by Myrna I. Sessa

Why you need one, and how it will help you run your practice

Why would an orthodontic practice ever need an employee handbook, you ask? Doesn’t everyone who works here know what is expected of them? My practice is too small. Handbooks are for big corporations. I don’t want to make promises I can’t keep!

Compelling arguments, but I don’t agree. As an HR professional for more than 24 years, with 8 years in my own consulting practice, I’ve found that all employers, whether they’re medical practices, software developers, architects, CPA firms, law practices, pension investors, or even orthodontists, need an employee handbook. I’ve prepared handbooks for companies with fewer than five employees as well as for ones with more than 1,000. Every one of them has employees, and if you have employees, you have issues.

An employee handbook is the most essential communication tool between an orthodontist and his or her employees. Employee handbooks are one of the few publications that all employees receive, and probably one of the few that almost all employees actually read. An employee handbook summarizes the relationship between the employer and the employee and briefly describes what management expects of employees. It’s also a marketing tool that describes the practice’s benefit plans, services, and time-off policies.

Handbooks describe various legal requirements, general information about the practice, work rules, procedures that need to be followed, and information about salary and pay practices.

No federal or state laws require an employer to have an employee handbook, but having one is a good idea for many reasons.

Reasons Your Practice Should Have an Employee Handbook
1) It sells the practice to the employees. The handbook provides information about what the employer offers workers. Even if an employee never makes use of a tuition reimbursement program, a parental leave of absence, or other benefits, such a collection of benefits can be a powerful motivator and an effective tool for reducing turnover.

2) It saves time and money. A well-prepared handbook will answer a great majority of the routine questions that would otherwise end up on your desk. When an employee knows to look in the handbook first, it saves management time.

3) It reaps the benefits of consistency. Published rules and policies reassure employees that everyone is treated fairly and consistently. A handbook may not only eliminate needless confusion and misunderstanding about policies, but it may also result in increased employee morale. Often, when I’ve completed a handbook for a client, employees are categorically pleased and grateful. (Of course, this assumes that management follows the guidelines and rules that have been set forth in the handbook.)

4) It meets legal requirements. Certain information is required by law to be provided to employees in writing, such as equal employment opportunity (EEO) statements, a sexual harassment policy, and an employment-at-will disclaimer. A handbook is the perfect place for these to be included.

5) Insurance companies require it. If you have directors’ and officers’ liability insurance, general liability insurance, employment practices insurance, or the like, the carriers will often ask whether or not you have an employee handbook. I would venture a guess that the lack of one could even affect your premium rates.

What Should Go in the Handbook?
Generally, I divide the employee handbooks I write into five sections:

1) Employment Policies: Includes a welcome to new employees, the EEO policy, harassment policies (including the all-important sexual harassment policy), categories of employment (full-time, part-time, exempt, nonexempt) and who to go to with questions.

I’d like to answer a common question: Why do we have to get so specific regarding full-time and part-time, and what the heck are exempt and nonexempt? I have found that many employers, particularly medical, dental, and orthodontic practices, have employees who are not on the typical 40-hour, full-time schedule—and by the way, full-time can be defined very differently among employers. Nevertheless, it’s critical to define the difference among employees, particularly as it concerns benefits and perquisites. Part-time people get different benefits. Recently, I was working with the office manager of an orthodontic practice to convert the practice’s vacation year from anniversary year to calendar year, and we realized that she was calculating vacation time based on 8-hour days for all employees, even though several staff members regularly worked 6- and 7-hour days. Why should someone who works a 6-hour day be entitled to an 8-hour vacation day?

The difference between exempt and nonexempt employees is a big issue. The US Department of Labor can come down hard if you misclassify your employees. Most employees in the United States are not exempt from the Fair Labor Standards Act. This is definitely the subject of an entire article itself, but briefly, those who are exempt from the law, such as executives, managers, and orthodontists, are not required to be paid overtime compensation. Those not exempt from the law (dental assistants, office workers) must be paid 1.5 times the hourly rate of pay for all hours worked in excess of 40 per week. You don’t have to include this information in the handbook, but you do have to comply with the law.

2) The Pay section includes Recording Time Worked (time sheets and time cards for nonexempt employees), Payday, Performance Reviews, Pay Raises, Bonuses (if any), pay advances (don’t do it!), and overtime. One of my orthodontist clients used his handbook to describe a very detailed bonus program.

3) The third section, which takes the most time to prepare and is also the one most read by your staff, is Time Away from Work and Other Benefits. Along with general descriptions of your benefits plans (health care, disability, dental/orthodontics, 401(k)), we also toss in social security and workers’ compensation, which we pay for, right?

