Ginny Hegarty, SPHR

	What’s a dentist to do when faced with 25-40 percent open time in the schedule? It seems that lately doctors are responding to this challenge by adjusting employee work schedules or sending employees home early. While I believe there is a better response, we’ll discuss that in a future blog post. For now, we’ll focus on the employee compensation issue.

	Disappointed that they are not getting all the hours they expected and, therefore, all the pay they were expecting to earn, employees are questioning whether or not it’s legal to reduce their hours and/or send them home due to lack of work.

	A couple of new phrases have been popping up in my e-mails lately. Doctors and team members have been asking about whether they are 

 Attorney Michael J. Meehan has contributed to this article to address the legal perspective in play.

It’s a gorgeous Friday afternoon in June, and apparently your patients have noticed. After a series of cancellations, your once-packed afternoon schedule is now wide open. You look around the office at your employees (whom you will now be paying to sit around the office the remainder of the afternoon) 

 and you have an idea. You announce to your employees that the practice will get an early start on the weekend and close at 2 p.m. Your employees are ecstatic at the news, and you give yourself a pat on the back. 

But then come the questions. Your assistant asks, “I still get paid for the afternoon, right?” Your hygienist is more direct and assertive, stating, “I’m fine with going home at 2 p.m., but I expect to be paid for the three hours I expected to work this afternoon. Legally, I was ‘engaged to wait’ for those three hours,

and I was not ‘waiting to be engaged.’ Therefore, I’m legally entitled to be compensated.”

	Doctor, your ingenious cost-saving early dismissal plan has now put you in quite a conundrum. Your employees are all looking at you, waiting for an explanation. So what’s the answer? As it is with many complex legal questions, the answer is, “It depends.”

	Your hygienist is referencing the Fair Labor Standards Act (“FLSA”), as interpreted by the 

. Whether the standard applies depends first on whether the employee is “exempt” or “non-exempt” under the statute. This is a complex question beyond the scope of this article. If you have questions about how your employees should be classified under FLSA, contact legal counsel or a human resources consultant.

	As for the terms “engaged to wait” versus “waiting to be engaged,” these derive from the FLSA and, for non-exempt employees, can help determine whether an employee needs to be compensated for time spent not working. Generally speaking, if an employee is waiting for work to do while on duty, he or she is “engaged to wait,” and the time counts as hours worked. For example, a receptionist does not clock out between phone calls. After hanging up, he or she is engaged to wait for the next call.

	By contrast, the Department of Labor takes the following into account when considering whether an employee is “waiting to be engaged:” 

			Was the employee advised of the time that he or she is required to return to work?

			Is time period in question long enough for the employee to use the time effectively for his or her own purposes?

			Was the employee informed in advance that he or she may leave the job?

	As you can see, the distinction is highly subjective and will depend on the facts and circumstances of each case. In our hypothetical scenario, the first three prongs are not likely an issue. The issue would turn on whether the employee was provided sufficient advanced notice of the early dismissal.

	However, over and above the answer, a more important question stems from the hypothetical scenario: Why didn’t you and your employees already know the answer? In legal questions of this nature, the dispute usually stems from a difference in expectation.

	If the above hypothetical scenario were to occur in your office, what would be the expectation of your employees? What have you done to manage those expectations and to protect yourself in the event of a disagreement? What documents (e.g., employment agreements, policies and procedures, etc.) can you direct your employees to for the answer? For example, your policy and procedures manual and employee agreements should include language that informs your employees that their hours of work may be increased or decreased to meet the needs of the practice.

	By addressing these issues in advance via employment agreements and/or policies and procedures, your practice can manage employee expectations and be in a better position to defend legal challenges on these grounds. Now would be a great time to review your materials and be certain that your HR house is in order.

What’s a dentist to do when faced with 25-40% open time in the schedule? It seems that lately doctors are responding to this challenge by adjusting employee work schedules or sending employees home early. While I believe there is a better response, we’ll discuss that in a future blog post. For now, we’ll focus on the employee compensation issue.

