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How to manage staff time off

Medical Economics JournalJune 25, 2018 edition
Volume 95
Issue 12

Physicians can be both firm and fair when employees need personal time away

When she was younger, primary care physician Dana Corriel, MD, worked at Disneyland as an outdoor vendor in a bright yellow uniform. There, says the director of quality at Highland Medical, PC, in Pearl River, N.Y., she and her fellow employees of the park felt like family.

That feeling, she says, results in employees being happier and at a medical practice, patients pick up on that.

To achieve this balance, employees’ requests need to be respected-as do the employer’s.

A former practice owner, Corriel operated on the family principle. Employees were given the benefit of the doubt and requests for sick time were typically honored. If “abuse” occurred, she’d discuss it with the employee, but always aimed for a mutual respect and understanding from both sides.

Now in her hospital-owned office, employees who can’t find child care can bring sick children in to play in an isolated room, instead of not coming to work.

“[Doctors] feel we can’t call out or we’ll feel guilty,” she says. “There was a stigma attached to that, even during the rigorous years of residency training.”

Some practices in the hospital’s system have adopted strict rules now, even docking employees their vacation time when offices close for a snow day. “That doesn’t seem fair,” she says, “but those are the hospital’s rules. It makes us think long and hard before closing the office.”
To allow some flexibility to staff while also maintaining a business, plan to get creative and organized about it all, says Kate Othus, MHA, of Aldrich CPAs and Advisors in Oregon. She recommends these seven strategies:

Start a paid time off (PTO) bank.

The idea is to pool vacation days, sick time, and an employee’s personal time, so the employee can use what they need when they need it. Think about work-life balance. According to the Society for Human Resource Management, PTO excludes paid holidays, such as Labor Day, Memorial Day, and Thanksgiving.

“PTO allows the employee to say, ‘I need the day off,’ without explaining why, so it creates some privacy for them,” says Othus. Salary.com notes that many healthcare organizations provide one set amount of paid days off for use at the employee’s discretion. Days off generally accumulate through years of service and the level of the employee within the organization.

Be consistent.

An employee handbook allows policy to be set in stone and avoid future conflict. “Maybe you think you’re creating a more flexible work environment,” says Othus. “But if you go case by case, instead of following what’s documented, and a couple of employees compare notes, you may have to deal with poor morale issues, or be accused of favoritism-and not by design.”

Don’t mess with guessing.

Othus recommends a tracking system as part of your payroll software, to chronicle absenteeism. “Then you have actual data to measure, if an employee’s requests or time off become a problem,” she says.

Creating a record also means that when Employee A asks, and there is a record that they’ve been prompt and diligent, you can say, “You’re always here, and you can absolutely take the day off or leave early if you need to, because you always more than make up for that time.”

Conversely, if Employee B is almost always late, and may be having other “social” issues at work, and both are impacting their ability to perform to expectations, documentation is key when you say: “Wow, you were late five times out of 20 last month, so I’m going to have a hard time granting this request while your work piles up, and your co-worker is being asked to cover.”

That trumps a more subjective response such as, “Well, you’ve ‘kind of’ been late a lot,” and now you’re into the “feeling” part of deciding time off when you need to be tougher. Make sure from the get-go that policies are written, updated, and understood, Othus says.

Get legal help.

Maybe you’re wondering, “Is this vacation time or PTO?” Federal and state guidelines come into play, and since you’re a healthcare professional and not a lawyer, it’s always best to seek the advice of a practice employment attorney to ensure you’re not violating any statutes. Develop the policy, have it reviewed, and then explain it to your employees, maybe more than once.

Understand all the options.

With a PTO program, you’ll need to make a few decisions. For example, is the time earned based on accrual and if so, can employees take time prior to full accrual? Your practice will need to develop guidelines for maternity, paternity, adoption, and surrogacy leave, along with bereavement leave. And, don’t forget jury duty. Have your handbook reviewed by your employment attorney, because issues related to leave can be complicated.

Having a grasp, or paying someone to have that grasp, means less disruption to your small practice, says Othus. “Most small, independent practices run lean, with just the right amount of staff, or maybe even one short,” she says. “It’s rare to be overstaffed and physicians tend to err on the side of ‘just right.’”

Have a Plan B.

It isn’t ideal when one employee has already gone to Mexico on a honeymoon, and another got called on to jury duty you thought would be one day, but could be long-term. “You may need to roll up your sleeves and call a temp service. And that person may not initially understand the organizational workflow, which is tough,” says Othus. “Still, it’s an option.”

See the big picture.

Invest time into your human resources infrastructure so staff knows how to use their benefits. “This impacts your culture, which impacts patient care,” Othus says.

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