Custom Medical Employee Handbook Guide

The CEDR Guide to Employee Handbooks

What exactly is a good medical employee handbook?

What information should be included in yours?

How can employee handbooks offer your business legal protections, and how might a poorly written one leave you vulnerable?

Find the answers to these questions and more in this Employee Handbook Guide.

Our Free Employee Handbook Guide

Your Medical Employee Handbook: What It Is and What It Isn’t

What does an employee handbook do?

Employee Handbooks Provide Legal Protections

Poor Employee Handbooks Leave You Vulnerable

What Should Go Inside Your Employee Handbook?

Common medical Employee Handbook Mistakes

How to Use Your Employee Handbook

Defining Your Employee Handbook

Your Employee Handbook: What It Is, and What It Isn’t

Medical employee handbooks are also referred to as an employee manual, staff handbook, HR manual, human resource manual, HR handbook, human resource handbook, or office manual, a legally compliant employee handbook is the cornerstone of your business’ HR management and compliance strategy.

Your employee handbook is the primary repository for your business’ employment policies, including those concerning paid and unpaid leave, sick time, employee behavior, standards of professionalism and appearance, the process for addressing employee concerns, how to deal with employee disputes, and more.

Your employee handbook IS NOT a manual of Standard Operating Procedures (SOPs) for your business, however, nor is it a place to arbitrarily list a series of office “rules” for your employees to follow (in fact, doing so could actually leave your business vulnerable to legal challenges). Where it IS appropriate for you to list guidelines and expectations for your employees in your handbook, those guidelines need to be written with an eye towards compliance with the federal, state, and local employment laws that apply to your business.

What does an employee handbook do?

If well written, your employee handbook can introduce new employees to your company’s unique culture and help them to establish expectations about what it’s like to work for your business.

If composed in accordance with relevant employment laws, your handbook can also serve as evidence in court that your business takes care to follow state, local, and federal laws should you ever find yourself facing an employment complaint or potential Department of Labor (DOL) audit.

Handbooks provide clarity.

A professionally made employee handbook can provide clarity for your employees by outlining expectations and company processes for them, and by clearly defining protocols for requesting time off, taking breaks, clocking hours, working overtime, reporting issues, etc. Well-written handbooks also provide clarity for managers by giving them a resource they can refer back to when handling HR issues and requests that come up infrequently or that have yet to be addressed at your business.

Handbooks save you time.

If your employees have easy access to their own copy at all times, a thorough, well-written employee handbook can also save employers and managers time by empowering employees to find the answers to their policy questions on their own (a feature we at CEDR refer to as “employee self-service”).

Quick-fix handbooks can leave your business vulnerable.

A poorly written handbook, on the other hand, can actually leave your business vulnerable to legal challenges and could even be used against you in court to prove that your business employs illegal policies. Further, whereas a well-written handbook creates clarity, a poorly written one will tend to breed confusion and may even CAUSE employee problems rather than helping to solve or avoid them altogether.

Employee Handbooks Provide Legal Protections

There is currently no federal law in existence saying that employers MUST have an employee handbook in order to be compliant with current employment laws (though there are some states and localities that require employers to present some policies to employees in writing). There are also no laws saying that employers MUST hire a lawyer when their business is facing litigation. Still, in both cases, it is in your best interest to do so.

More than one in ten small to medium-sized businesses in the US will face an employment lawsuit at some point in time, and that figure can be as much as 66 percent higher for states with employment laws that are more strict than the federal standards.

If you ever find yourself facing a potential Department of Labor (DOL) audit (which, it should be noted, can be just as stressful and devastating as an audit by the IRS), having a legally compliant handbook in place along with documentation to demonstrate that your policies and enforcement practices are fair and consistent can mean the difference between winning and losing a case. And, since the average employment lawsuit favoring employees takes several months to resolve and results in upwards of $10,000 in defense and settlement costs (before fines, fees, and penalties are applied), you don’t want to get caught flat-footed if the DOL or Equal Employment Opportunity Commission (EEOC) starts investigating.

By ensuring that the policies in your employee handbook are current and up-to-date with all federal, state, and local laws in your jurisdiction, you can demonstrate to interested authorities that your business is at least AWARE of the laws and is making an effort to follow them. But, awareness of the law is not enough.

In the event of an employment lawsuit or an investigation by the DOL, EEOC, or the National Labor Relations Board (NLRB), you’ll also need to be able to prove that:

Your employees have read and acknowledged receipt of your policies, and that

You are fair and consistent in your enforcement of those policies.