Disappointed that they are not getting all the hours they expected and, therefore, all the pay they were expecting to earn, employees are questioning whether or not it’s legal to reduce their hours and/or send them home due to lack of work.

A couple of new phrases have been popping up in my e-mails lately. Doctors and team members have been asking about whether they are 

It’s a gorgeous Friday afternoon in June, and apparently your patients have noticed. After a series of cancellations, your once-packed afternoon schedule is now wide open. You look around the office at your employees (whom you will now be paying to sit around the office the remainder of the afternoon) and you have an idea. You announce to your employees that the practice will get an early start on the weekend and close at 2 p.m. Your employees are ecstatic at the news, and you give yourself a pat on the back. 

Doctor, your ingenious cost-saving early dismissal plan has now put you in quite a conundrum. Your employees are all looking at you, waiting for an explanation. So what’s the answer? As it is with many complex legal questions, the answer is, “It depends.”

Your hygienist is referencing the Fair Labor Standards Act (“FLSA”), as interpreted by the 

As for the terms “engaged to wait” versus “waiting to be engaged,” these derive from the FLSA and, for non-exempt employees, can help determine whether an employee needs to be compensated for time spent not working. Generally speaking, if an employee is waiting for work to do while on duty, he or she is “engaged to wait,” and the time counts as hours worked. For example, a receptionist does not clock out between phone calls. After hanging up, he or she is engaged to wait for the next call.

By contrast, the Department of Labor takes the following into account when considering whether an employee is “waiting to be engaged:” 

Was the employee advised of the time that he or she is required to return to work?

Is time period in question long enough for the employee to use the time effectively for his or her own purposes?

Was the employee informed in advance that he or she may leave the job?

As you can see, the distinction is highly subjective and will depend on the facts and circumstances of each case. In our hypothetical scenario, the first three prongs are not likely an issue. The issue would turn on whether the employee was provided sufficient advanced notice of the early dismissal.

However, over and above the answer, a more important question stems from the hypothetical scenario: Why didn’t you and your employees already know the answer? In legal questions of this nature, the dispute usually stems from a difference in expectation.

If the above hypothetical scenario were to occur in your office, what would be the expectation of your employees? What have you done to manage those expectations and to protect yourself in the event of a disagreement? What documents (e.g., employment agreements, policies and procedures, etc.) can you direct your employees to for the answer? For example, your policy and procedures manual and employee agreements should include language that informs your employees that their hours of work may be increased or decreased to meet the needs of the practice.

By addressing these issues in advance via employment agreements and/or policies and procedures, your practice can manage employee expectations and be in a better position to defend legal challenges on these grounds. Now would be a great time to review your materials and be certain that your HR house is in order.

Articles

HR Hot Topics: Can you send your dental employees home without pay?

	After an exciting weekend, my two teams are set. Villanova won the Big East and Notre Dame took the ACC Championship. The bracket has been announced and Nova is a #1 seed in the East. The Irish are a #3 seed in the Midwest. It’s March. It’s time for some Madness. Here we go!

Even folks who don’t follow basketball any other time of the year will have a bracket or two. The American Gaming Association estimates that nearly 40 million people will complete over 70 million brackets and you can bet that many of those brackets will be part of a tournament office pool.

Hot read: The 7 most annoying things about your practice's waiting room

Many people, especially employers, wonder if it’s legal to let employees run an office pool that provides a cash reward. Are millions of otherwise law-abiding citizens breaking the law every March in the form of a $5 office pool bracket? “Technically speaking, yes,” says 

, an attorney in the health law practice of Fox Rothschild LLP. “Office pools for compensation are most likely illegal, and there have been cases where authorities have successfully charged pool organizers and participants with running an illegal gambling operation.

“However,” Meehan added with a smile, “I’d venture to say that in the vast majority of cases, the laws at issue are not very strictly enforced during the month of March.”

This seems to be a common sentiment. In his article in the Washington Post this past weekend, sports reporter Will Hobson writes, “while the tournament office pool is outlawed in much of the country, it is a crime roughly equivalent to driving 60 mph in a 55-mph zone.” Anne Fisher of Forbes quoted Challenger, Gray & Christmas CEO John Challenger’s opinion, “Trying to stop March Madness would be like trying to stop a freight train; if anything, employers should embrace it, and look for ways to use it as a tool to boost employee engagement.” 

