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Updating your Employee Manual


No employer ― medical practice or otherwise ― is too small to need a comprehensive employee manual. Is it time to update yours?

For many practices, an employee manual is something that sits on a shelf in your office manager's office and is only referred to when a new employee is hired. Many are woefully out of date, and most have either been cobbled together over the years to address basic items like vacation time, or replicated from generic sources that may not cover many of the items that are essential to medical practices.

So if you haven't looked at your manual in a while, now is the time to take a cold, hard look. Why? Because a manual that is drafted right and utilized appropriately becomes the most important communication tool between you and your employees, setting forth your expectations and describing what they can expect from your practice. It should also describe your legal obligations as an employer, as well as your employees' rights. Doing this not only allows you to comply with federal and state laws, but can protect you from frivolous claims and clearly defines where each party's obligations start and stop. No employer - medical practice or otherwise - is too small to need a comprehensive manual that spells out obligations, policies, and procedures.

What should a good employee manual include?

Start with an introduction stating that the goal of the manual is to clearly communicate your practice's obligations as an employer as well as what the employee's obligations are to you within the workplace.

Next, open the sections by addressing labor laws and anti-discrimination issues, and proceed with conduct, compensation, and compliance issues. The following is by no means a comprehensive list, but do make sure to adequately address these major items:

1. Labor Laws and Anti-Discrimination Policies

As an employer you must comply with federal and state labor laws and the equal employment opportunity laws prohibiting discrimination and harassment, as well as the Americans with Disabilities Act. Your employee manual should include a section about each of these laws; in addition you should post relevant labor laws in staff areas. Make yourself familiar with these laws. Many small employers do not take the time to do so and leave themselves vulnerable to violations and lawsuits. Two good places to start are with the EEOC and the DOL:

Equal Employment Opportunity Laws

Summary of Major Employer Laws which includes wages and hours, the Family and Medical Leave Act, workers' compensation, and Occupational Safety and Health Administration regulations.

2. Standards of Conduct

Clearly state your expectations, from dress code to ethics. In addition, even if you have a separate training program and manual, it is important to remind your employees of their legal obligations, such as compliance with HIPAA regulations, in this section too.

3. Compensation

Even though it seems obvious, clearly explain to your employees that as an employer you will make necessary deductions for federal and state taxes, as well as voluntary deductions (if any) toward benefits programs. In addition, outline your practice's policies on overtime, performance reviews, salary increases, and paid time off.

4. Time and Attendance

Describe your company's policies regarding work hours and schedules, attendance, punctuality, and reporting absences. Also note any disciplinary action associated with being routinely tardy or failing to show up to work.

5. Computers and Technology

Computers and communication technology are essential tools for any medical practice. Employees misusing these can have serious consequences for your practice. Protection of private health information (PHI) may be covered under your HIPAA policies, but employees may also have access to credit card numbers and other sensitive practice information that needs to be protected as well. You also will want to set policies regarding the download of sensitive information from the internet, as well as actions that will be taken for abusing internet privileges. Outline policies for appropriate computer and software use, and the steps employees should take to secure electronic information.

6. Employee Benefits

In addition to addressing compensation issues, detail benefit programs and eligibility requirements, including all benefits that may be required by law such as disability insurance, workers compensation insurance, and COBRA (Consolidated Omnibus Budget Reconciliation Act) in this section. The Small Business Association (SBA) has a handy Web page detailing employer benefit obligations. You should also provide details on any optional employee benefits, such as health insurance options, retirement, employee assistance, tuition reimbursement, or any other fringe benefits your practice provides. If you provide none, state that.

7. Leave Policies

Leave policies are a little different from paid time off (such as vacation, holidays, and basic sick time). Your practice's leave policies should be carefully documented, especially those you are required to provide by law. Family medical leave, jury duty, military leave, and time off for court cases and voting should all be documented to comply with state and local laws.

Don't be afraid to add as many policies and procedures to your employee manual as you need. The clearer you can be about these, the more everyone can benefit from them. Once you have updated (or created) your employee manual, make sure to include a signature page that states that the employee has read and understands the policies and procedures contained within.

Susanne Madden, MBA, is founder and CEO of The Verden Group, a consulting and business intelligence firm that specializes in practice management, physician education, and healthcare policy. She can be reached at or by visiting

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