Terminating the Lead MA Ten Days After an FMLA Request
Valerie has been lead medical assistant for nine years at a 22-employee practice. She turns rooms faster than anyone, trains every new hire, and is the only staff member who can run the practice's two point-of-care analyzers without errors. Over the last five months she has been late 14 times, twice by more than 40 minutes, and three MAs have complained that she yells at them. Two MAs resigned in that period; both cited her in exit interviews. Ten days ago Valerie submitted a request for intermittent FMLA leave to manage her father's changing dialysis schedule. The office manager has kept a running list of Valerie's lateness in a notebook, has never spoken with her about it, and has issued no written discipline. The physicians want to terminate her on Friday.
1. Can the practice terminate Valerie on Friday? Identify the exposure and lay out the sequence you would follow.
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Not on Friday. The conduct is likely terminable, but the timing is the problem: ten days after an FMLA request, in a practice with no documentation of a single conversation about the attendance, is the textbook mixed-motive fact pattern. The burden will fall on the practice to show it would have acted identically absent the leave request - and the notebook, unshared with the employee, does not establish that.
Sequence:
- Verify eligibility separately. Confirm the 50-employee/12-month thresholds if applicable, send the rights and responsibilities notice, and obtain the medical certification through HR, not through a supervisor's side conversation.
- Separate conduct from leave. The discussion addresses lateness, treatment of coworkers, and the specific complaints - never the FMLA request. Do not ask about her father, do not reference dialysis, and do not mention the request in the written document.
- Issue a written performance improvement plan with specific, measurable expectations, dates, and consequences, and apply the same attendance policy to similarly situated staff (pull the records to confirm you have).
- Investigate the complaints with dated statements and give Valerie a chance to respond.
- Pause the analyzer dependency. Cross-train two MAs immediately - that is a continuity risk regardless of how the discipline resolves, and its absence will make termination look reckless to the partners.
Termination becomes defensible after a documented plan, consistently applied. Note that intermittent FMLA may legitimately cover some absences; her own lateness that is not leave-related is not protected, but the practice must be able to tell the two apart in its records.
2. Two resignations in five months from the clinical support team. Is this a Valerie problem, a workflow problem, or both - and what would you do about it?
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Do the arithmetic on scope first. Two resignations from roughly twelve clinical staff in five months annualizes to about 40% turnover in that group, far above a typical 15–20%. Replacing an MA costs roughly half to one and a half times annual salary once recruiting, orientation, and lost productivity are counted - so this is a five-figure annual expense, not a personality conflict.
The pattern - Valerie turns rooms fastest, trains everyone, and is the only person who can run both analyzers - suggests she has absorbed three roles: clinical lead, trainer, and analyzer operator, with no supervisor layer. The yelling may be a symptom of a person with no authority and unrelenting throughput pressure. That is a workflow problem that also produces a conduct problem.
Actions:
- Run an anonymous staff survey and structured stay interviews, not just exit interviews - departing employees are the least useful source because they have nothing left to lose and no reason to be precise.
- Cross-train analyzer operation to at least three people.
- Create a genuine supervisory layer (a clinical supervisor or office manager) so the person enforcing standards is not also the person absorbing the workflow burden.
- Give Valerie a defined scope with written standards and the authority to match, and hold her to the conduct standard separately.
- Track turnover and complaint volume monthly to see whether the intervention works.
3. The practice pays every MA an annual salary of $780 per week with no overtime, and MAs routinely stay 30–45 minutes past shift to finish instrument processing. Assess the exposure and the fix.
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Paying a salary does not make an employee exempt. The FLSA exemption depends on the duties test, and medical assistants - performing clinical and clerical production work under supervision, without authority over matters of significance - do not meet the administrative or executive tests, and are not learned professionals. This group is almost certainly misclassifying its entire MA staff.
Quantify roughly: 8 MAs × 0.6 hours of overtime per week × 52 weeks ≈ 250 hours per year. At $15.00/hour, the half-time premium is $7.50, so the base exposure is ≈ $1,875 per year - small. What makes it dangerous is the multiplier: the DOL generally looks back two years (three for willful violations), and liquidated damages can double the back wages, with plaintiff's counsel fees on top in a private action. Across three years and the class of all MAs, the same math becomes a five-figure settlement plus fees, on a practice with a $1.52 million expense base.
Fix now, not at the next policy cycle:
- Reclassify MAs to hourly, convert the $780 weekly salary to an equivalent hourly rate at 40 hours ($19.50) - or whatever preserves take-home pay without creating a reclassification-pay cut complaint.
- Install a timekeeping system and require clock-in/clock-out; prohibit off-clock work in writing and enforce it.
- Audit for other off-clock exposure: morning huddles, chart prep before open, mandatory training.
- Have counsel assess a voluntary lookback and payment of back wages, which is generally treated far more favorably than waiting for a complaint.