Rules of the game

Aug. 1, 2000
A document that outlines the specifics of the conditions of employment can spare you untold grief when questions arise.

A document that outlines the specifics of the conditions of employment can spare you untold grief when questions arise.

Gregory L. Psaltis, DDS

Kathy, your loyal assistant of nine years, approaches you one day with a "favor to ask" because of problems with her six-year-old daughter`s new day-care provider. She wants to know if she can come to work 15 minutes later than usual each day, as long as she "promises" to "be really efficient" and "prepare all her morning duties the night before."

A part of you wants to say yes to this individual, who has worked hard for you during her career in your office. But another part of you sees the potential for problems with the other two assistants, both of whom also have children in day care.

This is one example of many requests that are put on the table for an employer to consider, and it appears that no matter what your decision, it will impact the office negatively. Losing Kathy would present a significant challenge, but alienating her co-workers could likewise create repercussions. What is a boss to do?

The greatest joys in my professional life are in the patient contact and the technical care I provide. After years of practice, my frustrations rarely come from these two aspects of my work. More often, I find that a variety of seemingly minor, yet relentless, issues swirl around my head like mosquitoes. These are rarely, if ever, based on the actual performance of dentistry, but, rather, tend to fall into the broad category of "taking care of my team." While this generalization encompasses many different parameters, the focus for this article will be on the specifics of the conditions of my team`s employment and the document that spares me untold grief when the inevitable questions arise. By having a document that spells out the "rules of the office," the answers are spelled out upfront for the vexing questions or favors that are asked and the resulting dilemma of choosing between being a "flexible boss" or being "hard."

I was given excellent advice during a brief association with two experienced pediatric dentists in Sacramento, Calif. They had been in practice for 22 years. Their philosophy was that they worked hard to achieve success, but planned carefully for failure. This is not a pessimistic viewpoint. I consider this philosophy to be one of the memorable pearls I learned from them - one that has served me well in many areas of my life. I view the "Conditions of Employment" as a boundary-setting document that is needed primarily at times of confusion. My basic belief is that people can work together if they feel that they are being treated fairly. However, there will be times when questions arise. The goal of your "Conditions of Employment" document should be to anticipate as many scenarios as possible, so that everyone understands the rules.

Let`s review some of the most critical components of a "Conditions of Employment" document. Your policy need not be limited to these categories, nor must it include all of them. However, keep in mind that the more thorough you are, the fewer problems you will have in the future.

The "Conditions of Employment" document in my partner`s and my office is 10 pages long and consists of 20 paragraphs. The sections that I feel are most vital to any office`s document include the following:

1. Regular work schedule

This section literally defines the exact times that constitute your work day and work week. It is the basis for pay and the basis for when employees are expected to be in the office. We also included a rejoinder about the nature of dentistry and the fact that we may run late on occasion. We specify that if a lunch hour is ever shortened by 30 minutes or more, the office will provide lunch to the team. It also is important to address overtime and how it will be handled. You should consult with an attorney to make sure your conditions meet state and federal standards.

2. Personal appearance

This is the place to define any requirements you have regarding the way your team members dress, wear jewelry and perfume, keep their hair, and what, if any, penalties occur because of infractions of these rules. In our practice, an Office Standards Committee deals with this. By doing this, the team is policing itself, taking the dentist out of the enforcement role.

3. Probationary period

This section defines the period of time during which assessment toward regular employment will be conducted. For us, it also defines precisely how and by whom these assessments will be done.

Our "Success Committees," which are comprised of three team members and one doctor, regularly critique the new employee and outline specific areas in need of improvement. Improvement must be shown in order to continue working in the office.

4. Regular period of employment

Here we define exactly when the probationary period ends and which benefits begin. In our practice, some benefits, such as medical insurance, only apply to "regular employees." During the first three months, some of the benefits are not available. By defining this specific point in time, new employees have a clear idea of when to expect each part of the benefit package.

5. Wages

Spell out the terms of payment (whether hourly or a monthly wage), the dates on which wages are to be paid, and the basis for any bonuses, if applicable. We allow employees to become eligible for a bonus after a full year of employment. We also specify that to be eligible for a bonus, employees must still be working in the practice up to the designated bonus payday. In this way, we avoid questions about who "deserves it." It is an objectively defined basis.

6. Holidays

Enumerate each holiday that the office observes. If a holiday falls on a weekend, include a statement about whether or not it will be observed on an alternate work day.

7. Vacation

Many formulas exist for defining a vacation benefit. Carefully lay out the guidelines for when the benefit actually begins and how it accrues. In our case, we do not allow time to accrue from one year to the next. We feel this policy encourages team members to take the time off they have coming. We feel this is critical to their ability to perform at the level of competence we expect.

