Articles By Fred

"I'm interviewing new employees. I've heard checking references is a good idea, what are your recommendations? On the other hand, what am I allowed to say when a prospective employer calls our office for a reference for one of our former employees?"

All too often, I come across a dentist client who avoids contacting references for new employees for a variety of reasons; not the least of which is he or she doesn’t know how to properly contact previous employers in order to obtain valuable information. Although, I’ve never come across someone who has applied for a job and provided a BAD reference! Understandably, people looking for work wouldn’t provide a reference that would give a poor report.

Sure, the most common concern here is how well the previous employer will cooperate with sensible questions that are commonplace with employment practices. Most employers would prefer to shy away from these kinds of phone calls due to the notion that negative statements may come back as a problem later. For the most part, we’re going to discuss contacting previous employers; the material is relevant to receiving reference checks, as well.

According to the Arizona Industrial Commission and Labor Board, no laws in our state of Arizona govern the issue of reference checks and what can or cannot be said. Following basic guidelines will help one decide how to disclose information about former employees and avoid litigation. One can never be too careful in today’s litigious society.

An employer may fear that if any negative statements are made one could be sued for libel (written) or slander (spoken). It is best to stick with the facts and lay aside personal feelings. Keep the information discussed basic and be brief.

In order to avoid defamation, a former employee must prove that information given out was false and that the information harmed his or her reputation. Proving the information given was true dismisses these types of legal battles. For example, disclosing disciplinary action taken during the employment period is justified provided that documentation signed by the former employee is on record. Make sure personnel files reflect fairness, objectivity and honesty; free of unproven gossip.

If an inquiry is made to your office about a former employee applying for a position in another dental office, speak only to the doctor, or the owner of the practice. Ultimately, these people are responsible for hiring, training, reviewing performance, and dismissing employees.

Thinking proactively in your own office, it would be wise to have an employment application that provides consent to contact previous employers. Include with the application simple language providing authorization to check references:

“I hereby certify that the information contained in this application form is true and correct to the best of my knowledge and agree to have any of the statements checked unless I have indicated to the contrary. I authorize the references listed above, as well as previous employers who you may contact, to provide any and all information concerning my previous employment and any other pertinent information that they may have.

Further, I release all parties and persons from any and all liability for any damages that may result from furnishing such information as well as from the use or disclosure of such information by the employer or any of its agents, employ­ees or representatives."

Next, during the initial interview, discuss with the applicant that you will be contacting previous employers, unless he or she objects. If the candidate objects, then ask, “Why?” Discussing this issue up front is smart because an answer the applicant provides along with their body language provides insight into whether or not the applicant will be a good hire.

Once you have the go ahead to contact previous employers, follow a process of asking questions that confirm information on the application. For example, confirm dates of employment and salary range. Ask if job duties and responsibilities were adequately performed. What are the person’s greatest strengths, and weaknesses? Was the former employee terminated or did they resign? And finally, the “Crown Jewel” of all questions that will tell a person most all he or she needs to know about a prospective employee is, “Given the opportunity, would you hire the employee again?” A “yes” or “no” answer speaks volumes. Take it from there.

By the way, in preparation for a telephone call from another person checking on a previous employee, consider the following. Be ready to begin the call by stating that you will be glad to discuss basic information, such as dates of employment, salary range from date of hire to end of employment, and job duties and responsibilities. This sets the stage nicely for what you intend to discuss and what the person on the other end may indeed with to know.

Keep in mind, a previous employer you are contacting may be reluctant to provide any information that may damage the candidates’ ability to seek and acquire employment. Although, some states, such as Kansas, have passed laws that require a person must show “clear and convincing evidence” that the former employer acted in bad faith in providing job-related information. Ask the questions we have discussed here and wait for responses that may clue you in to how anxious, or reluctant, the previous employer is to re-hire the person.

It also pays to be discrete while attending informal gatherings. Don’t speak freely at a meeting or other functions where social and/or business chatter may take place. Among colleagues and employees, disclose the reasons for firing strictly on a need-to-know basis. Limit the announcements to, “Sally has left the practice and we’re seeking a replacement.” Either ‘speak well of the dead’, or say nothing at all. For example, if one believes nothing positive can be said of a former employee, simply state that it is the policy of the practice not to comment on former employees with prospective employers. Airing grievances about someone will likely spread, potentially causing legal complications.

