How to handle disciplining dental staff

Employee discipline is one of the hardest, but necessary, components of practice ownership and employing staff.

It's human nature to avoid confrontation. As a leader, it's important to set the ground rules from the first day of employment. Creating an atmosphere of collaboration, mutual respect and trust early on can reap long-term rewards for the employee, the dentist as the employer and ultimately the practice. Employees who have a sense of ownership and investment will often perform in a manner that enables the practice to flourish and grow, according to CDA Practice Analyst Michelle Corbo.

"Happiness is infectious! This atmosphere will resonate with your patients and lead to potential referrals," Corbo said.

Corbo said it is important and recommended that dentists have an established office policy manual.

"Staying consistent with all employees in establishing clear, reasonable policies makes the difference between a smooth-running practice and one that's plagued with employee-related angst," Corbo said.

Dentists who don't already have a manual, or have one but it it's out-of-date, can download a Sample Employee Manual template here at no charge.

Adherence to the policies should be understood by all employees and enforced equally by the employer. Each employee should be familiar with office policies and the consequences that may occur if he or she violates a policy — keeping in mind that the dentist should be flexible in the enforcement of certain rules if extenuating circumstances should arise. Any changes in office policies should be posted for all employees to see in advance of the policy effective date.

"Provide employees an opportunity to ask questions and have each sign an acknowledgement of the new policy and place it in the employee personnel file," Corbo said.

If a problem develops with an employee, the dentist should be prepared to have an open discussion bringing the behavior to his or her attention.

"By showing confidence and trust by involving the employee in finding a solution, not only will you likely get your desired result, you will have given the employee an opportunity to grow professionally and personally," Corbo said.

If this approach isn't successful, the dentist could develop a performance improvement plan that works best for their practice. (When it's necessary to discipline an employee it's best to do so in private as to not cause embarrassment.)

There are situations in which a performance improvement plan approach may be warranted, as outlined below. However, it is important to emphasize in any written materials that employment remains at-will and either the employer or employee can terminate the employment at any time.

"Even if you decide to adopt a step approach to help facilitate disciplinary action, there are occasions when the first offense is egregious enough to warrant immediate termination," Corbo said.

One option for a performance improvement plan is as follows:

1. If it's a first nonserious violation of policy, perhaps provide a gentle reminder of your practice policy on an issue as it arises. Attempt to counsel the employee on ways to improve the behavior.

2. With a second offense, a sterner warning is given in the form of a written reprimand outlining any instances and warnings to date. Keep in mind that any timelines provided to the employee for improvement must be followed and adhered to prior to further action.

3. A final probationary warning with a clear understanding that any further instances are likely to result in dismissal.

While a dentist cannot control an employee's behavior or what he or she may do before or after a termination, it's important to have copies of any instances of poor performance or disciplinary forms placed in the employee's personnel record. If through this process it becomes apparent that the situation is not improving and the dentist's decision is to terminate the employee, having a documented record of events showing objective reasoning and the steps taken prior to reaching that decision will be important should they need to have an accurate reference.

"A hazy account of the details that led up to termination can tip the scales toward the employee if the circumstances surrounding the termination are questionable. If poorly handled, it can be a disaster," Corbo said.

In the long-run, it's better to try to improve employee performance than to go through the painful process of termination of employment -- unless the employee has behaved in such a way that warrants immediate termination such as gross misconduct or theft. Oftentimes, the performance issues are temporary and can be worked through, Corbo said.

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