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8 steps to quickly and (almost) painlessly creating an employee handbook tailored to your medical office

Writing an employee handbook from scratch can be a daunting task. Where do you start? What do you include? And how are you going to find time to write the thing? It’s tempting to set the job aside and wait until work slows down a bit. Of course if you wait for the perfect time to write, it’s unlikely that you will actually do it at all. So we’re here to help you get the project started.

Writing coach Daphne Gray-Grant understands how intimidating that blank piece of paper can be. She suggests breaking the process into small steps.

Prepare more, write less

When tackling a writing project, Gray-Grant suggests that 40 percent of your time should be spent on preparing to write, 20 percent on actually writing, and 40 percent on rewriting or revising.

This is why, of the eight steps below, only one of them focuses on writing.

Step 1: Understand why you’re doing this

In order to do anything well, it’s important to understand the reason behind the task. Gray-Grant points out that a good employee handbook will:

  • Ensure your employees are treated fairly and consistently
  • Help your office meet your business goals
  • Leave room for you, as manager, to use your discretion
  • Reduce legal claims relating to inconsistent or discriminatory treatment

Keep these objectives in mind when planning and writing the handbook.

Step 2: Don’t reinvent the wheel

There are some topics that should be included in almost every handbook, such as:

  • An introduction, including the purpose of the handbook
  • A message from the managing physician
  • The practice’s history
  • The practice’s vision, mission, values, and goals
  • A code of conduct
  • A non-competition agreement
  • A confidentiality agreement
  • A telecommuting policy
  • A dress code
  • Details about employee benefits
  • Time-off-work policies
  • A policy regarding computer and Internet use
  • Conflict resolution procedures
  • A workplace bullying policy
  • A harassment policy

Step 3: Customize your content

Now you want to address topics unique to your office. For example, if severe weather conditions are a reality in your region, are there communication procedures staff members must follow in case of a storm? Are there parking issues that require explanation? Security issues? Are visitors permitted in the workplace?

To customize your employee handbook, Gray-Grant suggests you borrow a trick used for decades by technical writers and creative writers alike: the mindmap.  

As Gray-Grant explains, the beauty of a mindmap is that it allows you to be free of the constraints of an outline. It helps you develop topic ideas unique to your office and allows for your culture’s voice.

Here’s how to do it.

Sit down with a blank piece of paper and a few colored pencils or highlighters. Turn the paper horizontal and in the center of it write: What do employees working at our office need to know?  

Now let the right side—that is, the creative side—of your brain take over.

Circle the central question a few times and maybe even retrace it. Then, without stopping to think, draw a line from the question and write the first word that comes to mind. Circle it. Go back to the central phrase and draw a line and write the next word that comes to mind. Circle it. Go back to the central phrase and continue drawing lines outward to different words or phrases that come to mind.

When a word you write sparks another closely related idea, draw a line from that word to the new word. Keep branching out.

Do this as fast as you can. If a word doesn’t come to mind, keep circling the central phrase or the last word you wrote. You can even doodle something that the word triggers. The idea is to keep your hand moving and to not overthink.

The words or phrases can be anything related to your central phrase—it can be information about the patients, physician quirks, special events that your office observes, coffee preferences, time-saving billing tricks that you want staff to use, whatever. Keep drawing lines and bubbles from each related thought.

As you mindmap, you’ll notice that words or phrases are leading you to a larger topic you hadn’t considered. For example, perhaps you jot down something about the importance of prompt replies to patients, or a physician’s preference that patients be addressed by Mr. and Ms. instead of their first names. If so, you might realize the need to include a section in your handbook on patient communication best practices. These revelations will come to you suddenly. And when you recognize these connections, you’ll feel a shift—what Gray-Grant calls the “aha moment.” You’re ready to write.

You might feel a little self-conscious or uncomfortable through this process. That’s understandable. You’re a professional. But what this exercise does is allows you to identify seemingly random associations that you normally wouldn’t consider.