"I definitely need help in setting up an employee manual because I have no idea where to start. What are the main components? What’s important and what isn’t?"

Personnel Management in dental offices requires specific elements to be effective; not the least of which is a manual that clearly spells out the general policies, terms of employment, and compensation & benefits of your office. Handy to have with the manual are documents that help bring clarity to issues and for proper information safekeeping. It is not just another “system”, or important legal document. It is the reference point for how employees are expected to behave and conduct themselves, and how the employer will provide for a safe, professional, and (hopefully) prosperous work environment.

Without this tool and its components, office policies tend to be ambiguous, and employees are left to guess how they’re supposed to behave in certain situations. Even with this in mind, a manual must not rest alone. Proper leadership skills must be orchestrated by the employer along with a written guidebook to ensure successful human resource management.

What I will attempt to do in this article is explain essential background information on human resources that must co-exist with a written guidebook on personnel policies. I’ll finish by providing guidance on how to construct and effectively integrate an employee manual into the workplace.

Truth is, in my experience, ALL dental offices need an employee manual; unfortunately, only a few have a current working guidebook.

But where does one start?

My suggestion is to obtain an employee manual already prepared for dental offices. There are several on the market that are worthwhile and can be purchased at a fair fee. As a service to each of my consulting clients, I have developed a personnel manual that fits specifically into the dental environment. In any case, a proper manual would have the capability of being fine-tuned, or individualized for each dental office, due to the unique qualities found in each practice. The employer should ensure a working environment exists in his or her office that supports fair employment practices. Let’s dive into some of those concepts so that you will have an idea regarding what manual will be a perfect fit for your office.

A cornerstone in business management is providing employees with the reason why things are done a certain way. Establishing principles that will keep a business running effectively while handling any personnel issues is in line with this concept. Employers should make sure time is spent thinking about how their business will be run, and how decisions will be made. For example, if one declares, “We will always respect other people’s time in our office”, then one tends to focus on staying on time during the course of the day. And, appointments that are scheduled are not moved for the convenience of the office, but rather kept for the benefit of the patient.

In terms of personnel management, consider establishing principles that will help make decisions easier to come by. For instance, “We will strive to be fair to the employee in all aspects of human resources” would be a sensible tenet to adopt. In this way, when a situation arises, fairness would be the prevailing principle ensuring an appropriate outcome.

Another consideration may be to incorporate the “Reasonable Man Theory”; an ancient English common law which follows, ‘in any circumstance, a person is expected to know what is real and/or reasonable and do what is prudent’.

When dealing with personnel management issues, one must ask, “From who’s perspective is it reasonable?” In today’s day and age, the employee’s perspective of reasonable is used. In that case, examine each situation through the eyes of the employee. What one risks is the inherent loss to business through decreased productivity from people who are not treated reasonably and prudently in the work place.

In order to keep morale high, remove hurdles to productivity. Here are some suggestions that can help promote good management of people.

• Create a mission statement – define the practice’s “big picture”.
• Help people understand “why” they are doing what they’re doing by explaining standards of care and protocols for each job responsibility.
• Have complete job descriptions - they are the foundation for effective personnel management. And, job descriptions clarify the employee’s responsibilities, wiping out ambiguity in the workplace.
• Build an office where people know how they’re doing: provide objective feedback on performance.
• Develop tools & reports that employees utilize that help them become accountable for their job requirements and work expectations.
• Endeavor to help make all employees feel comfortable and fulfilled in their work.
• Ensure a non-hostile work environment exists that is private and safe.

One important aspect in personnel management, in particular the State of Arizona, is the clear establishment of employment “at will”. In simple, this is employment that lasts as long as both parties will it to last. If one party elects to discontinue the arrangement, then the arrangement is discontinued. Put another way, if the person is employed, the employment lasts as long as both parties agree equally.

Avoid the following common errors and maintain employment “at will”. Don’t promise permanent employment; again, employment lasts as long as both parties agree equally. Next, make “at-will” employment very clear by placing it in the personnel manual and on job applications. Also, avoid any “Termination for Cause” statements in the manual or employment documentation, as this may negate the “at-will” status of employment in the office. Finally, don’t neglect to obtain a signed acknowledgement of receipt of the manual! In this way, employees confirm they have read and understand the manual in its entirety and agree to abide by the policies set forth.