8. Medical insurance (if applicable)

This benefit needs clear boundaries, including when it begins (at what point in time of employment), which plan is provided, and who is included in the plan (whether or not family members can be added). We allow family members to be added, but at the expense of the employee. Team members may select a plan other than the one that we provide, but the practice only pays a dollar amount up to the equivalent of the premium for the designated plan.

9. Definitions of full-time, part-time, and temporary employees

If your benefit package depends on the working status of the employee, you need to delineate between full-time, part-time, and temporary employment. Cross-reference which benefits apply to employees in each category once your "Conditions of Employment" are written in outline form.

10. Leaves of absence

Check with your attorney regarding your state`s laws about maternity leave. Local statutes may determine your policies. Beyond that, you also can establish guidelines here for extended illnesses or injury, and specify how long benefits will continue under these circumstances. For example, in our practice, we agree to a four-week period of time to continue medical insurance. We also specify that an employee on extended leave will have her/his job held open for six weeks from the time of absence.

11. Continuing education

If your practice has either benefits or requirements concerning continuing education, this is where to clarify them. This may include a variety of possibilities. For example, you can define courses that are required by you, the employer, and whether or not there is extra pay when these courses occur on defined "nonworkdays." You also should address the courses that individual employees request to attend and whether or not the practice will pay the tuition. Other issues may include whether transportation, room, and/or food are included for courses that are not in your immediate geographic area. For our employees, we have defined a daily dollar amount for food per day for courses that require a single meal and an amount for courses that require an overnight stay. The more detail you can include, the less likely you are to have confusion.

12. Retirement plan (if applicable)

As with other benefits, inform your employees about the practice`s plan and the basis for eligibility. We have a SARSEPP plan, which allows flexibility in participation. As a result, we have clearly stated that the level of contribution each year is solely at the discretion of the employer.

13. Infection-control training

Not only is it a good idea to have an infection-control manual, but it also is wise to state in your employment document that employees must study your manual. In this way, you have made it clear that the requirement of OSHA training is being addressed in an active way in your practice, so that no questions can arise later about its importance.

14. Termination of employment

This is one of the most important categories to address in advance - the specific reasons for dismissal from the business. We not only enumerate reasons (illegal activities, lack of aptitude, any reason detrimental to the practice, etc.), but we further include a "not all-inclusive" statement, so that we are not limited to our list. In this way, we have established specific criteria that must be met as a minimum for continuing employment in our office.

One issue that we have included in our "Conditions of Employment" is a "commitment to positive behavior." This is an area that some offices may not feel is vital, but we believe it is important because we spend so much time on the development of team and communication. This policy not only addresses the issue of conflict, but it also provides a framework for resolving it.

Our employment document includes a four-step plan for conflict resolution that is taught and supported in our team meetings. When these steps are not followed, dismissal will result. This has been successful in minimizing infighting and has kept the doctors from having to be referees for disputes.

Offices may want to address other points in their employment document. One such area is a sickness (often called "wellness") benefit. We combined wellness with vacation into a single category called "days off," so that the less time employees are sick, the more time they can take as vacation time. The total number of days that are paid, however, is clearly defined.

We also have chosen to include a section that emphasizes that our office will provide the hepatitis vaccine for all interested personnel. It is plainly stated in the employment document that we recommend the vaccine.

Administrative matters (such as employees receiving keys to the office) and general definitions complete our "Conditions of Employment" document.

Work in progress

A "Conditions of Employment" document is a work in progress. Each year, we review our document thoroughly to see if any of our policies are unclear, if anything has been omitted, or if something simply no longer applies. Corrections are simple if the document is on a word-processor or computer.

My partner and I have adopted the convention of opening up the "Conditions of Employment" document to discussion and/or suggestions by the team in September or October. Nov. 1 is our deadline for any ideas or questions about our policies.

We do this so that changes can be made by Dec. 1. Then, team members will have a full month to review the changes and ask questions. The document is ready to be signed on the first work day of the new year.

The services of an attorney are invaluable in the creation of an employment document. Clearly, you want to be in compliance with all federal and state regulations. By putting the time and effort into a well-crafted document, you can fend off numerous questions or problems that may crop up later.

Our "Conditions of Employment" have served us well, even though it has been necessary to amend them on several occasions. It has enabled us to focus far more of our time and energy on providing quality care to our patients, rather than constantly struggling to stamp out fires with staff members. Since providing care is the purpose and the greatest joy of our practice, the importance of our "Conditions of Employment" cannot be overstated in creating greater peace of mind for my partner and as employers.

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