Recognize the Warning Signs of Impending Job Termination

Learn to read the tea leaves and foresee winds of change.

In today’s dynamic healthcare environment, physicians face job insecurity similar to that of other employees, and perhaps more so. Several factors correlate with physicians being fired. These include being the first person in a new or unclear job, working for an entity with sustained financial losses, and persistent conflict with a boss or board member concerning personal style or organizational strategy. Additional variables include recent termination or departure of a boss, recent merger or acquisition, and widespread organizational downsizing or re-engineering.

Recognizing these early warning signs of potential termination can empower physicians to make decisions about their careers before the axe falls. Understanding these signals can help soften the blow of job loss and facilitate a smoother transition to new opportunities.

Behavioral Changes from Management

One of the first indicators of job insecurity is a shift in management’s behavior. Reduced communication, where your manager avoids engaging in meaningful conversations, can signal a breakdown in the professional relationship. Exclusion from meetings or projects may indicate a diminishing role within the organization. Increased micromanagement often reflects a lack of trust in your abilities, while frequent negative feedback and unclear expectations can undermine your confidence and performance.

These behavioral changes suggest a need for open dialogue with your boss or someone in management to address any concerns and clarify expectations rather than retreat or disengage.

Shifts in Your Workload

Changes in your workload can also be telling. A lack of new assignments or the removal of responsibilities may indicate that your contributions are no longer valued. Unusually negative performance reviews, especially when they seem unwarranted, can be a precursor to termination. These shifts should prompt self-reflection and a discussion with your supervisor to understand the underlying reasons and explore ways to improve.

Company-wide or Organizational Changes

Sometimes, the signs are not personal but, rather, are a reflection of broader organizational changes. Budget cuts, a hiring freeze, or a perceived reduction in the importance of your role can all impact job security. These changes may not be within your control, but being aware of them can help you prepare for potential outcomes.

I’ve had to deal with MADness — mergers, acquisitions, and downsizing — numerous times. Security is never guaranteed in these circumstances, but it’s better to be on the acquiring end than the acquired. Regardless, mergers rarely have a human side, because business imperatives drive these transactions.

Social and Professional Dynamics

The workplace atmosphere also can offer clues. If colleagues begin to act differently, seeming hesitant to engage, it could be indicative of rumors or known changes about your employment status. A loss of privileges without explanation or circulating rumors about layoffs can further contribute to a sense of instability. Maintaining strong professional relationships and open communication can help circumvent these social dynamics.

Direct Indicators

More direct indicators of impending termination include being placed on a Performance Improvement Plan (PIP) or being assigned tasks that are difficult or impossible to achieve. If your boss avoids discussing your future within the organization, it may be time to consider your options. These direct signals require careful evaluation of your position and proactive steps to secure your career.

Strategic Response

If you notice several of these signs, acting strategically rather than reacting impulsively is crucial. Resigning immediately to “save face” can have significant financial implications, including the loss of severance or unemployment benefits. Instead, consider updating your resume, networking with colleagues, and exploring new opportunities while still employed. Open communication with management about your role and performance can sometimes reverse negative perceptions.

Recognizing and addressing predictive warning signs can help physicians confront job insecurity with confidence. By staying informed and proactive, you can safeguard your professional future and ensure a smoother transition to new opportunities, should the need arise.

Remember, your career is a journey, and each challenge presents an opportunity for growth and advancement. Job loss resembles the opening of a window: it may initially feel like an unwelcome draft, but it also provides fresh air and new perspectives, leading to growth and transformation.

Excerpted from How to Jumpstart Your Medical Career and Thrive in Practice Practical Advice and Insight from a Battle-Tested Physician (American Association for Physician Leadership, 2025).