Time has tested the theory that a fantastic team is built around reliable personnel management systems. Hiring protocols are followed so that people with the right skills and temperament are screened and hired properly. They are employed because they know they can perform the duties described in the job description, and references have provided positive reinforcement of their good work history. From their first day on the job, they know what to expect because they’ve read a manual describing how things work in the office and what is expected of them in return. During their time of service, they know how well they’re performing because a formal review process evaluates their work productivity against the employer’s expectations. Consequently, employees are accountable for the results of their actions – good or bad.

In the final analysis, all who work in a dental practice should provide for a profitable and gratifying experience. A personnel manual that is customized to fit the particular aspects of any practice is a must; only then can it be utilized to maximize employee performance. I’ll state the obvious in that just purchasing a manual will not solve personnel issues. Editing the manual to suit the particular nuances of an individual office and incorporating the manual with good employment policies, complete protocols, and sound philosophies are proper business strategies. Following through on what is established within the manual will result in excellent human resources.

An effective employer shows he/she cares with fair employment policies and parameters for continued employment. Use the above suggestions to construct a guidebook or manual that is complementary of the management and business principles of the practice.

"Performance Reviews. I hate doing them; and they're time consuming. Are they really necessary? If so, how do I conduct a meaningful performance review?"
Yes, they're really necessary. And conducting meaningful reviews are not difficult when properly planned and orchestrated.

But before we get started on the subject matter, let's go back to when the employee was first hired. A quick review of the steps to ensure a proper hire are to (1) request a resume with cover letter, (2) have the potential employee complete a thorough employment application and sign it, (3) conduct a brief preliminary interview to collect these items and to get to know the applicant. After the interview, research past work history of the employee by comparing time lines on the resume with the time lines on the employment application; but sure they are consistent. Contact previous employers and ask them the following questions to corroborate the applicant's information; and be sure to ask to speak to the doctor, or owner of the practice!

• Confirm dates of employment: "When did the employee start working and when did employment end?"
• Confirm salary range: "What was the rate of pay when the employee started, and what was it at the end of employment?"
• Job duties and responsibilities; were they adequately performed: "What were the employee's duties and responsibilities? How well were they performed?"
• Strengths, weaknesses: "What would you say are the employee's greatest strengths? What are the employee's weaknesses?"
• Terminated or resigned: "Did the employee resign, or was the employee terminated?"
• Re-hire: "If you had the opportunity, would you hire the employee back to your office?"

Confirm with the application and resume that the dates of employment match up; look for consistency in date ranges and identify any gaps in employment. For example, if the potential employee provided information showing he or she worked from January 2008 until February 2010, yet the previous employer shows dates worked from January 2008 through March 2009, make note and prepare to ask the potential employee about the discrepancy in employment time lines.

Rate of pay is important since you may be interviewing a candidate who is outside your normal range of pay for the position. And, the candidate may claim a higher rate of pay from previous employment to leverage better pay.

The reference may be reluctant to provide any information that may damage the candidates' ability to seek and acquire employment. Although, some states have passed laws that require a person must show "clear and convincing evidence" that the former employer acted in bad faith in providing job-related information. Ask the above questions confidently as they are standard and safe; and wait for responses that will help lead to a decision to hire or not.

In addition to the steps discussed here, an employer may find that conducting a background check of an individual, going beyond a friendly recommendation for hire from a colleague or other respected source. To be too trusting can be a detriment. Embezzlement and fraud in dentistry is rampant; careful hiring starts at the onset.

Once you have an employee in place, performance evaluations are a necessary management tool that will help people achieve and even exceed their potential. It also is the stronghold for an employer to keep tabs on business operations and essential in helping employees realize strengths as well as their shortcomings in order to improve performance. When orchestrated properly, these evaluations are powerful developmental tools.

The following will help guide doctors through a simple performance evaluation in order to gain the most positive experiences for themselves and their employees as well.

The evaluation assesses performance on a yearly basis, but there should be a plan set in place for the day-to-day process as well. This assessment would be applicable for any employee; new or established, especially when people are hired under the right circumstances. Best employment practices follow a standard for other employees to realize this is necessary for their continued employment.