More from Ginny Hegarty:	HR Hot Topic: Tattoos and piercings in the dental practice

Many studies show that about 50% of the time, the tournament fun has a positive impact on office morale. However, that doesn’t mean you must have an office pool to benefit from all the fun.

Chances are your office will be alive with tournament energy, regardless of whether your practice has an office pool or not. Your employees are likely fired up about the brackets they have going with family and friends. Many of your patients have probably jumped on the “Madness train” as well.

You can choose not to have an office pool, but to tap into the energy by having the team and patients talk it up and share their excitement. You can even throw a tournament office party or open house to celebrate with patients and/or referring doctors and their employees.

If you decide to sanction an office pool, it’s a good idea to set some boundaries. Be sure your employees know that no one should be taking a cut for running an office pool, as this can be seen as promoting illegal gambling.

Remind everyone of the guidelines that should be in place in your policy and procedures manual regarding BYOD issues (Bring Your Own Device) and personal use of the practice computers and Internet access.

For instance, if you have a policy that states cell phones should be kept on silent and away from your work area at all times, be sure everyone in your office understands that the office NCAA pool is not a license to keep your cell phone out, stream the games or check the scores. It’s also not a green light for surfing the Internet between patients to watch the tournament live.

Set guidelines for how and when the team can keep up with the games that are played during work hours. For example:

You might set a plan for lunch and mid-afternoon breaks for a team member to update everyone on a white board in the team lounge.

Some practices celebrate the hometown teams and keep the scores on a white board in the reception area and asks patients to help keep them up-to-date.

Other practices choose to have the games playing on the practice televisions.

More from Ginny Hegarty:	Ignore your patients' complaints at your own risk

The corporate world may be bracing for a billion dollar hit in lost productivity, however, due to the interpersonal way dentistry operates, the tournament can be a big boost for your dental practice.

When your practice employees are authentic, enjoying themselves and having fun, it shows! People like to do business with people they like and trust, so give your patients a chance to get to know all of you better on a personal level. Go ahead, tap into the fun, root for your favorite teams, post your team spirit photos to your Facebook page and get caught up in the excitement of this wonderful American tradition.

which provides practice and team development services to dentistry since 1997

 and proudly serves as the Immediate Past-President of The Academy of Dental Management Consultants. If your practice would benefit from HR support or an up-to-date policy and procedures manual, contact Ginny at (610) 873-8404 or through 

Note: Basketball photo © Justin Smith / Wikimedia Commons, CC-By-SA-3.0

 After an exciting weekend, my two teams are set. Villanova won the Big East and Notre Dame took the ACC Championship. The bracket has been announced and Nova is a #1 seed in the East. The Irish are a #3 seed in the Midwest. It’s March. It’s time for some Madness. Here we go!

What to know about your dental practice and the NCAA basketball tournament bracket

It’s 10:15 on a warm spring morning, yet in Jayne’s dental practice the heat is on! Jayne is the administrative assistant in a popular dental practice in town. While it may be lovely outside, Jayne can feel the heat of the two patients’ eyes glaring at her, searing laser-like heat focused right on her! These patients had 10:00 appointments and they have been waiting for 15 minutes. They are annoyed and on the verge of full-on anger.

This I know for sure: Patients don’t mind waiting near as much as they mind being ignored. Two of the best internal marketing strategies you and your team can initiate are a commitment to:

2. Top-notch communication between the team and the patient when something stands in the way of meeting #1 goal.

 I teach teams is the 5-Minute Rule. The administrative assistant is responsible to monitor the reception room and stay fully aware of who is waiting, when they were scheduled and when five minutes has passed since their scheduled appointment time. At the 5-minute mark, the administrative assistant [AA] physically walks to the clinical area and makes eye contact with her patient’s provider or provider’s assistant. She then holds us one open hand showing all five fingers to signal she is using on the 5-minute rule. The clinical assistant responds according to this guide:

1 finger = we’re be done in a minute or two

2 fingers = we will need about 3-6 minutes

5 fingers = we’re going to be a while, initiate Plan B

The AA can then return to the patient in the reception area, acknowledge and apologize to the patient for the delay, and give the patient an idea of how much longer the wait will be. Most patients are very grateful for the update and will understand up to about a 15 or 20 minutes delay. Plan B offers the patient the option of making a call to adjust their schedule or rescheduling their appointment if necessary.

