By Mark A. Master, CPA

Published October 2007

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It takes well-trained and motivated people to deliver top-notch medical care. One great tool for getting everyone on your staff pulling in the same direction is an employee manual.

A well-written manual provides a general description of your practice’s rules of the road, letting employees know how the practice operates and where they fit in.

Clearly outlining benefits, duties and responsibilities can save you time, improve employee morale, prevent disagreements, and help you avoid costly lawsuits by nipping the "I-didn’t-know-that-was-office-policy" defense right in the bud.

First and foremost, don’t confuse an "employee handbook" with a "policy and procedures manual," which is typically addressed to office managers and supervisors. Rather, an employee handbook interprets and clarifies your practice’s policies and procedures as they apply specifically to the staff.

This is a document where you can spell out your expectations of employees, and what their expectations of you can be. Along these lines, your handbook should contain explicit statements that:

· The manual is not a contract of employment.

· The employer has the right to unilaterally change policies at any time.

· Employees work at the employer’s will and can be dismissed at any time (note that some states have exceptions to this rule, so have an attorney check this section).

· Violation of the policies will subject employees to discipline, including termination from employment.

It’s important to realize that there is no one-size-fits-all employee manual. Your manual should be customized to your particular practice and how your practice really works.

While it should certainly cover all of the bases, it shouldn’t sound regimented or dictatorial. Don’t waste your time and your employees’ time by getting overly detailed – if the document gets bulky, no one will seriously read it. And be sure to leave some flexibility in the interpretation and administration of your office policies so that you’ll have options when dealing with individual cases. If you paint yourself into a corner by scripting too many "what-if" scenarios into the manual, your future decision-making will be limited.

Write it. Keep it short and simple, using everyday language and avoiding complex legal jargon. Here, your office manager and/or practice consultant may be able to provide valuable guidance. Try to cover a broad list of topics, but be careful not to go into too much detail in the manual; otherwise it will be in a constant state of revision.

Borrow it. A good way to start your writing project off on the right note is to borrow and review another company or practice’s manual. Ask a friend, family member or colleague if you can review theirs. While you will have to heavily tailor the book to meet your practice’s unique needs and reflect your culture, this can be a great starting point. This borrowed document can also provide an example that will help you organize your own book.

Organize it. If the information is in a binder, use tabs with section names, or use icons for online versions. There are also software packages on the market which can lead you through the entire writing process, as well as organize the final document. "Employee Manual Builder" (Jian), "Employee Handbook Template" (The Guru Group, Inc.), and "Office Policy Manual" (TemplateZone.com) are just a few such packages that will simplify the process.

Review it. Spend a staff meeting or two reviewing the manual to ensure its accuracy, relevance and understanding. The meetings may provide you with valuable ideas for additions to the book and ensure that you are not forgetting any issue that your employees really care about. This will also foster employee buy-in for the new policies. They will also appreciate being made to feel like a part of the process. Then have an experienced health care attorney familiar with current labor laws review the final draft.

Hedge it. Make it clear that the handbook doesn’t cover every possible problem or situation, and that you reserve the right to add, delete or change any policy or guideline at any time without prior notice. Disclaimers should also be inserted into the book whenever you discuss disciplinary or firing procedures. For example, you should include a disclaimer stating that employment can be terminated at any time for any reason. This will protect you legally in the event of dispute by a terminated employee.

Present it. When the new manual is finished and approved, present it to the practice as complete. If they understand the logic behind your policies, it will be easier for employees and supervisors alike to follow and enforce them. This will lead to fewer headaches and confusion down the road as policies are implemented. As part of their orientation, have new employees formally review the manual. Provide an opportunity for them to ask questions or seek clarification.

Acknowledge it. Along these lines, have all employees sign a statement acknowledging that they’ve read, understood and accept the handbook. As new employees are added, make sure to take this crucial step of documenting their acceptance of the rules each and every time.

Update it. Have a qualified attorney review your manual annually to ensure compliance with any changes in federal or state labor laws. If any significant changes are made, be sure to distribute the new information, collect and destroy any old policy pages, and consider having a brief meeting to go over the changes with your staff.

Live it. An employee manual is not a document to be created and then left on the shelf. Many companies have lawsuits brought against them because even though the policies were clear, supervisors did not understand them or enact them properly. Make certain that you, your partners and any office supervisors follow the manual and consult it whenever a situation arises in your practice.

There are several basic items that every manual should cover. General information for new hires on facility issues, lunch times, parking policies, supplies and other basics is a must. You should also be sure to include information on things such as phone, computer and confidentiality policies, as well as an organizational chart to show which employee performs which duties. Each practice is unique, however, so make sure to address your needs

A thorough employee handbook typically covers these areas:

· Practice mission/vision statement and philosophy.

· Work schedule.

· Attendance and punctuality.

· Environment (language, smoking, security).

· Severe weather policies.

· Vacations.

· Jury duty.

· Military leave of absence.

· Personal leave of absence.

· Bereavement.

· Compensation.

· Benefits.

· Insurance issues.

· Compensatory time off.

· Job descriptions.

· Dress code.

· Performance reviews.

· Career development.

· Office equipment.

· Patient confidentiality.

· Health and safety.

· Personal conduct standards.

· Use of property and supplies.

· Grievance procedures.

· Harassment.

· Termination.

· Equal opportunity statement.

Need some help? The following resources provide useful guidelines for employee manuals:

Group Practice Personnel Policies Manual, by Alys Novak and Courtney Price, available from the Medical Group Management Association.

Create Your Own Employee Handbook: A Legal & Practical Guide, by Lisa Guerin and Amy DelPo, comes with a CD-ROM that allows you to cut-and-paste the policies you need to create your own handbook.

Doctors Management (http://drsmgmt.com) and the Professional Association of Health Care Office Management (http://pahcom.com) sell personnel policy manuals.

Many medical societies and consultants also have samples that you can use as guidelines.

While drafting an employee manual may seem like a daunting task at first, it is an important way to protect your practice and establish structure for your employees. Your employees will appreciate having this resource in the long run as well, improving morale and efficiency. With so many resources available to help you create this document, the best time to start is now.

Mark A. Master, CPA is Partner-in-Charge, Healthcare Services, Goldenberg Rosenthal, LLP in Jenkintown, Pa.