When politics enter the operatory: managing sensitive conversations in dental practices

In the intimate setting of a dental practice, team members work together closely for many hours each day. Conversations inevitably flow beyond teeth and gums, but when discussions veer into politics or controversial social issues, practice owners and managers face a dilemma: how should they address these situations?

While you may be tempted to prohibit such discussions altogether, this approach carries its own risks. In an increasingly polarized country, now is a better time than ever to look at the challenges of mitigating controversial conversations among dental staff and providing practical strategies for maintaining a cohesive workplace culture.

The legal landscape

Before attempting to restrict workplace conversations, it's important to understand the legal framework. The National Labor Relations Act (NLRA) protects employees' rights to engage in "concerted activities" regarding workplace conditions-even in nonunionized settings. This includes discussions about compensation and benefits, workplace safety protocols, management practices, and working hours and conditions.

These concerted activities could involve politically adjacent topics like endorsing a specific measure or a candidate who might enact laws that provide better working conditions or benefits for employees.

Many states also have laws explicitly protecting employees' political activities and expressions. For example:

• California: Employers may not prevent an employee from participating in the political arena in any capacity or threaten to discharge an employee for engaging or refusing to engage in certain political activities.

• Colorado: Employers may not create or enforce a rule or policy to prevent an employee from engaging or participating in politics or discharge an employee for lawful off-duty activities, such as voting in an election or advocating for a particular candidate or political viewpoint (subject to a private cause of action). 

• New York: Employers may not coerce employees through direct or indirect threats of discharge or discharge them because of their political beliefs or voting activities.

Thus, an attempt to enforce overly broad restrictions could expose your practice to legal liability. The First Amendment protections don't generally apply to private employers, but there may be some exceptions-for example, if your practice receives significant government funding (Medicare/Medicaid).

Attempts to regulate conversations can inadvertently create discrimination claims if the rules are applied inconsistently based on viewpoint and/or disproportionately silence certain groups, for example, prohibiting discussions about George Floyd but allowing conversations about Donald Trump.

Focus on behavior, not content

Instead of asking, "How can we stop these discussions?" consider a more productive question: "How can we ensure these conversations don't damage our practice culture?"

Policies that address disruptive behavior rather than specific topics generally survive legal scrutiny. For example:

• Conversations must never impact the quality of patient care

• Discussions must remain nondiscriminatory, nonconfrontational, nonviolent, etc.

• Patient areas are off-limits for personal, potentially inflammatory, and controversial topics

Courts generally uphold reasonable limitations on when and where discussions can occur, provided they:

• Apply equally to all nonwork discussions

• Serve legitimate business purposes

• Leave adequate alternative channels for expression

While we encourage allowing space for personal expression and discussion, remain alert for conversations that:

• Disrupt workflow or patient care

• Include discriminatory language or content

• Escalate into personal attacks

• Harass others based on protected characteristics

• Create a hostile work environment

These are indicators that you need to address these problematic conversations. If/when that occurs, here are some guidelines:

1. Address it privately. Speak with involved staff members individually rather than publicly calling them out.

2. Focus on impact, not intent. Say "This conversation is making others uncomfortable" rather than "You're being insensitive."

3. Redirect rather than restrict. "Let's focus on our patients and leave personal conversations to break time or after-hours."

4. Use coaching language. "How might we express different viewpoints while maintaining our cohesive environment?"

If certain team members consistently create tension or disrespect boundaries, try the following techniques:

1. Document specific incidents and their impact on the practice.

2. Hold formal conversations with clear expectations for improvement.

3. Follow your practice's discipline policy if needed.

4. Consult HR professionals or legal counsel for guidance.

Conclusion

Managing political discussions in dental practices requires balancing workplace harmony with legal compliance. By focusing on behavior rather than content, implementing reasonable time and place restrictions, and ensuring consistent application of policies, practice managers can reduce legal risk while maintaining a productive work environment.