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How an employee manual can help control risk, contain costs


The questions of whether your medical practice should have an employee handbook and what should be covered in the document are important for any physician practice owner to answer. This manual will impact every aspect of the practice on a daily basis.

It is fundamental that a  medical practice have an employee handbook, because a properly drafted  handbook can be a critical tool for risk management, communication and cost containment.

Related coverage:Delegating tasks to staff improves patient care 

An employee handbook informs employees and supervisors of the workplace rules and policies in a uniform manner, and serves many functions, including:

  • providing clarity regarding expectations and the standards that must be followed;

  • informing employees about workplace policies designed to enhance an entity’s operational viability and efficiency, such as overtime issues;

  • informing employees of their rights and benefits in a clear, consistent manner;

  • notifying employees about appropriate grievance and complaint procedures; and

  • explaining an employee’s at-will status and that the employee did not have an implied or express contract

An employee handbook can reduce the risks of litigation or provide a defense in a litigation by, for example, demonstrating the employer’s intended consistent treatment of its employees, and showing a plaintiff/employee’s violation of the workplace rules and/or that a plaintiff/employee’s claim for benefits is baseless given the express language of the handbook.

Although there are costs (attorney’s fees) associated with drafting an employee handbook, those are fairly minimal, and are more than offset by the risks and potential costs to a practice that does not have one. 

Certain fundamental concepts must be addressed in a handbook. It should include a highly visible disclaimer stating expressly that the handbook does not constitute a contract between the employer and the employee or alter “at will” employment relationships.

Read more:The role of staff in meeting quality metrics 

The handbook should make clear the employer’s authority and right to amend the handbook. The employer should regularly audit and update the handbook, preferably at least once a year, to ensure that it is consistent with current law and the practices in the workplace.  An outdated handbook may be a detriment in litigation.     

It’s also important for the employer to collect and maintain signed acknowledgements from all employees that they received, read and understand the handbook, that it supersedes prior handbooks and acknowledge they will comply with its terms.

Keep these acknowledgements in each employee’s file, because they may prove helpful in a litigation if an employee claims ignorance of workplace policies.   

An employer should not promise too much or be too rigid in delineating its policies. Failure to heed this admonition may lead to a limitation on the employer’s ability to act. Use language that endows the employer with appropriate discretion when acting.  

Finally, ensure that the handbook is consistent with the culture and practices of the workplace and that management is on board with its terms. Consult with frontline supervisors to ensure consistency between policies and actual practices and to ensure that the policies included in the handbook can actually be enforced.

Andrew L. Zwerling, JD, is a partner-director at Garfunkel Wild, P.C. in Great Neck, New York. Send your legal questions to medec@advanstar.com.

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