I had a conversation with a healthcare executive recently about a problem employee.
This person was a bully. Creating lateral violence. Making life miserable for their peers.
But they were also incredibly knowledgeable and in a position that was hard to hire for. A “superstar” in terms of clinical skills.
The executive said: “I know I need to do something. But oh my god, it’ll cost us so much to recruit and replace that person.”
And I asked the question nobody wants to answer: “What is it costing you not to replace them?”
The Math We Do (and Don’t) Do
Here’s the math organizations always do when they have a problem employee. They consider:
- Recruitment expenses
- Onboarding and training time
- Temporary coverage or overtime
- Lost productivity during transition
- Time spent on performance management or termination
Those costs are visible. Tangible. Easy to calculate. And scary. So they look at that number and think: “We can’t afford to solve this problem.”
We think they can. In fact, we think they can’t afford not to.
The Cost of a Toxic Employee
Let’s use this toxic employee who’s hard to replace as an example. Here are some of the costs of keeping them on board.
Turnover
The people the bully is targeting eventually leave. Not because they can’t do the job. Because they can’t stand working in that environment.
And here’s the kicker: The people who leave first are usually your best people. Because they have options. They can get jobs elsewhere. So you’re losing high performers while keeping the toxic one.
Lost productivity
When people are dealing with bullying, they’re not focused on their work. They’re stressed. Anxious. Spending energy navigating the toxic environment instead of caring for patients.
Research shows that dealing with workplace bullying can reduce productivity by 40%. Forty percent. That’s not a small cost. That’s massive.
Recruitment costs
Remember—you’re not just dealing with the cost of potentially replacing the bully. You’re dealing with the ongoing cost of replacing everyone the bully drives away. Multiply that by however many people leave over the months or years you tolerate the behavior.
Damaged team morale
Even the people who don’t leave are affected. They see that the organization tolerates bullying. They learn that it doesn’t matter how you treat people as long as you’re good at your job.
That erodes culture. Fast.
Patient experience impact
Do you think a team dealing with lateral violence is delivering excellent patient care? Do you think patients don’t notice the tension, the stress, the dysfunction?
Of course they notice. And it shows up in your patient experience scores. Your reputation. Your loyalty.
Potential legal liability
If someone files a complaint, a grievance, or a lawsuit related to the hostile work environment, that’s another cost. Legal fees. Settlement costs. Reputation damage.
Add all of that up.
Now compare it to the cost of actually addressing the problem. Replacing one person. Or holding them accountable until they either change or choose to leave.
Which is higher?
Here’s the brutal truth: Inaction is a choice. And it has a cost.
When you choose not to address a problem, you’re not avoiding cost. You’re just choosing to pay it in a different way. You’re choosing to pay it in turnover. In damaged morale. In eroded culture. In patient experience decline. In reputation damage.
And those costs compound over time. They don’t stay static. They get worse.
The question is: what are you willing to do about it?
Tags: DecisionMaking, HealthcareLeadership, Leadership, OrganizationalCulture, ToxicWorkplace
