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 By Neil B. Gailmard, OD, MBA, FAAO, Editor May 13, 2009 - Tip #379 
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Who sets the staff work schedule?

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Here's a scenario that can take you by surprise, sound good at first and then turn into a problem. A staff member mentions in passing that she is going to stay late at the office tonight because insurance claims are backed up and she wants to get them filed.

We could easily substitute several variables in the scenario:

Instead of staying after office hours...

  • ... the employee may arrive early. Real early.
  • ... she may just work through lunch.
  • ... she may ask if she can work from home and turn in her hours.

Instead of insurance claims...

  • ... the staff member may need to catch up on lab work.
  • ... recalls and statements have not been run.
  • ... patients need to be called.
  • ... fill in any task you wish.

Great work ethic?

At first, the doctor or manager is extremely pleased and impressed by the work ethic of this employee. It is so nice to see a clear demonstration of concern for the practice. Often, working extra hours outside of the actual work schedule gradually increases, maybe with no discussion or permission. A busy doctor may not even notice and even if she does, she is simply grateful the work is getting done. When I have faced these situations, I always find myself asking: why can't the work get done during normal business hours? Is the motivation to work extra really about concern for the practice or is it a way to generate more wages for the individual?

I hate to seem harsh but employees have been known to take advantage in the work place now and then. I'm not saying all creative work schedules are bad, only that they should occur with the bosses full approval and with a real knowledge about the nature of the work. That last part is where most doctors fall short. Most of them have no idea about the administrative work process and many like it that way. An office manager has a better chance of understanding the work flow, but even she may be in the dark in some specialized areas, like insurance processing.

What is wrong with it?

I can think of a few things:

  • Staff may waste time during normal work hours in order to have some work to do after hours.
  • Staff may like working when no one can interrupt (or supervise), but work may not get done as quickly. You'll never know.
  • Employees who work after hours can't multitask, like answer the phone or greet people.
  • It may require time and half pay (see below).

What to do?

If the extra work seems like it is needed fairly often, I would rather hire another employee than authorize existing staff to work additional time. First, I think there are advantages to having more staff members present during business hours. Some doctors don't want to hire more employees, but I disagree with that. A larger staff offers better service and deeper coverage. Second, I think employees who work more than 40 hours per week can get burned out and the friendly attitude that is so important may suffer.

How to change things

Once a situation has been allowed to stand for a long time, it becomes de facto office policy. That does not mean you can't change it, but I would proceed with caution. I would start by having an honest, private discussion with any employee that a change in schedule may affect. Have some past data about work hours available and state that you would like to have the work done during normal business hours in the future. Ask openly if that will present a problem and then listen. State the reasons for the change honestly; it's OK to say you have to watch payroll costs from a business standpoint and that you want deeper staff coverage. Avoid accusing anyone of wrongdoing.

If a change in work hours will present a problem due to the drop in income, try to develop a plan that will make it easier for the employee, but still let you regain control of the hours worked. Perhaps the change can be implemented gradually over a couple of months. Perhaps it is time for a wage review and a raise. Every case is individual, but there is usually an agreeable solution.

The goal is for the practice owner and manager to set the schedule and implement an office policy about start times, quitting times, lunch breaks and overtime approval. As a side note, my practice uses a virtual time clock on a computer workstation for employees to "punch" in and out. These inexpensive programs keep excellent payroll records.


I'm especially wary of the employee who is so good natured as to tell the boss not to worry about paying overtime wages. Perhaps the doctor has cited the expense of time and a half wages as a reason that extra hours can't be approved and the employee responded by saying she will just work for straight pay. Don't allow this. State employment law generally requires that hourly workers be paid time and a half if they go over 40 hours per week. The cooperative employee of today can easily become the bitter ex-employee of the future who will file a complaint. Payroll records last a long time and they don't lie.

There may indeed be some special occasions (vacation coverage, illness, special projects) when overtime makes great sense and in those cases, approve it for a willing staffer and pay the time and a half.

Best wishes for continued success,

Read Past Tips Neil B. Gailmard, OD, MBA, FAAO
Editor, Optometric Management Tip of the Week

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Send questions and comments to neil@gailmard.com.

Dr. Gailmard offers consulting services to eye care professionals through Prima Eye Group; information is available at www.primaeyegroup.com.

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