The best way to do this is to set aside enough time for your new employees to read your employee handbook in its entirety on their first day of work as part of the onboarding process.

Your employees do not need to agree with a policy for it to be in effect. They do need to know it is in effect to be able to follow it, however. For this reason, we recommend reserving the final page of your handbook as an acknowledgment page and having your employees sign and return that page to you as soon as they have read the document.

Using a secure digital document storage system like HR Vault can significantly streamline this process in a number of ways, such as by allowing you to check for electronic signature receipts as needed rather than hunting down paper copies, by allowing you to share every handbook update with a click of a button, and by eliminating the need to print out physical copies.

Making sure that your handbook is accessible to employees in a digital format also offers some additional legal protections for your practice by making it impossible for employees to claim they lost their copy of your handbook, never received it, or were never told where to find it in the office.

But, whether you choose to print out your handbook and collect physical signatures, or to distribute your document and collect signatures digitally, having that acknowledgment on record will help prevent any employees from being able to claim ignorance of a particular policy in a court setting.

The legal requirement to provide policies to your employees in writing varies by state, but you should know that your policies will provide no protection for your business without proper documentation and an employee signature acknowledging that they have read and understood those policies.

In the event of an employment lawsuit or an investigation by the DOL, EEOC, or the National Labor Relations Board (NLRB), you’ll also need to be able to prove that:

Your employees have read and acknowledged receipt of your policies, and that

You are fair and consistent in your enforcement of those policies.

The best way to do this is to set aside enough time for your new employees to read your employee handbook in its entirety on their first day of work as part of the onboarding process.

Your business is unique.
Your employee handbook should reflect that.

Free Handbook Evaluation

Risks of Weak Handbooks

Poor Employee Handbooks Leave You Vulnerable

Whereas an employee handbook regularly updated for compliance with changing local, state, and federal employment laws can serve as evidence in favor of your business and may even provide you with an affirmative defense in court, a poorly written and/or outdated employee handbook can actually be used as evidence against you.

If your handbook was written by anyone other than an HR expert or an employment law attorney in your business’ specific jurisdiction, not only is there a good chance that the document will be missing specific policies intended to protect your business, it’s also likely that some of the policies included in that document will be either haphazardly composed or downright illegal.

Customization Is Key

Sampling a policy from another business or relying on DIY employee handbook templates is a dangerous game.

Each states provides its own set of laws that must be followed in addition to federal employment statutes and regulations. Some localities (specifically, cities and counties) also specify their own unique employment laws. This means that, depending on where your business is located, it may well be subject to as many as four different sets of laws and regulations, each of which could change in ways that impact the legality of the policies in your handbook at any point.

The size of your business may also affect how certain laws apply to it. At the federal level, the Family and Medical Leave Act (FMLA), for example, requires that employers provide up to 12 weeks of unpaid leave to employees for the purposes of tending to or caring for ill or injured family members, but that law only applies to businesses with 50 or more employees.

Still, even if you only employ a half-dozen people, using FMLA language in your employee handbook effectively serves to make the FMLA applicable to your organization and all of the employees who work for it despite the fact that your business would not otherwise be subject to that law if the language had been strategically excluded from your handbook.

Thus, by sampling policies from a larger business, another state, or another locality — or by using a template or relying on a “specialist” that is not familiar with all relevant laws — you may be inadvertently and unnecessarily applying extra limitations to your business that it would not otherwise be required to follow.

Your “Common Sense” Policies Might Be Illegal

Oftentimes, the policies that employers want to include in their employee handbooks in an effort to address specific problem behaviors they’ve dealt with in the past actually go against employment laws at multiple levels.

For example, a dress code policy that includes restrictions that differ based on employee gender (think requirements to wear makeup, specific hair grooming standards, etc.) could easily be construed as sex discrimination. And, in some cases, placing restrictions on certain types of clothing, hairstyles, or other things that you as a business owner might consider elements of “personal expression” could be interpreted as religious or racial discrimination by a judge.

In the section of this resource dedicated to “Common Employee Handbook Mistakes,” we provide a list of some of the most common illegal policies we’ve seen in the employee handbooks reviewed by the HR experts in our Solution Center.

