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Employment Practices

Balancing the roles of healthcare provider and employer can be a challenge. Get advice on how to write job descriptions, create applications, place help wanted ads, set meal breaks, establish alternative work schedules, and terminate an employee.

Interns and Volunteers

September 27, 2021 1873


For a worker to qualify for an unpaid internship, the following criteria described below must be applied.

Primary Beneficiary Test

The primary beneficiary test looks at the “economic reality” of the intern-employer relationship to determine which party is the relationship’s primary beneficiary — the employer or the individual.

Employers need to consider seven factors that point to the intern being the primary beneficiary of the relationship and properly classified as unpaid.

  • The intern and the employer clearly understand that there is no expectation of compensation. Any promise of compensation, express or implied, suggests that the intern is an employee — and vice versa.
  • The internship provides training similar to that given in an educational environment, including the clinical and other hands-on training provided by educational institutions.
  • The internship is tied to the intern’s formal education program by integrated coursework or the receipt of academic credit.
  • The internship accommodates the intern’s academic commitments by corresponding to the academic calendar.
  • The internship’s duration is limited to the period in which the internship provides the intern with beneficial learning.
  • The intern’s work complements, rather than displaces, the work of paid employees while providing significant educational benefits to the intern.
  • The intern and the employer understand that the internship is conducted without entitlement to a paid job at the conclusion of the internship.

No single factor listed is determinative whether an intern or student is an employee, each relationship should be considered on the unique circumstances of each case.

Employers should carefully consider the primary beneficiary of the intern-employer relationship using the test outlined above and the work interns will be performing when considering the use of unpaid interns. If the employer benefits most from the arrangement, the individual should be treated and paid as an employee.

The more an internship is structured around a classroom or academic experience, the more likely the intern will be determined not to be entitled to pay.

If you utilize unpaid interns, have them sign a written agreement provided by the school or program acknowledging that they have no expectation of being paid.

Patient Information Privacy and Security Laws

Train student interns on the dental practice’s privacy policies and procedures. Obtain acknowledgement of training. Training documentation should include name of trainer, date of training, training subject(s), training resources and participant names. Annual training is not required but training or retraining should occur when policies and procedures change, when it is clear that policies and procedures are not being followed and after any instance of unauthorized use or disclosure of patient information.

Workers’ Compensation

An intern might be eligible for workers’ compensation coverage if they are unpaid, but their duties and schedule are directly controlled by you as the employer. The contract agreement with the school or program should outline responsibilities.

Because coverage for unpaid interns can vary from state to state, it’s best to check with your workers’ compensation insurer or agent.


In California, those who “volunteer” their services are generally considered a person who performs work for public service, religious or humanitarian reasons without promise, expectation or receipt of pay for that work.

The classification is determined by the party’s intent. If a person intends to volunteer their services for civic, charitable or humanitarian purposes, for a public agency or non-profit, not as an employee and without expecting pay (Cal. Labor Code sec. 1720.4). The person typically will not be considered an employee of the religious, charitable or similar nonprofit entity that receives the services.

Employers of dental practices often receive requests from minors and others who offer to “volunteer” their services to gain work experience. An individual generally cannot “volunteer” to work at a for-profit entity for no pay for the purpose of gaining experience.

If you are a for-profit entity, people who perform work for you are generally employees and you should comply with wage and hour laws, anti-discrimination laws and anti-harassment laws.

For example, employees asked to “volunteer” to represent your practice at a local event or health fair would need to be paid for time worked (including any applicable overtime), mileage and travel time to and from the event.

Protection for Interns and Volunteers

California’s Fair Employment and Housing Act provides protections against harassment and discrimination to unpaid interns and volunteers. Further, protection extends to religious belief protections and religious accommodation requirements to anyone in an apprenticeship training program, an unpaid internship or any other program to provide unpaid experience in the workplace or industry.

Minimum Wage and Paid Sick Leave Ordinances by City/County

Individual cities and counties across California have passed local ordinances relating to minimum wage and sick leave laws — with eligibility rules varying from city to city. Check with local city government as to whether any local minimum wage ordinances may apply to employees in your practice. Periodically check local websites as rates in these cities could change at any time.  

Interns and Volunteers

Employers should proceed with caution when using unpaid interns or volunteers. Most interns are considered employees in the eyes of the law, which means you must comply with wage and hour laws, including paying them at least minimum wage.

CFRA Guidance

Dental practice owners should be aware and prepared for major changes to California’s Family Rights Act that go into effect Jan. 1, 2021.

Learn more


End of Year Updates for Your Practice

What you need to know to keep your practice compliant and avoid legal risks in 2021.


Employee Manual Resources

Create a personalized employee manual using an online tool or a sample employee manual.

General New Hire Toolkit

This toolkit covers recruiting, interviewing, hiring and onboarding, and provides a general list of basic hiring documents. If you are hiring a temporary employee or associate dentist, you will also need our additional hiring toolkits.

View General New Hire Toolkit
Hiring Associates Toolkit

Associates may be classified as either an independent contractor or an employee. This toolkit includes information to help you determine how to hire an associate.

View Hiring Associates Toolkit
Hiring Temporary Employees

Short-term employees are considered employees by the State of California and require additional documentation. This toolkit covers hiring, paying and terminating temporary employees.

View Hiring Temporary Employees Toolkit

View Hiring Temporary Employees Toolkit

Resource Library

Access an online library of downloadable articles, guides, templates, checklists and forms.

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