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Employee handbook compliance 101

An employee handbook is a living, active guide that your medical practice looks to and points to when your employees have questions about their employment. It is also a vital document that backs you up when you are making your management decisions.

And most importantly, on the legal side, a properly crafted employee handbook is a litigation-avoidance tool, according to Paul Edwards, CEO and co-founder of CEDR HR Solutions and Ali Edwards, senior counsel and co-owner of CEDR HR Solutions.

“A good handbook is something that is clearly written and it really needs to be done by an employment law professional. This is not something that doctors learn in medical school,” says Ali.

An employee handbook needs to be updated regularly and it must comply with all current federal, state and local laws.

“Municipalities are actually passing paid sick leave laws and they are differing from one (place) to another,” says Paul, adding that people who are doing their own research for employee handbooks run the risk of relying on laws which do not apply to their medical practice locations.

A solid handbook includes the following elements:

  • An at-will disclaimer. At-will means you or your employees can terminate the employment relationship at any time without cause and with or without notice.
  • A clear leave-of-absence policy.
  • A time-off policy (paid and unpaid.)
  • A disciplinary policy.
  • An anti-harassment/anti-discrimination policy.
  • A dress code policy that does not infringe on a worker’s rights, such as religion.

A poor handbook is one whose origins and updates are uncertain and whose contents are not clear and easy to follow.

Five office policies that are easy to get wrong

1. At-will disclaimers: Your handbook needs to state that “nothing in this handbook creates any right of continued employment” and “no contract is formed by this employee handbook.” Never include language such as “these are our agreements,” “You agree to…” or “This at-will relationship may not be changed or modified in any way.”

2. National Labor Relations Act: You cannot have any language in your employee handbook—such as confidentiality or social media policies—that chill your employees’ ability to discuss their wages/pay, working conditions, or benefits. Paul says stating in your handbook that all employees are expected to be respectful and courteous to coworkers, managers, and patients at all times is a violation of the NLRA. It is also illegal under the Act to state in your handbook that gossiping is strictly forbidden. “If you get caught violating the NLRA, not only are you defending a lawsuit, defending your handbook and having to rewrite (it) and pay attorneys and fines and back-pay, but you can be forced to offer the employee who caused all this nightmare their job back,” says Ali.

3. Harassment and discrimination: The big problem here is retaliating against an employee who has previously complained about something. “You want to have really good and clear anti-discrimination and anti-retaliation policies and a very clear complaint procedure,” she says. It is also important to have all employees sign their handbooks, properly train managers on the policies in place, always follow your procedures, and thoroughly and promptly investigate all complaints. Document everything. Get complaints down in writing and seek professional advice before taking any adverse action against an employee.

4. Leaves of absence: Typical problems include not having clear policies written in your handbook; applying the wrong laws; and not consistently following and documenting your leave-of-absence policies. These policies must include the potential length of a leave; an option to extend a leave; doctor certification; reinstatement rights; cross-training to fill gaps; and fitness for duty upon return. “An overwhelming number of workers in the medical industry are women, so to not have a leave of absence policy which directly addresses maternity leave and several of the things that you need to include in that policy is just suicide,” says Paul. “You are not gaining any protections for yourself and you are going to end up doing something different with one employee and the next.”

5. Disciplinary procedures: The worst type of disciplinary policy to have in a handbook is a “three-strikes-and-you’re out” one that starts with a verbal warning and progresses to a written warning and suspension. Such a policy ties your hands. You need to be able to give feedback to your employees, document that feedback and give them an opportunity to improve. Ali says your medical practice needs a flexible progressive corrective coaching policy that gives you the right to combine steps or skip steps and provide them in writing to your employees. Let them take the written comments home, review them and respond to them. “There is nothing wrong with you giving people second and third chances. That’s completely up to you,” says Paul. Coaching should never be given by a manager who is tired, hungry or angry. It needs to be factual, state clear expectations and the consequences of not meeting those expectations, and express confidence in the employee’s ability to correct problematic behavior.


A compliant, updated handbook, coupled with sufficient training of managers and a reliable, expert resource you can call when a problem arises can protect your office, reduce liability, and reduce turnover.

Editor’s picks:

Can your employee handbook help you safely terminate an employee?

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

Office handbook: danger in saying too much or too little









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