Scheduling inequities

May 1, 2003
I have always enjoyed your advice in RDH magazine and now find myself in need of your opinion.

By Dianne Glasscoe

Dear Dianne:

I have always enjoyed your advice in RDH magazine and now find myself in need of your opinion.

For more than 20 years, I have worked in the same practice. Recently, we moved our office into a new, state-of-the-art facility. Overall, our office is very unique — lots of learning, lots of fun! We just got digital X-rays and intraoral cameras in all seven operatories, so I feel very blessed to be where I am.

We work four days — Monday, Tuesday, Thursday, and Friday. We are closed on Wednesday. Lately, the doctor has been rearranging the schedule to be open on occasional Wednesdays, sometimes without consulting us or informing us until we hear it "through the grapevine." Many of us have families and other obligations on our day off, so this is really causing an upset. Trying to talk with the doctor has not been effective. I do enjoy having Wednesday off and find after 28 years of being a hygienist that two days in a row of hard work is about all my wrist can take.

Another irritation is that days when the office is closed for vacation have to be made up on our day off. This seems like no vacation at all!

Also, there is a meeting about office management and profits coming up this year in another state that he wants us all to attend. Many of us do not feel comfortable leaving our families to attend this overnight seminar or to fly.

My question is this: How much input do the staff members have regarding the schedule? If we are hired to work a certain schedule, are we obligated to work other days as the boss sees fit? Are we obligated to attend meetings out of the area where we live?

I am a little confused about the situation. I understand the need for an office to make a profit, and we do work very hard when we are open. However, some things just do not seem fair. What is your opinion?
Confused Hygienist

Dear Confused:

Twenty years with the same practice is a compliment to you and your boss. There must be lots of good relationships and camaraderie built over that period of time. Additionally, you are fortunate to get to work in nice, modern facilities and have the privilege of using wonderful technology.

However, new facilities and new technology come at a high cost! Most likely, your doctor has seen the need to step up production to help cover the costs of all the recent improvements. I expect that is why he has scheduled some workdays when you are accustomed to being off. Your "grapevine" method of communication is probably his way of avoiding dropping the bomb on the whole group at one time. He is aware that staff members do not like to work on their day off, but he is stressing over production enough that he feels it is necessary. His non-confrontational method of conveying the bad news of working an extra day is disrespectful.

I believe many doctors err when they make policy changes and do not seek staff input. I can also tell you that many doctors do not understand the obligations and stresses that female employees experience in trying to work full time and keep their home and children in order. Dentistry is a stressful profession. Doctors usually have wives (or even husbands!) at home that take care of all those duties associated with running the home. They don't stop to consider that their female staff has another full-time job waiting for them at home. The day off becomes sacred for doing those things that require being at home. I know. I understand.

Anytime an office works less than a 40-hour week, the doctor can add additional hours without having to pay overtime. If you have an office policy manual, there is usually a section about days and hours of office operation. There may also be a clause about working on the regular day off for various reasons.

I also understand your consternation about having to work your scheduled day off to make up a holiday. Again, lost production is the issue. However, if you think about it, you are benefiting by getting extra pay if you receive paid holidays. The difference is that your boss is operating under a load of new debt so he feels that extra production is necessary to maintain his present lifestyle and pay the bills.

Dental practices have very high overhead compared to other professions. The typical dental practice runs a 60 to 65 percent overhead. However, I have seen practices with overhead as high as 75 to 80 percent, which means the doctor's slice of the pie is small indeed. Believe it or not, I have seen practices where the doctor was just meeting overhead, and, after all the bills were paid, there was little or nothing left for him.

Now, let's talk about the issue of long-distance meetings. He wants to take the whole office to a meeting that would require an overnight stay and air travel. Obviously, the doctor feels the need to increase practice profit. It could be that his business profit is declining, which is not at all unusual in economic downturns. He feels it is so important that he is willing to foot the entire bill (which is substantial!) to fly everyone to this meeting, pay their expenses, and pay their salary. Of course, you can decline to go. However, that makes you appear antagonistic toward his desire to improve the practice. At least he is not like some doctors who go to these meetings and come back bursting to rearrange the entire practice without having the staff members on board.

You are not obligated to attend out-of-town meetings. But think about this: What if you were the boss? What if you owned the practice? What if you wanted to take all your staff members to some meeting that you felt was very important and were footing the entire bill? Would you be insulted if someone turned you down? Probably. If I were you, I'd go and have a good time, all at the doctor's expense.

This is a hard situation. Having been there as long as you have, I feel certain you do not want to change practices now, and I'd feel the same way.

It would be advantageous for you to talk to the doctor again. Approach it like this: "Doctor, I want you to know that I appreciate working with you. I think you do wonderful dentistry and treat our patients with care and concern" (or whatever you wish to start with by way of complimenting your doctor). "But, could I share a couple of concerns I have? First, when you add days to our schedule, we often learn about it secondhand. Why is that?"

Let the doctor talk. Then continue, "I certainly want to do my part, but having to work five days in a row is very hard on me physically. Also, I schedule things like doctor appointments and activities with my children on that day." Give him the reasons why working the extra day is presenting a hardship to you.

Always present yourself as a team player with no hidden agenda, but tell the doctor that you need advance notice when you are expected to work your scheduled day off. You might want to inquire about getting a temporary hygienist to work for you sometimes, especially if you are having wrist problems. The bottom line is that he needs to help you and the rest of the staff members understand why he wants to make changes. Opening up some dialogue between the two of you can start that process.

I've heard it said that the only people who like change are wet babies! Change can be good sometimes, but it is always painful at first. The changes would come a lot easier if the doctor would allow staff participation in the decision-making. However, considering everything you stated in your letter, my bet is that the good in this practice outweighs the bad. I hope that for you and the rest of the staff members, things will settle down and the doctor will return to the traditional four-day workweek. I am certain he misses his day off too!
Best wishes,

Dianne D. Glasscoe, RDH, BS, is a professional speaker, writer, and consultant to dental practices across the United States. She is CEO of Professional Dental Management, based in Lexington, N.C. To contact Glasscoe for speaking or consulting, call (336) 472-3515, fax (336) 472-5567, or email [email protected]. Visit her Web site at www.profession