This may feel unnerving to the new employee, but it helps keep expectations high, in the same way as keeping an existing employee from not becoming complacent. Therefore, for new employees, provide an evaluation at the end of a 90-day orientation period; yearly for the established employee. Both doctor and employee will come to the meeting with their ideas on performance thus far and ways to improve performance; usually this information is in the form of a templated employee review form.

If an event occurs that requires immediate attention, don't wait for the scheduled "Performance Review" to discuss this situation; address it immediately. If this is a repeat offense, the disciplinary process must be instituted. This process should be followed exactly as your Employee Manual specifies; usually an anecdotal write-up that a formal verbal discussion was held, including the employee behaviors and recommendations for correction that were discussed. If problems continue, a formal report listing documented incidents, recommended solutions, and disciplinary actions set forth should be made and become part of the permanent employee file. This report must be reviewed and signed by both employer and employee. When documenting employee behaviors, be certain that you remain objective. Never contain subjective documentation.

For a subjective example; 'Julie seemed aggravated and snapped at a patient'. An objective example; 'Julie stated "You have to sign this" pushed papers across the console quickly toward the patient and left the room. Upon leaving the office, the patient exclaimed, "Wow, that was rude!"'

In addition to documenting objectively, make sure that the date, time, and patient initials are included so that during the performance review or disciplinary process the facts are clear.

Structure the evaluation as part of an ongoing process, rather than a solitary event.
Although formal performance evaluations are structured to occur on a scheduled basis, as stated previously, employee behavior and job performance should be evaluated daily. This is an ongoing process; tedious, yes, but valuable. It will be the keystone in the continuous supervisory cycle of refining job descriptions, setting goals, providing constant feedback, and coaching. Doctors must be actively engaged in these supervisory duties and not take the path of least resistance. If gone unresolved, unacceptable activity or behavior that causes stress and frustration may fester not only with the doctor but with other staff members. Eventually tempers flare.

Make anecdotal notes during the period.
When staff members perform well, make a written note of these events as well as when poor performance is observed. Write down specific actions, results, and dates in an informal file. Use a spiral notebook and label it "Anecdotal Notes", have a space for each employee, and keep it in a locked desk drawer. These notes are not part of the "official" personnel file. Over the course of a year, since one has developed a trained eye for these matters, there should be dozens of written anecdotes that will assist in accurate recall.

Have available the date, time, and specific issue or behavior that occurred. Here is an example of an incorrect note:

"Sometime before lunch last week, overheard employee cursing under her breath; showed anger in front of patients."

"Observed {Staff Member} being a team player."

Here is an example of a correct note:

"1/9/2011: 10:35 a.m. Used the profanity 'shit' within earshot of patients, slammed down telephone receiver."

"2/12/11: 9:30 a.m. Overheard {staff member} ask other team members, "I'm all caught up with my work; is there anything I can do to help you?"

Focus on the relationship and specific job duties; not the paper evaluation form.
Don't let the written evaluation form become a restriction; use it as a guide. Consider adding questions not listed on a form that pertains to the individual's job description or duties. This may provide for a more meaningful evaluation for the team member.

Schedule the meeting in advance; provide a blank copy of the evaluation.
Block out time in your day to conduct performance evaluations. Yes, productivity is sacrificed; but these meetings are important and are vital to the future performance of the practice. Remember the management edict, "Work ON your business (dental practice), not just IN your business." Give a blank copy of the evaluation and ask the employee to evaluate his or her own performance. Attach a copy of the job description for reference. Suggest the employee consider assembling notes on the following:

• Achievements and/or successes
• Ways to improve upon performance (including perceived barriers to change)
• How well the employee believes they work with others
• Special skills acquired during the period that add value to the practice
• Plans to enhance performance through continuing education of interest in the coming year

Let enough time pass before the evaluation for both the employee and doctor to assemble their information; usually a week will suffice. Be punctual! It sends the wrong message to employees when performance reviews are late or cancelled.

Keep it private.
Conduct the review in a private area of the office. Focused communication as well as confidentiality is required. If the facility doesn't have a private place, consider a neutral site that is quiet where interruptions are avoided, other than a true emergency.

Be objective; "Just the Facts"; listen carefully.
Make sure that the information you give on an employee's performance is strictly objective. In other words, provide only the facts as you have documented them during the period. Keep your language forthright and clear. If the performance is outstanding or unacceptable, say so. Computer management reports may aid in demonstrating exceptional or poor performance; use them if applicable. Allow the employee to share his or her views of performance, listening carefully to the other side of the story. This helps the employee take an active role in the evaluation without diminishing the authority of the employer.