Poorly Written Handbooks Make Employment Lawyers Salivate

Whereas a quality, legally compliant employee handbook will make it difficult for an employee or former employee to successfully pursue litigation against your business following a wage-and-hour or discrimination claim, an employee handbook that has fallen out of compliance or otherwise contains policies that are outside of the scope of relevant employment laws may be all an attorney needs to win a legal case against you or your business.

Again, though a quality handbook will likely serve as evidence in your favor in court, a poor handbook can be used as evidence against you. For this reason, it is of the utmost importance that you ensure that your employee handbook is written and checked for legal compliance by a qualified professional and that it is reviewed at least annually to ensure that it remains up-to-date with all changes to federal, state, and local employment laws.

What Should Go Inside Your Employee Handbook?

Your employee handbook should serve as an introduction to your company, as a resource that your employees can use to familiarize themselves with your company’s policies, and as a reference that your employees and managers can consult at any time as needed. As such, your handbook should be thorough (CEDR’s employee handbook is a total of 55 pages long), and it should include elements that are in service to each of those goals.

Since your employees are all going to be asked to read and sign your employee handbook on their first day of employment, consider using the first several pages of the document to introduce new hires to your unique company culture.

Provide some context and background information about your business including its core values as well as its purpose, mission, and vision statements. Make an effort to outline and define your company’s relationship to its employees — what do you expect from them in terms of motivation, general behavior, and attitude at work?

Define the terms of employment for your employees, and let them know there is no guarantee of long-term employment.

At-Will Status: Explain that employment at your company is on an “at-will” basis, meaning that employees can resign their positions at any time with or without a reason and that you as the employer can terminate them at any time for any legal reason or for no reason at all.
Your Handbook Is Not a Contract: Make sure that the page you reserve for gathering employee signatures is explicitly labeled an “acknowledgment” of your company policies rather than asking employees to “agree” with the policies in place.

Define the structure of your workweek and related procedures for tracking time.

Workweek: Define your workweek as it applies to payroll (from “Sunday to Saturday” or from “Monday to Sunday”, for instance).
Timekeeping: How are employees expected to keep track of their hours at work? When should they clock in and out? State that employees shouldn’t clock in or out for their coworkers and that employees shouldn’t work off the clock.
Breaks: Are breaks mandatory at your business? When do employees need to clock out for breaks? Does your state or locality require any breaks? What sort of breaks does your business allow, and how long are those breaks allowed to be?

Define your expectations for appearance and interactions with both customers and colleagues in your employee handbook.

Dress Code: The way your employees dress is an important part of your company culture. Be clear about what is and isn’t appropriate to wear to work. This can include addressing specific types of clothing, types of shoes, piercings, tattoos, etc. Just make sure that you aren’t instituting policies that might be seen as discriminatory, and avoid forbidding items that are protected by law such as religious garb or protected hairstyles.
Hygiene Standards: Clearly, your employees shouldn’t show up to work smelling like sweat or covered in filth, but you can’t enforce a policy that isn’t on record.
Conduct: Outline standards of communication, including setting guidelines for appropriate language when speaking with customers and colleagues.

Define sexual and workplace harassment for your employees and outline your stance on discrimination.

Equal Opportunity Employer: Explain that your business is aware of and makes every effort to abide by employment discrimination laws. It’s not a bad idea to state that your company “does not discriminate on the basis of…” and then list the various legally protected classes that apply in your business’ jurisdiction.
Harassment: Make clear what sort of behaviors constitute harassment as well as how your company deals with violations of your anti-harassment policies.
Accommodations: Describe the process for requesting accommodations for disabilities.

Explain your company’s commitment to providing a safe and healthy workplace for all employees especially as you are required to do so by state and federal laws.

Notice of Harmful or Dangerous Chemicals: If working for your business could cause employees to be exposed to specific chemicals that are known to be hazardous (such as nitrous and x-rays in dental offices), say so in your employee handbook. Encourage employees to ask questions about potential hazards and to talk to their healthcare providers if they have any concerns.
Drug and Alcohol Policies: Provide your stance on drug and alcohol use, including smoking, and when and if drug and alcohol testing might be required of employees. Just keep in mind, certain protections may apply. For example, some states might have off-duty conduct protections that prevent you from banning cigarette smoking during breaks. States in which marijuana is classified as medicine may have laws that prevent you from creating a policy against off-the-clock cannabis use.
Work-related Injuries: What should employees do if they are injured at work?
Violence: Clearly, violence and threats of violence cannot be tolerated at a workplace. Explain how such situations are handled at your business.

