A recent viral video parodies the plight of hiring managers. After admiring a hand-drawn “resume’” and checking the job candidate’s pulse, the manager asks, “When can you start?”
While the fictitious interview was meant to be comedy, the struggle to find candidates to fill open positions is a reality for most employers in today’s market. The results of a November 2021 poll from the ADA Health Policy Institute found that 9 out of 10 hiring dentists indicate that it has been “extremely” or “very” challenging to recruit dental hygienists and dental assistants in the past year.
In a climate of such need, it is understandable that dentists who find qualified and available new employees are eager to have them begin working as quickly as possible. However, prioritizing job duty training over educating new employees about crucial office policies can lead to miscommunication and increased risk of misconduct. The Dentists Insurance Company’s dedicated Risk Management analysts advise you to minimize risk by documenting your practice’s employment policies and making sure all employees — both seasoned and new — are offered training on the practical implementation of and adherence to those policies.
A case study in employment practices
A phone call received by TDIC’s Risk Management Advice Line came from a practice owner who needed guidance on handling the aftermath of an employee’s termination. The employee in question was a dental assistant who displayed stellar work habits during the first 90 days of employment. Unfortunately, in the days that followed, the dental assistant developed an attitude that was out of sync with the culture of teamwork the practice owner felt was established within the office. For example, the practice owner noticed the assistant rolled her eyes when asked to do things.
Problems with the employee escalated from that point. In another instance, after being asked to clean the last operatory of the day, the employee responded by throwing her sterilization gloves down on the counter, then further demonstrated her anger by slamming items around the room as she cleaned. The assistant arrived late to work most mornings and frequently complained to other staff about their office being too busy and the lack of opportunity to take scheduled breaks. Her interaction with other staff members became increasingly strained.
When the new employee’s behavior became intolerable, the practice owner made the decision to terminate the employment. He called the employee one evening after work to let her know that her services were no longer needed and final pay would be directly deposited to her account. The practice owner was relieved to end the association with an employee who had disrupted what he felt had previously been a positive working environment for his staff. You can imagine this dentist’s shock and dismay when, a few weeks later, he received a letter from an attorney representing the ex-employee, requesting a copy of her personnel file.
When the practice owner contacted the TDIC Risk Management Advice Line for guidance, he told the Risk Management analyst that he didn’t feel the issues during the ex-employee’s time in his practice warranted a discussion to address concerns about her work. He assumed that the employee was well aware of her behavior and the negative impact it had on the team. He concluded that she simply didn’t care how she was perceived by him or her teammates and expected to be terminated. When asked if the office had an employee manual that referenced his office’s employment practices, attendance or rest and meal break policies, the practice owner stated that he treated his employees as “family.” In the past, all employees got along well without conflict, so he didn’t think it was necessary to establish any formal protocols.
According to TDIC’s Risk Management team, often a request for a copy of an employee’s personnel file from a legal representative is followed by another letter threatening further legal action with allegations such as wage and hour violations – including failure to provide meal and rest breaks, failure to pay meal and rest break premiums and failure to provide wage statements. Such accusations are made in response to the termination of the employee and are also accompanied by a settlement demand to resolve these claims. The attorney may purposely avoid addressing any issues pertaining to the termination if this is not the strongest case and instead call into question the level of administrative oversight performed by the office.
Mitigating risk begins with communicating expectations
A lawsuit filed by a current or former employee is a difficult way to learn the importance of effectively documenting and communicating the conditions and expectations of employment within your practice. It’s best to provide documentation of office standards and ensure that all employees — regardless of position or tenure — acknowledge recognition and understanding of those standards. Not only should priority be given to sharing your practice’s employment policies during new-employee onboarding, but time should also be devoted to reviewing the policies with all staff on a regular basis.
TDIC’s Risk Management analysts urge dentists to utilize a document called an employee manual to effectively document and share workplace expectations and policies. A customized, up-to-date employee manual is an easily implemented yet powerful tool to improve and safeguard your practice. It can be your primary defense in everything from day-to-day office disputes to full-blown legal claims, along with minimizing confusion and miscommunication about policies and regulations.
An employment manual like this is also beneficial to employees, giving them a roadmap of your expectations. Think of this resource as a guide of your practice’s culture, which includes benefits, dress code, punctuality and attendance expectations. By clearly outlining these policies and documenting them formally in an employee manual, you avoid unfairly or inadvertently singling someone out when course correction is necessary. An employee manual also simplifies the performance evaluation and corrective action process, as reference to performance — improved or needed — can be related back to your manual and your established office policies.