The key part of this section illustrates time off: vacations, holidays, absences, lateness, and leaves of absence. I cannot tell you how much conversation and controversy these time-off policies generate, but let me tell you, once they’re completed, they’re solid, they work, and they help you better manage your practice! There are several choices to make about the time-off policy: How much? Does the amount of time off increase with service? Can employees carry over unused vacation into subsequent years? What happens if someone takes too much time off? Are there times when you do not want your employees to take time off? What happens in your office if you’re teaching, at a conference, or on vacation? What happens with unused vacation at termination? Should employees receive a set number of sick days (I call them absent days, because there are other reasons employees take unscheduled time off) assuming they will use them all, or should you not set a number and leave it open? These are all questions that arise when developing and drafting time-off policies.

4) On the Job incorporates the workweek hours, standards of conduct expected, business conduct, patient and public relations, solicitation and distribution, confidentiality, personal telephone calls (always an issue!), e-mail, dress policy/uniforms, and care of the kitchen area—you wouldn’t believe how many employers make a big deal in their handbooks about people cleaning up after themselves in office kitchens!

5) Safety encompasses safety rules, good housekeeping, smoking, and substance abuse.

One orthodontist client asked me to include his “office shutdown” procedures, as well as his “office duties prior to patient treatment” procedures in the handbook. Every employee handbook should be customized to your individual practice. An off-the-shelf (or Internet) version could get you into trouble.

The most important page of the employee handbook is the Receipt Page, on which each employee acknowledges that he or she has received and will read the book. He or she also acknowledges that he or she is an at-will employee and can be terminated at any time, for any reason, with or without cause or notice. Have you heard that one before?

Legal Concerns
Despite all their good points, employee handbooks may create legal liability issues if a handbook policy runs counter to state or federal employment laws or when breach-of-contract or wrongful discharge claims arise from a failure to follow handbook policies and procedures. Some states, for example, legislate that vacation pay can never be forfeited. Other states have mandated short-term disability—and I can’t tell you how many differences in jury duty laws exist among the states.

When I write employee handbooks for my clients, I insist that the policies included in the books are broad and that the book clearly states that these are guidelines. I’ve seen some horrific books coming off the Internet that cause shudders down my spine. For example, I’ve seen very specific rules and detailed descriptions in disciplinary and discharge policies. Here’s an illustration: when an infraction occurs, you “must give your employee a verbal warning first, a written warning 5 days later, a suspension 8 days later, and termination 15 days later.”

That’s just ridiculous! You want a disciplinary policy so open that you, the employer, at your sole discretion, can levy any form of discipline you choose and have the ability, if necessary, to fire someone on the spot, although I would hope that would rarely happen.

Certainly, handbooks must not be construed as legal contracts, and my handbook outline visibly states this in more than one place. A disclaimer that a handbook is not a contract must be in the book. Never use the word “permanent” when referring to employees. Do you really want to say that someone is an employee at your practice for life? Avoid exhaustive lists of rules and regulations, and, of course, enforce the policies that are in the book equitably and consistently across your employee population. That doesn’t mean you can’t fire someone with “only” eight absences this year, but her coworker has been out 10 times. Each situation is determined by reviewing all the facts and circumstances.

Wrapping Up
As you can tell, I’m passionate about employee handbooks! I spend the majority of my time in two areas: developing employee handbooks and dealing with disciplinary actions and terminations (the latter, once again, is a topic for another article). My clients love their handbooks; their employees love their handbooks; and I suggest that they be revised every so often. Probably every 2 years is a good idea. Cultures change. Ideas change. Laws change. I never put names of people in handbooks, because that definitely changes. It’s important that you do your best to adhere to the handbook’s policies as best you can. Too many exceptions to a policy can make the handbook worthless.

My final comment is about presenting the employee handbook to your staff. If it’s a new handbook, I recommend distributing it and then having a meeting a few days later to review the key points. It’s an opportunity to emphasize the book’s important points, to describe policy changes, and to listen to the employees’ thoughts about the book. I presented a book to a pediatric practice once, and the dress policy stated “no sneakers.” I found it interesting that the nurses and nursing assistants who were in the room participating in the handbook presentation were all wearing sneakers.

I recommend a brief verbal summary of the handbook be presented to every new employee, and, of course, in both cases (presentations of new handbooks and summaries to new employees), be sure to get that receipt signed and filed in the employee personnel files.

Enjoy creating your new employee handbook!

Myrna I. Sessa has been a human resources professional since 1982 and is a principal at HR Innovations LLC, which offers professional HR expertise to the small business owner. She can be reached at [email protected].