This part of the session is the most important part of the evaluation. Again, it is extremely important to view issues objectively with evidence.

Eventually, the employment review will end with the two performance evaluations signed by both parties. An action plan agreed upon by the employer and employee that will help the employee improve performance and focus on the future goals of the practice must accompany the signed documents.

Both the employee and employer must sign and date the evaluation. This will become a permanent part of the employee's personnel file. At this time, introduce a merit increase, if applicable, or bonus for exemplary performance. Remember that the act of conducting a performance review does not imply a merit increase or bonus.

Performance evaluations can be stressful. And, some people shy away from this important personnel management tool in order to avoid confrontation. The evaluation must be truthful; otherwise if a problem employee is dismissed and all evaluations showed good quality performance, the disgruntled employee might find justification in pursuing legal action because of wrongful termination.

Use these tips to become more proactive in handling performance reviews, and create an environment that reduces stress during the evaluation. Continue to work on ways that will enhance people and practice performance.

As my employees do so much for me and work hard every day, I would like them to know the value I provide them in terms of compensation and benefits. Do you have any advice on how to do this in a constructive, positive way?

Hard working employees in a dental office that achieve results are deserving of good pay and fringe benefits. Sometimes the hard work these diligent employees put forth goes unnoticed and unfortunately unappreciated, at times. Get your pencil sharpened and we’ll run through an easy and effective exercise to help everyone understand the total value of the compensation and benefits you provide to your well-deserving team.

First, I recommend using the trailing 12 months of payroll and benefits data. In this way, the information can be examined over a reasonable period of time.

Tabulate the gross salary and/or hourly pay and overtime wages. Include, if any, employer contributions such as Social Security, Medicare taxes paid (FICA), Federal Unemployment Tax (FUTA), State Unemployment Insurance, and any other taxes paid by the employer on behalf of the employee.

Next, include any employer paid benefits such as a bonus or productivity award, continuing education, life insurance premium, health and/or major medical insurance, vision coverage, covered parking slip, health club membership, uniform allowance, child care assistance, and pension and/or profit sharing plan contribution and match (if any). Tabulate at the usual and customary fee that would normally be charged any dental treatment provided to the employee and/or family members as an employee benefit. Subtract any fees paid by the employee for lab or co-payments.

Now, put together the amount of time benefits paid including holiday pay, vacation pay, sick/wellness pay, and any paid time off that was provided to the employee.

If you get the idea, we’re putting together all of the paid compensation and dollar value of the benefits provided the employee. Add these amounts together and put them to the side.

Finally, from payroll records, compile all hours worked by the employee during the 12-month period. Include total hours the employee actually worked, and total hours taken for paid time off, holiday, vacation, etc.

Divide the total compensation and benefits in dollars by the number of hours the employee actually worked. This amount is the effective value of the employee’s hourly pay. It will shock you, so be ready!

The good news here is that the study will demonstrate that excellent employees who put together a hard days work, who get great results from their efforts, are very well paid; rightly so. It may also reveal that employees that are not getting the results you expect may be paid more than they are worth.

Another element to this study is the battle some employers have with employees who come to them and say, “I know a dental office down the street will pay me $14 per hour; I’m only making $10 per hour. You’ll have to match the $14 or I’m heading down the road.”

Holding an employer hostage to supposed better pay is an awful way to negotiate compensation. One solution is to let the person move on down the road and test the water in greener pastures. Another solution to this problem is to prepare and present the compensation and benefits summary described in this article. If the amounts are different, consider what next steps to take. Be careful; since this subject has come up with one employee, chances are, it will come up with another.

Alternatively, you may suggest a sit down meeting to discuss what expectations you have that are not being met, or how well the employee is performing and that the compensation is “right along the lines of $14 per hour, all totaled”.

I’d very much like to suggest that for each employee in the office, conduct regular performance reviews and include this compensation and benefits summary to demonstrate pay provided for the work performed. It will assist in discussing how to proceed with pay commensurate with work and results.

From the Author: For an easy to use worksheet for this process, send an e-mail to fred@azda.org and request an “Annual Compensation Summary”.