TDIC policyholders have access to downloadable sample employee manuals specific to the state in which they practice. CDA members also have access to a sample employee manual through Practice Support as well as an employee manual generator. These are excellent resources to efficiently create or update dentistry-focused office policies.
Prevent and be protected against costly lawsuits
While having an employee manual itself is not a legal requirement, there are many sound legal reasons for having one. Some employment laws require employers to notify employees of certain workplace rights in writing, so a well-developed manual that can be given to employees is an important step in documenting your compliance with federal, state and local employment regulations. By outlining employment laws and any other standards your practice adheres to, along with the consequences of policy violations, within the form of a manual and recording employees’ acknowledgement of reading that manual, you have the protection of due diligence on your side.
The absence of an employee manual greatly increases the likelihood of an employee filing suit. Practices that don’t have employee manuals are considered proverbial low-hanging fruit for successful lawsuits, because the lack of an employ manual is indicative of potential negligence in other aspects of the business. A manual is one of the simplest yet most effective ways to deter opposing legal counsel from deciding to file a lawsuit.
Keep manuals current and specific
Just as you update tools and technology in your practice environment, make sure your employee manual keeps pace with regular updates. Having an employee manual that contains outdated or erroneous policies can be almost as dangerous as having no manual at all. It should be a living document — one that you add to or subtract from in cadence with changing employment laws and practice guidelines.
You may be tempted to adopt another practice’s manual or utilize a generic document provided by your payroll company. Unfortunately, simply copying the contents of another company’s employee manual is unlikely to satisfy the unique human resources needs of your own workforce. You risk not being specific, consistent and objective.
By outlining policies that are tailored to your practice in your manual to reference during employee communication, performance evaluations and disciplinary actions, you ensure every situation is handled objectively and consistently. Frequently, the root of poor employee performance is confusion, lack of clarity or an inconsistent approach to process. It can be validating for all employees to refer back to the manual when questions arise. Furthermore, adherence to policies outlined in an employee handbook strengthens the role of the dentist as leader in the practice.
Periodically conduct an audit of day-to-day operations within your practice to assess how closely you and your employees are following the guidelines outlined in the employee handbook you’ve provided. When updates are necessary, all employees should be informed of the changes and should acknowledge their understanding of those changes.
Creating and implementing an employee manual
TDIC’s sample manuals and CDA’s employee manual generator contain content developed by employment attorneys and HR specialists. Their understanding of state employment laws and dental employment practices offers a sound starting point for your handbook. Most importantly, both tools can be customized to meet the needs of your practice. They include:
- Standards for performance and protection against HR-related legal claims.
- Best practices tailored to your practice’s unique goals and culture.
- Federal and state-compliant policies for your practice’s size and location.
Before you begin the process of creating an employee manual or handbook, prepare to address human resources policies that apply to your practice, including:
- Details of benefits offered (PTO, holidays, health insurance, in-house benefits, etc.).
- Mandatory paid sick leave requirements for full- and part-time employees.
- Rate of pay for mandatory meetings, training, travel time and on-call work.
- Alternate work schedule and its impact on benefits, as applicable.
- Dress code or uniform standards.
Once you have created or updated your employee manual, it’s time to implement it in your practice. If you have been working without an employee manual or using a generic one, make time to introduce the new document to your employees during a staff meeting. For new employees, during onboarding, prioritize giving them access to the document, offering an overview of important points, allowing them time to read it and recording their acknowledgment of receipt and understanding.
Whether you are implementing an employee manual for the first time or already have a robust handbook in place, consider the following:
- Do your employees have access to a current copy of the manual?
- Have you kept records showing that your employees acknowledged reading the manual?
- Are any changes or updates you’ve made to the manual also acknowledged by employees?
- Are you referring to practice policies within the manual during new-employee onboarding?
Practice owners should consider an employee manual one of the most important documents in their human resources tool kit. Not only can definitive employee policies resolve disputes, they can also thwart issues before they arise, protecting both the employer and the employee from any misperceptions and the potential for litigation. Taking time to document your practice policies in an employment manual and introducing it to all employees is an important investment in the long-term well-being of your dental practice.
TDIC’s Risk Management Advice Line is a benefit of CDA membership. Schedule a consultation with an experienced risk management analyst or call 800.733.0633. Reprinted with permission from the California Dental Association, copyright February 2022.