I saw a short clip from Gary Vaynerchuk recently, and I found myself nodding along the whole way through. His point was simple. If you want to improve the culture of your organisation, fire the toxic employee, even if they happen to be one of your top performers.

I agree with him wholeheartedly.

When someone is making the working environment miserable for everyone else, they have to go. I know it’s the conversation most practice owners and managers would rather put off for another month, or another year. But here’s the thing. Building a good culture isn’t about team bonding days, chocolate chip biscuits in the staff room, birthday cakes and “employee of the month” certificates. Those things are lovely, but they’re the icing. A good culture is about creating an environment where your good and great employees are free to thrive. And they can’t thrive if they’re spending their energy walking on eggshells around one person.

So what does build a strong team culture?

TRUST. Your team needs to trust that you’ll do the right thing by them. That you’ll have their back, keep confidences, and think about how your business decisions are going to affect them before you make them.

SAFETY. This means you put systems in place, make hiring and firing decisions, and even manage patients in a way that protects your team from harassment, bullying and ridicule. It also means creating a workplace where people feel free to speak up about the uncomfortable truths in the team and the business, without it costing them anything.

ACTION. You do the things you say you’re going to do, and you do them as quickly as you can. Every time you follow through, you build trust. Every time you don’t, you chip away at the sense of safety in your team.

APPRECIATION. Just as you’d like your team to go above and beyond what they’re paid for, you do the same for them. You show it, you say it, and you announce it in ways that mean something. More often than not, that simply means taking the time to be specific about what you love about their efforts, their performance and the version of themselves they bring to work every day.

Now, think about what happens to all four of those when you keep a toxic employee on.

Your team watches you tolerate behaviour that they know is wrong, and their trust in you drops. They stop speaking up, because they’ve seen that nothing changes, or worse, that speaking up makes things harder for them. They see you promising a better workplace and not acting. And any appreciation you give feels a bit hollow when the person making everyone’s life difficult is still being carried along.

The cost of this is enormous, and it’s often hidden. Your good people start to disengage. Your great people, the ones who have options, quietly start looking elsewhere, and they’re usually the first to leave. You lose time to managing conflict, smoothing things over and cleaning up the fallout. Patients pick up on tension at the front desk and in the surgery far more than we like to think. New team members either get pulled into the negativity or they don’t last. And you, as the leader, lose credibility every week the situation continues. That high performer might be bringing in great numbers, but when you add up everything they’re costing you, the maths rarely stacks up in their favour.

If you’re not sure whether you’re dealing with a difficult day or something more entrenched, here are the kinds of behaviours I’m talking about:

• Gossiping about colleagues, patients or management

• Working behind a friendly facade that drops the moment they feel threatened

• Blaming others when things go wrong

• Micro-managing team members who aren’t theirs to manage

• Taking credit for other people’s work

• Never taking accountability

• Creating drama

• Complaining constantly

• Speaking badly about the bosses without good reason

• Being defensive or aggressive when given feedback

• Opposing every change, no matter what it is

• Refusing to help other team members with their tasks when needed

• Slacking off while others pick up the slack

• Bringing their personal life into the workplace as a reason for poor performance, time and time again

One or two of these on a bad week doesn’t make someone toxic. We’re all human. It’s when these behaviours become a pattern that you have a problem you need to address.

So how do you move someone on in a way that’s fair, and in line with Fair Work guidelines? It starts with a proper process, and it starts with you.

Set up a meeting with them. Let them know ahead of time what it’s about and that they’re welcome to bring a support person.

At the start of the meeting, own the role you’ve played in things getting to this point. Something like, “I’ve been noticing certain behaviours for a while now, and I’ve tolerated them. I didn’t want to upset the applecart, and I was hoping things would sort themselves out or that it was just a phase. That’s on me. But this has now become entrenched behaviour, and I won’t be tolerating it anymore.”

Then go through the behaviours one by one, with specific examples, so they know exactly what you’re talking about. Vague feedback like “your attitude isn’t great” gives them nothing to work with and gives you nothing to stand on later. “On Tuesday, when Sarah asked for help with the sterilising, you told her it wasn’t your job and walked off” is clear and hard to argue with.

Then ask for their feedback. “What do you think about what I’ve said?” They deserve to have their say, and you need to listen. They might blame other people, the systems, or you. Let them say it. Then calmly respond with something like, “I hear you. That doesn’t change the need for these changes in your performance now. This is important and it needs immediate attention.”

Next, for every behaviour you’ve raised, tell them specifically what you’d like to see instead. If they gossip, what does good communication look like in your practice? If they refuse to help, what does being a team player look like day to day? Be just as specific here as you were with the problems.

Let them know you’re going to create a plan together, focusing on a couple of shifts in behaviour each week so it doesn’t feel overwhelming. Build the plan, then book in weekly follow-up meetings and put them in the diary straight away. Don’t leave it as “we’ll catch up soon”. At each follow-up, talk about where improvements have been made, if any, what isn’t improving and still needs to, and what further training, support or resources they need to get there.

Be honest with them about how critical this is. Tell them you’re giving them every chance to improve, but if the changes aren’t made despite the support, then this isn’t the right workplace for them.

If there’s no improvement, tell them there’ll be another meeting once you’ve put the support in place for the following week. And say this part clearly. If there’s still no change by then, the likely outcome of that meeting is that their position here will be terminated.

Document everything. Every meeting, every example, every agreed action, every piece of support offered. Ask them to sign the performance improvement plan to show their commitment to it. If they refuse to sign, that tells you something too. Either they completely disagree with what you’ve raised, or they have no intention of changing. Either way, make a note that they declined to sign and continue with the process anyway.

Fair Work rules can differ depending on the size of your business and how long the person has been with you, so it’s always worth checking the Fair Work website or getting some HR or legal advice before you start. A good, fair process protects you, and it also gives the employee a real chance to turn things around. Some people do.

But if they don’t, and you’ve done the work, you can let them go knowing you did the right thing. And I promise you, the rest of your team will notice. You’ll likely hear a collective sigh of relief, see people smiling a bit more at work, and find your good and great people finally have the room to be exactly that.

That’s what culture really is.