Step 4: Delegate what you can

Once your mindmap has helped you identify the topics to include in the handbook, you can choose to write the whole thing yourself or, better still, assign portions of it to others in the office.

The benefits of delegating portions of the handbook are twofold: first, it frees you up to oversee the project and, second, it gives other members of the office an opportunity to take ownership of the project, leading to a greater chance of staff buy-in.

But, of course, you want to ensure that you have a cohesive handbook that is written clearly and on time. To achieve that, Gray-Grant suggests you:

  1. Give small jobs to many people
  2. Assign a person a subject he or she is personally interested in
  3. Specify the word count
  4. Include the deadline in the subject of the email
  5. Start with a fake deadline
  6. Send a reminder a week before the due date

By the way, don’t be concerned about assigning a task to a busy colleague. Says Gray-Grant, “It’s a paradox, but it’s been shown that busy people usually get more done.”

Step 5: Write!

Remember, only 20 percent of this project is writing. But for many people, that’s the hardest part of all. The trick is to not expect perfection the first time through. In fact, Gray-Grant suggests that for your first draft, you drop that expectation completely and embrace what she calls the “crappy first draft.”

“If your first draft doesn’t need to be perfect, you’ll be able to write in about half the time you normally take,” says Gray-Grant. “Writing a crappy first draft means you don’t have to edit while you write.”

Here are some techniques to get the first draft started:

  • Turn on a timer for 20 minutes and do not allow yourself to do anything other than write until the timer goes off.
  • Turn off your monitor or drape a towel over the screen. Why? Those angry red squiggly lines beneath typos and fragmented sentences can be very distracting. Typing blind will encourage you to just write and not edit as you go.
  • Now mindmap again. This time, make your central phrase a topic, say, dress code. And when you reach the “aha moment,” stop mindmapping and start writing. Fast. Write down everything.
  • When you get stuck on something that requires more information, don’t stop writing to do your research. Instead, write yourself a series of notes to look into when you’ve finished this writing time.

Step 6: Revise and Edit

Once you have produced your rough draft, you can focus on the editing and rewriting stage.

“Instead of just editing once, I advise passing through your draft many times, looking for and repairing specific problems,” says Gray-Grant.

She suggests you look for:

  • Sentence length. “Ideally, your average should be somewhere between 14 and 18 words. It’s perfectly okay—desirable, even—to have some 38- and 41-word sentences. But these need to be balanced by some super short ones,” she says.
  • Unnecessarily complicated words
  • Unnecessary words
  • Clichés
  • “Spend one pass reading aloud and check the rhythm of your prose. If it sounds clunky then rework it until it sounds better,” says Gray-Grant. “Even corporate prose needs to be rhythmical.”

“This may sound like a lot of work,” she says, “but most of these edits, or ‘passes’ as I like to call them, are actually pretty easy.”

Step 7: Protect the practice

Remember, there are some legal considerations you need to be mindful of when putting together the employee handbook. For example, it could appear to be creating a contract between the office and an employee. The language used in the handbook might reduce your ability to manage employees or it might not protect the office adequately against employment-related claims. Also, the language used might appear to show favoritism to certain employees or discriminate against other employees.

“Don’t let these concerns hinder you,” says Gray-Grant. “Just be sure to have your employee handbook properly reviewed by an employment lawyer.”

You’ll also want to include a disclaimer in your handbook stating that the handbook is intended to offer only policies and guidelines and is not to be construed as a contract or an implied contract.

This disclaimer should be reiterated on the acknowledgement of receipt that you have each employee sign and date and then place in the employee’s personnel file.

Step 8: Submit the handbook for approval

Once you have a workable draft, it’s time to submit the handbook for approval. But, says Gray-Grant, don’t call it that, if you want to keep the feedback manageable and the project moving along.

“Call this stage ‘fact-finding’ instead of ‘approval’ and find a senior champion who is willing to lead a small group of people in the signing off process,” she says.


Don’t expect to produce a comprehensive employee handbook right away. Start small, says Gray-Grant, and remember: “First drafts don’t have to be perfect. They just have to be written.”

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