The teams with the best on-time performance realize that it takes the entire team to make this happen:

Everyone commits to arriving on time and being prepared to start the day on time.

At the morning huddle, the hygiene and assisting teams identify the hygiene check windows of opportunity and create a plan to keep the all providers running on time.

The administrative team manages the reception area and the clock.

The team reviews any missteps and discusses plans to avoid the same issues in the future.

On-time performance is a core value, a point of pride. The team tracks, reviews and analysis the results on a regular basis.

The best marketing and practice growth strategies create a reason for patients to think of you, talk about you, and refer their family, friends and coworkers. Everyone is busy these days and has very little patience for poor customer service. Your strategy is to get patients talking about how their dentist respects their time and doesn’t keep them waiting. When the unexpected or emergency situation happens, give patients further evidence of your appreciation and respect for their time through your service recovery initiatives. Happy patients are loyal patients that refer others.

As the patient impacted by the delay is leaving, I also recommend that you have a service recovery strategy in place to reward the patient for their patience and understanding. Give your patient a small gift card to the local coffee shop or ice cream parlor so your patient leaves remembering your kindness and respect for their time, rather than the delay.

It’s often said that an unhappy client tells five others, while a happy client tells one. Aim for making patients happy by running on time. When you hit the inevitable speed bump that slows you down, handle it well and patients will still talk about your great care and service—while they enjoy their next Caramel Macchiato with whipped cream!

Make the 5-minute rule one the HR Top Topics at your next team meeting and reap the rewards.

HR Hot Topic: Communication in the dental practice ... Ignore patients at your own risk

Can you name the 12 different types of popular ear piercings?

Yes, you read that correctly, there are indeed 12 different ways to pierce an ear. Here’s the bigger question: How many are acceptable under your appearance policy?

As 42% of the adult workforce now has tattoos and 61% of American adults has a piercing other than on the earlobe

, body ink and piercings continue to be an HR Hot Topic in the workplace. Dentistry is no exception. 

Most dentists understand that they have the right to establish appearance guidelines; however, they can get into trouble in the application of those policies. The majority of my dental clients prefer an appearance policy that calls for “

professional dress and moderate personal grooming and adornments

.” Most of my clients also take a position against visible tattoos and have a policy limiting piercings to the earlobe.

Related reading: Top 10 tips for tats and piercings in the dental practice

Here are two scenarios that several clients have dealt with, along with my recommendation for how to handle these situations safely and legally.

#1 “My administrative assistant came in today with a small nose stud piercing. I’m actually ok with it, but another employee is upset because our policy does not allow her to wear her eight earrings. If I allow the nose ring, do I open myself up to all kinds of exceptions to the policy?”

#2  “My hygienist has a tattoo I didn’t know about. It was brought to my attention by a coworker who was told to cover up a large tattoo she has on her forearm. The hygienist’s tattoo is a very small flower on her ankle that is only visible when her slacks ride up while she’s sitting down working on a patient. I’m ok with the hygienist’s tattoo. Must I require all tattoos to be covered up or take the risk of being sued for discrimination?

Here’s the bottom line question: “Do I have some discretion in applying my appearance policy?”  The answer is YES! Yes, but keep reading so you fully understand how to do that legally and safely.

In the case of the nose stud in scenario #1, a small, single diamond stud in the nose could reasonably be considered ‘moderate’ while eight studs along the entire outer ear could reasonably be considered ‘immoderate.’

