A picture may be worth a thousand words, but a written employee policy is worth a thousand stress-free days

Many chiropractic offices are family-owned and operated—or at least they start out that way. So, it is not surprising that most chiropractors simply do not see themselves as employers, which leads to many offices operating without written policies and procedures.

The novelty of health care is that many clinics operate with little or no business skills that are otherwise mandatory in running a small business. Many health care professionals are not exposed to business law classes or managerial training. For the most part, doctors are not business persons. Life and death concerns and the pain and suffering of patients take precedent over mundane issues such as employee manuals.

Minding Your Business
However, employer/employee relationships are serious legal matters. Employers must abide by the laws and regulations that govern issues from paychecks to family leave laws, and interview rules to the termination process. Written employee policies prevent misunderstandings and assist in implementing standards critical for a successful business, regardless of the type of business or size of staff.

The Supreme Court has indicated that employers can help protect themselves against certain liabilities, such as sexual harassment and other legal issues, by having an effective written policy that includes explicit information regarding the company’s policy and procedures for handling such issues. The Health Insurance Portability and Accountability Act (HIPAA) recommends written policies and procedures with self-reporting logs to prove that accurate policies are in place.

A written employee policy helps the employee as well as the employer. One of its biggest roles is that the policy acts as its own entity—it is the supervisor, the boss, the rule maker, the unbiased decider, the equalizer. The written policy is the reference book on issues that no longer need to be personally made by an office manager or doctor. For example: “I would like to—let you take an extra day off; get your paycheck early; let you wear jeans to work—but unfortunately the employee manual says that can’t be done.” This is a definite stress reliever for anyone in management who has ever had to say no.

Legal Brief
Writing an employee policy can be a daunting endeavor. How much information should you cover? Can it be too specific? (Yes!) How do you know which laws cover small businesses and which apply only to those that employ more than a certain number of employees?

Almost all employers know, or can easily find, basic rules of employment. For example, discrimination is not allowed based on the Civil Rights Act of 1964 (race, color, national origin, and sex). But they may not know that body piercing and tattoos are not protected under federal discrimination laws. They may know that the Equal Employment Opportunity Commission (EEOC) regulates employee rights. However, in a decision by the 11th Circuit Court of Appeals (Harper vs Blockbuster, 139F.3rd 1385—1998), the court upheld an employer’s policy that required only male employees to cut their hair. Or, that a California law prohibits employers from implementing a dress code that does not allow women to wear pants to work (Section 12947.5 of the California Government Code). These are topics covered in an employee manual that require a solid understanding of the law.

There are companies and attorneys specializing in employment issues who draft employee policies. Since many employment laws are state specific, use an employment attorney in your area to design or proof your final policy.

Rough Draft
Even if you are planning on hiring someone to write your policy, a basic draft will help in understanding the key issues. This draft can be a template for the project.

Employees are hired with a certain amount of reasonable expectations, such as loyalty, dedication, and trustworthiness. In return, employees expect fairness, consistency, and respect. Mutual benefits are enjoyed when both parties exceed their expectations. Written policies clearly communicate these protocols and expectations. An employee policy may denote specific rules and requirements in some areas, while only implying general behavior without detailing every point in others.

The keys points that should be covered are:
• Section 1: Philosophy and purpose of the practice.
Incorporate a mission statement and let employees know the practice goals.

• Section 2: General information.
Policies regarding application and hiring process, orientation, probationary period, standards of conduct, random drug screening (if applicable), and most important, any “employment-at-will” issues that apply in your state.

• Section 3: Professional appearance and attitude.
Dress code policies, make-up, hair and jewelry restrictions, name tag requirements, pager and cell phone usage, restrictions on dating patients, drinking or drugs on the job, eating, drinking or chewing gum at the front desk, receiving or making personal phone calls during work hours or in front of patients, break room use, personal belonging storage, and team-work attitude.

• Section 4: Personnel issues.
Illness and absences, punctuality, employee parking, smoking, sexual harassment, vacation time and requests, extended sick leave or maternity leave, and access to personnel file.

• Section 5: Payroll issues.
Pay periods, time sheets, overtime, deductions, paid holidays, raises and reviews, and authorization to have someone else pick up paychecks.

• Section 6: Benefits.
Chiropractic care, medical care insurance, workers’ compensation, life insurance, retirement (401K), profit sharing, educational assistance or reimbursement, and bonuses.

• Section 7: Office policies.
Personal use of equipment, use of the Internet (during work hours or on breaks), regulations on taking work and files out of the office, solicitation of patients for nonclinic activities, interoffice gossip, discussion of marketing strategies, insubordination, civil or criminal convictions, confidentiality of patient information and clinic business, confidentiality of salaries, following the chain of command, use of office supplies and postage, being in the clinic after-hours, and company policy on second-income jobs.

• Section 8: Safety.
Rules of use on equipment and x-rays, hazardous wastes, and reporting injuries and accidents.

• Section 9: Activities.
Required attendance at seminars, staff meetings, and professional functions.

• Section 10: Legal and ethical conduct.
Unprofessional conduct, employee evaluations, grievance procedures, disciplinary actions, and termination procedures.

To formalize the procedure of implementing an employee policy, add a form at the back of the manual that certifies that the employee has read and understands the policy. Have the statement signed, dated, and witnessed. Give a copy to employees and keep a copy in their personnel file. Whenever an update is made, make sure all employees receive a copy of the changes, and again, have them sign, date, and witness a statement to acknowledge the changes.

Finally, an employee manual should be clear and concise. Keep it simple and on a level that employees understand. A written employee policy will help diminish the your stress and reduce micromanaging staff issues. CP

Ces Soyring, CA, is cofounder of the National Academy of Chiropractic Assistants (www.naca-online.com) and a chiropractic consultant. She can be reached at: 888-218-7757 or via email: naca_csoyring@yahoo.com.