Addressing the Employee Element
The second Tuesday of each month, practice managers and industry service providers gather for an educational Nashville Medical Group Management Association (NMGMA) meeting at Saint Thomas West Hospital.
The May meeting covered "HR: The Human Element" with an expert human resources panel featuring Keith Dennen, healthcare attorney, Farris Bobango; Libby Tucker, regional HR consultant, Paychex; and Deborah Tulloss, employee experience manager, Heritage Medical Associates. The trio shared insights and fielded audience questions regarding a range of employee situations and issues routinely faced by medical practices.
"HR - we call the heartbeat of any organization because we set the tone," Tulloss began. "The culture is set by the lowest level of performance you allow the company to have."
Tucker agreed, noting the field has expanded far beyond hiring and firing to encompass strategic vision and helping define and deploy the corporate culture, as well as keeping abreast of employment and labor laws. "We're the ones who are going to minimize the risk of the business owner," she said.
Dennen added, "Tennessee is an 'at will' state, meaning you can be fired for any reason at all ... as long as it's not an illegal reason." He noted federal law outlines protected characteristics, which include age, sex, race and religion, among others.
Dennen continued, "Every client I have, the biggest potential problem they have is an employee. Every employee is a potential plaintiff in an EOC lawsuit." In his observation, Dennen added, the inherent regulatory and compliance nature of delivering healthcare has made employees generally more attuned to laws and their own workplace rights than is often found in other, less regulated industries.
Tulloss said Heritage Medical has 14 locations, 140-plus providers and more than 600 employees. In such a large practice, she said it's critical that HR act as an umbrella with the same rules and expectations for all to ensure everyone is treated fairly. "We have to set the expectations globally," she said. "If you really want to get yourself in trouble on the HR spectrum, act on how you feel," Tulloss continued. "HR has nothing to do with feelings. It has to do with the law and what is fair and equitable."
Tucker said it's important to have empathy when an employee has an issue, but the resolution should go back to the practice's written policy. "Blame it on the policy," she added.
Tulloss agreed, and laughingly told the audience of practice managers and administrators, "I'm going to teach you three words that will get you through any HR situation - the first two are 'I understand' and the third one is 'however.'" While the moment was lighthearted, Tulloss said the underlying message was serious when people ask for exceptions to stated policy. "My rule of thumb has always been that if I can't make that same exception for the next 10 people who come through the door, then I shouldn't do it," she explained. "Those who ask for the most exceptions over the next 10 years become the most exceptional problems ... and that's never failed me."
On the flip side, she noted, if an exception to a rule could be made for the next 10 employees, then the underlying policy ... or absence of one ... should be reviewed. For example, her practice recently implemented a policy that reflected the changing work world as technology now allows some employees to work from home.
Dennen added the biggest takeaway should be to have a policy in place and to make sure information is well communicated to all employees. "Too many people download an HR handbook from the internet and don't really even know what's in there," he said.
"Part of the way our laws have been set up is focused on fairness," he continued. You can't grant extra leave to one person because you like them and deny another employee because he gets on your nerves. Dennen said if you have written policies in place, then you at least have the ability to answer why an action was taken or denied if questioned. Ever the attorney, he did note having a written policy doesn't exempt employers from following the law.
That's no easy task, Tucker said, pointing out laws impacting employees and employment frequently change or are added to the complex mix. "We have a team of analysts who do nothing but keep up with the laws," Tucker said of Paychex.
Dennen added, "Trade organizations like NMGMA do a really great job of keeping you up to date on laws and changes."
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