Therefore, the employer could allow the nose stud and not the eight earrings. The key is to be sure that your decisions do not impact employees in a way that would rise to the level of discrimination. For instance, don’t allow tattoos and piercings for women, but not for men. Don’t give more latitude to younger employees than your older employees, since body ink and tattoos are more common in adults under 30. Apply your policy consistently across all ages.

In example #2, it can also be seen as reasonable to allow a small, inconspicuous ankle tattoo and require that a larger forearm tattoo be covered up. In that same spirit, you might also reasonably consider a small wrist or ring tattoo to be acceptable under the policy, while still requiring the forearm tattoo to be covered.

, an attorney in the health law group of Fox Rothschild LLP. Michael encourages his clients to develop policies that can be applied flexibly, but also consistently. He noted, “It is certainly a best practice to apply a policy consistently, but this does not mean an employer cannot use his or her discretion. That said, before exercising that discretion, the employer should take some time to think about how it may be interpreted. You never want your discretion in applying that policy to be construed as discrimination based on a protected class.”

Related reading: 6 rules every dentist should follow to avoid frivolous lawsuits

Use your discretion. If you feel that the nose stud or the ankle tattoo do not meet your moderate standard, you can require that both be covered or removed (in the case of the nose stud) while at work. But if you prefer to allow one and not the other, use “consistent discretion” in applying your policies and you will be able to minimize your risks in this area.

This topic continues to trend as companies are beginning to relax their stance toward piercings and tattoos. We’ll take another look at how and why big business is responding in a future post.

HR Hot Topics: Tattoos & piercings in the dental practice

Picture yourself on a blind date. Your heart is pounding with excitement. You haven’t been on a date in years and you’ve never been on a blind date, but Amy, your best friend at work says this guy is terrific!

You are definitely out of your comfort zone, but then a funny thing happens. You see each other and you relax. He gives you flowers. You sit across from each other and talk and you discover that you both enjoy an active, healthy lifestyle.

You’re thinking, “This is promising.” Then Mr. Wonderful says, “I can’t help but think that you might benefit from a better exercise routine. Let me tell you about the great gym I belong to.”

What? Does he think I’m out of shape? Who is he to tell me I need a better exercise routine? I can’t believe he is so superficial and rude. How can I gracefully excuse myself and get out of here?

Can you imagine how you’d feel? You’d think back to see if you missed some of the warning signs. Amy liked him. She thought you’d be a good match. He was sweet on the phone, the restaurant was lovely, and he brought flowers. Still, you were blindsided. You’ll be polite and when he asks if he can call you, you’ll nod and say, “Of course,” knowing full well that you will not answer his call or ever talk with him again.

Mr. Wonderful is also wondering what went wrong. He’s thinking, “I tried to put my best foot forward. I even brought her flowers. It seemed to be going so well. Geez, I even cared enough to tell her all about the amazing gym I just discovered. This trainer has a 20-minute routine that gets me better results than anything I’ve ever done. I guess she wasn’t as interested in staying as healthy and active as I thought she was.”

Two different perspectives which one is accurate? The truth is that it doesn’t matter. Regardless of both people’s best intentions, the relationship never got off the ground.

What does this have to do with dentistry? Everything!

 Most people have had the experience of thinking they were connecting with a patient and then experienced a disconnect just like the dating snafu above. The initial phone call was terrific. They welcomed the patient warmly. They offered a beverage, a comfortable massage chair, aromatherapy candles, music selections, and warm blankets that created a spa-like experience. Everything was going well and you expected the patient would move forward only to find out the patient didn’t schedule a next appointment.

You’ve probably scratched your head and wondered what happened. Maybe your patient said “yes” while at the office, scheduled his or her visit, and then cancelled. Again, you’re left wondering what went wrong and why the patient has changed his or her mind. You were so sure that you understood what the patient wanted but, in reality, it’s possible that what you truly understood was what YOU wanted for the patient.

Relationships take different forms -- some personal, some social, some professional -- yet the relationship rules remain the same.

People choose other people they like and trust.

The best way to know what someone wants is to ask.

Don’t make assumptions or you may believe them to be true.

If you don’t like the answers you’re getting, ask better questions.

