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Writing Your Office Manual

For years I’ve heard practice management gurus stress the importance of having an office manual.  It makes sense to write a kind of “instruction book” for your team that defines roles and rules to keep everybody on the same page.  But when I opened my own practice from scratch I totally ignored that advice.

I recently discussed the 4 Biggest Mistakes I Made When I Opened My Practice and I listed this as being one of them.  Why did I put off writing an office manual for so long?  Probably because everyone on my team seemed to get along fine.  Probably because our “rules” seemed pretty straight forward and I didn’t think there would be any misunderstanding.  Wrong, wrong, wrong.

Just look at some resources for creating office manuals and you’ll realize that there are so many minor issues that need to be resolved.  I’ll give you an example.  Do you pay for a certain number of vacation days per year?  Okay, can a team member call out sick and use a vacation day to get paid?  Do the unused days accumulate from year to year?  Do the years accumulate/replenish on January first or on the employee’s anniversary of joining the practice?

You can see how a small issue like employee vacation days can quickly become complicated and fuzzy.  There are many different answers to these policy questions; the important thing is to write it down so that there is no confusion.  An attorney will also advise you that a good office manual is your protection.  If you fire someone because they do not follow an office policy (e.g. constant lateness) than you will want to be damn sure that policy is written down clearly somewhere.

Okay, so you’re ready to write an office manual.  Where do we begin?  There are good resources out there like The ADA Practical Guide to Creating an Employee Office Manual.  Do some research and you’ll find suggestions for what to include.

Here’s what I included in my manual:

Mission Statement – A short and sweet description of what makes your office special.

Work Schedule – What days and what hours are dedicated to patient care.  If you need some flexibility than you should mention it here.  For example, perhaps you are working only one Saturday a month but you plan on expanding it to two or three in the future.

Team Hours – Do you want your assistant to arrive 30 minutes before the first patient?  Is 15 minutes early enough?  Will you have a regularly scheduled morning and/or end of day huddle?

Time Clock Policy and Lateness  – What do you considered to be “late?”  Are employee’s allowed to be tardy only a certain number of times?

Absenteeism – Failure to show up for work without any notification is grounds for immediate termination, unless there are some genuine unforeseen circumstances.  I also write my cell phone number here so the team knows they can always reach me in an emergency to let me know about missing work.

Sick and Personal Days – This could be a whole post unto itself. I listed above some of the questions you should consider.

Paid Holidays – Perhaps you will decide to not work on Christmas.  Will you pay the team for that day?  What about Christmas Eve?

Office Meetings – We have two semi-annual group meetings, one of which includes individual performance review.  You should be clear with your team how and when they will be evaluated.

Team Dental Care – Does your team get free dental care?  What about their significant others and close family?  Do they get a discount?

Dress Code – Scrubs, business attire, casual Fridays… whatever you want.  This is a great place to be clear that you don’t want your front desk staff to wear hooded sweatshirts and flip-flops.

Personal Time during Patient Care Time – Are you banning Facebook from the office?  Don’t want any cell phones in the operatory?

Termination – Would you like to have two weeks notice if an employee is quitting?  If you fire someone can they expect a paycheck for the rest of the week?

Here are some final thoughts on office manuals.  First, it’s not a bad idea to have your business attorney look it over after you’ve written it.  Second, consider the manual a “living document.”  It’s not written in stone and can be updated and edited as your practice evolves.  And last, I personally don’t like the idea of having employees sign the manual; it seems a bit much.  Instead, have the document in an accessible place and review it as necessary.


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