

  • Consider giving more entitlement than what is required by the ESA. Fair and generous termination terms will expedite acceptance and significantly decrease any chance of legal action.
  • Ensure all information regarding employee entitlements is accurate. Check the ESA and look at the original employment agreement. You can also consult an employment lawyer, if you have any doubts.
  • Do not discuss the termination of an employee with others at work. If the terminated employee finds out you are speaking negatively about them, it could be grounds for legal action.
  • Offer to give the terminated employee a positive reference. There may be exceptional circumstances, but for most, there was a time when the employee performed the job well. Furthermore, a positive reference may help the person secure a job faster, which could potentially decrease your settlement obligations.
  • Keep news of an upcoming termination confidential and inform only those who need to know.
  • Have two people participate in the termination meeting to avoid potential accusations after the fact. One should be the employee’s direct supervisor and the other either a clinic owner, partner or trusted staff member
  • Make a list of what office items are in the employee’s possession and need to be returned.
  • Shortly following the termination, communicate to the rest of the staff that the employee is no longer working there. You do not need to provide an explanation or give further details as to why, but you do want to maintain morale and have employees feel confident about their job.
  • Be diligent with post-termination activities, such as sending out the final pay and issuing a record of employment (ROE).

The termination process is one of crossing Ts and dotting Is. With planning and professional execution, it is possible to remain discreet. Following the steps and suggested practices in this section will drastically decrease the chances of a terminated employee taking legal action against you.

Related Articles

Legislation and RegulationThis page will keep you up to date on regulatory issues and legislation, including CASL, FSCO Service Provider Licensing and workplace legislation.

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