There’s never a second chance to make a great first impression.

If someone does not weigh in on a decision, they cannot truly buy into it.

 “I have definitely been there, thinking I’ve educated my patient to understanding the best solution only to have them surprise me. Here’s an example:

I just gave the perfect treatment presentation, or so I thought. I bonded with the patient, he laughed at all of my favorite jokes. I discussed his X-rays and intraoral photos. I showed him how we could straighten and whiten his teeth. Then came the dreaded question, “How much is all that going to cost? Besides, I don’t want a mouth full of braces at my age!”

I swallowed down the lump in my throat, “Well ... Brittany can answer that question for you up front. As far as your crooked front teeth, we could do some bonding that would work pretty well to make it less noticeable.”

I made a classic and fatal mistake. I gave the prescription before the diagnosis and I never asked my patient important questions that uncovered what he desired.”

In both the blind date example and Dr. Elliott’s example above, one party offered an opinion or advice that the receiving party was not yet asking for or prepared to hear. In both cases, a relationship that initially felt promising never got off the ground.

After personally training more than 7,000 delegates in his two-day Ethical Sales Training program in the United Kingdom, Ashley Latter has come to the conclusion that the biggest communication mistake dentists make is they sell their products and services before finding out what the patient requires or wants.

“The majority of dentists think that the more they talk, the better chance they have of treatment acceptance,” says Latter.

After taking part in Latter’s program, Dr. Elliott has made some critical changes that are dramatically increasing her case acceptance. For example, when Dr. Elliott sees a patient with some anterior crowding who mentions an upcoming wedding, she doesn’t say, “We could fix those crooked teeth with braces and some whitening in time for your wedding. Let me show you how.” Instead, Dr. Elliott gets to know her patient and is now skilled at making the emotional connections between the patient’s current and desired situation. She uses a very simple, yet powerful process to help the patient lead the way to choosing the best solution for himself.

This patient shared that he often holds back on fully smiling or covers his mouth to hide his crooked teeth. With all the photos that will be taken on the big day, he is nervous. Once comfortable and feeling safe, he reveals his wish to be able to smile confidently and show just how truly happy he is. He’s afraid that with the wedding just six months away that he’s waited too long. Now that he’s ready, Dr. Elliott can present the perfect solution in Six Month Smiles Cosmetic Braces along with whitening.

Often the treatment presentation can look like a tennis match with the doctor and the patient batting the ball back and forth, with the doctor making a recommendation and the patient raising an objection over and over again.

The beauty of Latter’s approach to case presentation is that it puts you and your patient on the same side. The relationship between doctor and patient is supportive not adversarial.

There are many advantages to this ethical sales process including:

The patients start telling you the benefits of the treatment.

Treatment becomes their idea, in which case they are more likely to accept and you will get fewer objections to the cost of treatment

“I once heard a statement that has lived with me for many years. Prescription before diagnosis is malpractice,” said Latter. “If you do this, it’s malpractice. You risk offering the wrong solution.”

 “This program has taught me that just when I naturally jump in with solutions is when I need to step back and ask questions. This course has changed me and my practice like no other I’ve taken.”

Ashley Latter is internationally renowned for helping practices create more opportunities to deliver the dentistry their patients want. He writes an e-mail newsletter 

 (for those of us in the United States, that means twice a month) that is read by more than 12,000 dentists worldwide.

After all the cutting-edge education and sexy technology is in place, the magic still doesn’t happen until people connect. Communication-skills training is a game-changer that will make the difference for you, your team, and your patients. It can even help on that next blind date!

Editor's Note: Erin Elliott, DDS and Ginny Hegarty, SPHR teach the Ethical Sales and Communication program. To learn more, visit 

http://www.6monthsmiles.com/pages/dentist_home/ethicalsalesoverview.aspx

The importance of creating and building a relationship with the dental patient

President Obama has announced a one-year delay to a key component of the 

 stating, “Insurers can extend current plans otherwise canceled in 2014.” While waiting for insurance companies to further clarify, there is one, less talked about provision of the ACA to which dentists should be paying attention.

