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Tattoos and piercings: what’s your policy?

If ink and body jewelry seem more prevalent than they once were, it’s not your imagination. Tattoos and piercings have become commonplace, especially among people of a certain age.

Consider these numbers from Statistics Brain, a website that aggregates research data. Taking into account all age groups, 23 percent of American women and 19 percent of American men have one or more tattoos. However, among Americans 30 to 39 years of age, 38 percent have one or more tattoos; and among Americans 25 to 29 years of age, 30 percent wear ink.

Piercings, according to a Harris Poll, are even more common. Currently, 49 percent of U.S. adults have pierced ears, and the practice, especially in recent years, includes men. Meanwhile, 7 percent of U.S. adults have a piercing on their body, but not on their face; and 4 percent have a piercing on their face, but not on their ears.

With the percentages so high, it has become necessary to establish guidelines for what is and is not acceptable with regard to employee tattoos and body piercings.

A proactive approach

These guidelines should take the form of a written policy. One approach is to create a separate policy for jewelry and tattoos.

See model policy here.

Another approach is to incorporate these guidelines into your practice’s dress code policy.

Elizabeth W. Woodcock, MBA, FACMPE, CPC, healthcare speaker, trainer, and co-author of “Operating Policies & Procedures Manual for Medical Practices – 4th Edition,” published by MGMA, includes this statement about piercings as part of a larger dress code policy featured in the book: “If an employee desires to wear jewelry, it must be small and simple. It cannot obstruct his or her work, and should be visible on the ear only (that means no facial jewelry such as nose, eyebrow, lip, etc., piercings).”

With regard to tattoos, Woodcock includes one sentence as part of the dress code policy that, although simple, is definitive: “Tattoos and other body art must be covered at all times while on duty.”

Still, body art is subject to change. A manager may hire someone who doesn’t have a visible tattoo, and then the person shows up for work one Monday with a tattoo in clear view. What should be done in a case like this?

“I would suggest having a statement for candidates regarding the policy for the dress code, which should include body art (as well as shoes, dress, etc.). If the new employee violates the stated policy, then disciplinary action is in order,” says Woodcock, who provides consultative services for medical practices through her firm Woodcock & Associates.

As far as disciplinary action, Woodcock spells this out in the book’s policy as well: “Employees who arrive for work inappropriately dressed are sent home to remedy the situation and directed to return to work in appropriate attire immediately. Under such circumstances, employees are not paid for the time away from work.”

Manager’s responsibility

A situation like the one described speaks to the need for ongoing monitoring of employee appearance, and reminders about the practice’s dress code. But what are the best ways to ensure that the policy stays top of mind?

Woodcock recommends annual review of all policies and procedures, with a signature of understanding. She also cites the need for managerial responsibility.

“Of course, letting things slide just means that the policy won’t stay on the top of the mind – in fact, just the opposite. So, ensuring compliance with your own policy is crucial,” Woodcock tells Medical Office Manager.

Appearance matters

Another issue with regard to policy and enforcement is that managers tend to think in terms of “dress code.” Woodcock, instead, speaks about the importance of focusing on “professional appearance.”

Medical Office Manager asked her to explain the difference, and why “professional appearance” is preferable.

“Dress code, in most minds, is simply clothing. For a medical practice, a business dedicated to saving lives, presenting oneself as a professional is vital for all positions,” Woodcock says.

Nevertheless, even the most detailed policies will not address every situation. As a result, some managers have decided to look to the past for a solution.

“I am seeing uniforms come back into fashion. It takes a lot of the guess work out of this situation, and allows the practice to present itself, via its employees, in a consistent manner, with a very professional, tailored brand,” Woodcock says.

“Plus, employees typically love it because they don’t have to think about what to wear to work. With an allowance, they don’t even have to think about what to buy! With so many options (versus the historical sterile scrubs), uniforms are a terrific way to solve much of the dress code issues. What a win/win!”

Medical Office Manager adds one caveat: Make sure uniforms cover tattoos.

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Model Policy: Jewelry and tattoos









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