Dentists will be required to comply with the ACA’s provisions requiring employers to count their employees so they can properly report those who are full-time equivalent (FTE) employees.

 for their audit and enforcement activities. Now is the time to take a closer look at Employee Classifications and Status. According to a recent advice from 

, “The financial stakes for errors in worker classification are high and will only increase once the ACA is fully effective.”

 does not define full-time employee status, but leaves it to the employer to determine, provision 

of the Affordable Care Act states that 30 hours per week average is the statutory definition of a full-time employee.

 (FLSA) requirements for “exempt” status are extensive, specific, and stringent and generally apply to executives, managerial, or professional positions. It’s important to note that it is rare for dental employees to meet these strict standards.

 from Overtime: 95% of dental employees. Non-exempt employees can receive their compensation either in the form of salary, a daily rate, or an hourly wage. Do not confuse “salaried” employees with “exempt” employee status. Even a salaried, non-exempt employee must be paid overtime.

Overtime: Pay at least 1 1/2 times the employee's regular rate of pay for all hours worked over 40 in a workweek or over any state-mandated daily threshold. For clarification in your state, feel free to contact me at 

: the IRS uses a “20-factor test,” to access independent contractor status. If the company exercises too much control, the worker is deemed to be an employee. 95% of all employees do not meet the stringent standard to be classified as independent contractors.

 reported, “In the last 2 years alone, the DOL claims to have collected over $18.2 million in back wages for workers who were misclassified. That’s a 97% increase, and states collect their share too. Employers should be looking over their shoulder. With a mix of state and federal taxing, worker’s compensation and unemployment agencies all probing for dollars, one dispute often triggers another.”


Editor's Note: Want to read more information on the effects of the Affordable Care Act on dental practices? 

Click here to watch editorial director Kevin Henry's interview with insurance expert Teresa Duncan.

Editor's Note: Photo of U.S. Capitol courtesy of keithreifsnyder on Flickr.com.

The Affordable Care Act: What you need to know about properly counting dental team members

Even the best and the brightest teams will fall short of their goals if they are not all on the same page.

I’ve seen talented teams that are actually more of a group of people working alongside each other, but with competing priorities, plateau, unable to advance to the next level of success.

The best way out of this rut - so you create new growth - starts with coming together to shift the energy in the practice, to shift the practice culture.

If you want to create a new culture, you have to change the energy feeding the old culture. Here’s a more everyday example of how to look at it.

At your next team meeting, I challenge you to go one step further and write down what you do 

 using any words that could be found in your job description.  Work with a partner so you can rate each other’s answers and nix the ones that might be a task on a job description.

you do what you do… and we all know it’s so much more than fixing teeth. It’s about who you are being when you do what you do… it’s about changing lives, restoring confidence and lifting people up.

Ginny is the President of The Academy of Dental Management Consultants and a visiting faculty member at The Las Vegas Institute for Advanced Dental Studies (LVI). She authors the HR411 column in the Progressive Dentist Magazine and writes for First Impressions Magazine. She has podcasts on HR Best Practices available on the Academy of General Dentistry website.  Ginny also lectures at the Kornberg School of Dentistry at Temple University in Philadelphia as part of the Practice Management Program. 

How to break through the stress and shift your practice’s energy [VIDEO]

When it comes to employees' self-expresion, set your policies now to avoid trouble later.

A recent Harris International Poll revealed that 21% of adults in the United States have tattoos. That figure includes 38% of 30-somethings and 27% of 40-49-year-olds. Piercings (other than earrings) are also becoming much more commonplace as 25% of 30-somethings have a piercing somewhere other than their earlobes according to the Pew Research Center.

As the world is changing and body art and jewelry is becoming more prevalent, what can the more conservative and traditional employer do about it?

To start, take a step back and consider very carefully just what policies you want to put in place.

Are you okay with a moderate butterfly or flower tattoo? How about symbols or text? Eyebrow or nose rings versus lip or tongue piercings? Are there specific industry or culture considerations in play that you need to address? Is there a safety issue to be considered? Could a piercing interfere with equipment and potentially harm to an employee? Safety trumps most other reasons or requests. Be sure to document the reasoning behind your decisions.

Different positions within a company can have different requirements based on specific job duties.

A recent Society of Human Resource Management (SHRM) article by Joanne Deschenaux includes this legal opinion:

“Generally speaking, an employer has leeway over what kind of policies to set regarding tattoos and piercings,” said Marc Scheiner, an employment lawyer at the Duane Morris firm’s Philadelphia office. “When the reasons behind [appearance] codes are ‘company image,’ those are the grayest areas.” Decisions will usually turn on the facts of the specific case, but Scheiner said courts want to see both sides be flexible. “The employee has to work with the employer to find reasonable accommodations,” he explained.

Here is the leading legal advice being offered through the Society of Human Resource Management (SHRM):

Be very clear and have your policy in writing.

Do away with all across-the-board bans as religious accommodations and discrimination issues may come into play.

Don’t be too restrictive or you risk missing out on talented candidates.

Be specific but allow for some discretion. You can say no visible tattoos or only small tattoos, but don’t get into stating acceptable dimensions or styles.

Be aware that some religions prohibit the covering up of religious tattoos so you’ll need to be careful in applying a “no visible tattoos” policy.

Apply your policy consistently. You can’t randomly allow one person to have a nose ring or tattoo and not another unless religious accommodations are being considered. Your position will be hard to defend if it’s applied arbitrarily.

Offensive images can be banned. However, whether on tattoos, jewelry, clothing, pictures, or email, they must all be dealt with in the same way to prevent creating harassment claims or a hostile work environment. Offensive is offensive in all forms.

Sometimes the cover-ups attract more negative attention than the original body art. Are Band-Aids acceptable, or do you prefer opaque makeup, clothing, or bracelets?

Tattoos and piercings are only two issues that must be clearly defined in a solid appearance policy from your Policy & Procedures manual. Now is a great time to address your appearance policy and how it also deals with perfume, body odor, cleanliness, cleavage, and provocative dress.

Given that most hiring managers are still part of the older GenX or Baby Boomer generation, prejudice toward body art is still a reality to be dealt with. Be sure to train your managers on the law. 

HR Hot Topic: Top 10 tips for tats and piercings in the dental practice

Whenever I ask a team “If you were doing something that was holding your team back, would you want ..."

 Your coworkers to talk behind your back?

 Your coworkers to go to your doctor to report on you?

They ALWAYS, ALWAYS answer "A" -- I’d want someone to tell me.

If we’d want it for ourselves, we must be willing to give that level of support to each other, right?

I think one of the simplest changes you can make in your office that can have the greatest impact is to reframe accountability for your team. 

Reframe it as a Gift You Give Each Other. Remember teams always say that’s what you truly want, so let’s honor each other’s wishes.

Any of us that have been involved in sports teams or watched our children on these teams, know that a great coach doesn’t ride the weakest players, they push those with the most talent so they can realize their potential.  Holding someone to a higher standard is a sign of respect and confidence that a person has the talent, skill, and the ability to be better.

Remember leadership doesn’t just come from the top down. Every day each of you has the opportunity to lead one another. The best team members crave accountability; they want the recognition and the appreciation for their great results.

There’s an old adage: “You Don’t Get What You Expect … You Get What You Accept” 

We each need to step up, stop accepting less, and stop settling for good enough. Success is a choice that each of us gets to make.  As a team, it’s a choice you need to make together as you put a solid action plan in place.

You’ll be amazed at what your team can come up with when you start with a clean slate and give everyone a voice in a Strategic Planning process. You’ve heard it before: Most people don’t plan to fail – they fail to plan.  Systems alone don’t achieve great results – it takes a synergy between the systems and the people.

It takes a strategic plan. And when that synergy happens it creates a triple win for the patients, the team and the practice.  It turns success into significance.  That takes us full circle back to what each of us really wants in life … to make a difference for those around us. It also makes for a fun work environment for everyone, except the pink elephants in the room, of course … they’ll be moving on…