Your time-off policies are an important piece of the benefits package offered to your employees. Explain these policies in detail to save time answering questions about them later.

Sick Leave: Ensure that your company’s sick leave policies are compliant with state and local laws.
Vacation Leave: Does your business offer paid vacation days? Who is entitled to them, and when do they kick in? What is the process for requesting time off? What happens to unused vacation at the end of the benefit year or at the time of separation?
Leave of Absence: Is your business subject to the Family and Medical Leave Act? How much leave will you offer employees? Will you continue to offer benefits during that time? Try to write leave policies such that they can apply to multiple types of leave (medical, temporary disability, maternity, etc.) rather than having individual policies in place for every potential type of leave.
Holidays: Do your employees get any holidays off? If so, which ones? Will employees be paid for those days
Tardiness/Absenteeism: How does your office handle tardiness or unexcused absences? What should employees do when they know they will be late and/or absent from work?

Would any of your employees go to work if they weren’t being paid? Let employees know how they can expect to be paid and give an overview of other items that are included in their compensation package.

Paychecks: How often does your business issue paychecks, and how are those paychecks delivered?
Benefits: Define who is eligible to receive benefits and when? If applicable, you can also include non-monetary benefits such as gym memberships, parking passes, and any other perks of employment your business offers in this section.
Bonuses: Does your company offer bonuses to employees? Who is eligible for those bonuses and how might leave affect their payment?
Overtime: You can’t legally refuse to pay overtime, but you can ask that employees have overtime approved before working it. That way, you’ll have some recourse to address employees who appear to be abusing your overtime policy.
Addressing Payroll Errors: Save yourself time later by informing employees upfront how to address questions or problems with payroll. Consider having them approve timecards before payday to minimize errors.

You’ll want to have a policy in place to explain the process for reporting employee concerns as well as an outline for how such claims are investigated.

Process: How and to whom should employees report issues? Avoid applying a timeframe for reporting issues as this could dissuade employees from coming forward if they have failed to do so outside of that timeframe.
Retaliation: Make it clear that employees who report issues in good faith will not be reprimanded or retaliated against.
Investigation: Make it a matter of policy for employees to cooperate with all internal and external investigations as needed.

Make it clear that the policies in your employee handbook may be changed with or without notice to employees. Also, be sure to put the onus of staying up-to-date on those policies on the employees.

Your handbook should always be seen as the last word on a company policy. It should be clear that the content in that document always takes precedence over any other policy documents which might seem to express a policy or interpretation of a policy that differs in anyway from that contained in your employee handbook.

When policies change, update your handbook to reflect those changes and have employees sign the updated handbook to acknowledge that they have been informed of and understand the updated policies.

If you can’t prove your employees have read and acknowledged the policies in your handbook, those policies can’t offer you any legal protection. Note that having an employee sign your handbook does not mean that they AGREE with all of the policies therein — just that they have read and understood them.

“Custom” means better.

Learn How a CEDR Handbook Protects Your Business.

Learn More

Common Employee Handbook Mistakes

Writing a legally compliant employee handbook is an involved process, and doing it right requires highly specialized knowledge about HR processes and familiarity with employment law. For this reason, when business owners attempt to cut corners when making their handbooks, any number of things can, and frequently do, go wrong.

Here are some of the most common (and costly) employee handbook mistakes we see on a regular basis:

Writing your handbook yourself.

In the same way that you wouldn’t perform a root canal on yourself to save money, we don’t recommend that employers write their own employee handbooks to save a few bucks. Unless you have advanced HR knowledge or a law degree along with years of experience working in employment law, by writing your handbook yourself, you are almost guaranteeing that the final product will be littered with policies that not only fail to protect you and your business, but that actually encourage and even support litigation against you. You are an expert at running your business — focus on that rather than moonlighting as your own attorney.

Using a generic handbook template.

There are a myriad handbook template options online — some are given away for free, others are sold for a fee. But, those templates tend to be built on a “one-size-fits-all” model, even though there is no “one-size” that can be made to fit every business.

Your handbook policies will differ based on where you are in the US — laws can differ substantially between different cities and counties within the same state. Further, if you are a healthcare provider, your policy needs will differ widely from those of, say, a restaurant or retail store. When it comes down to it, your business is even more unique than others in your state and industry, and your employee handbook should reflect that uniqueness.

Borrowing policies from someone else’s handbook.

Much like with using a boilerplate employee handbook template, sampling policies from another business can be just as troublesome (which is why we’ve previously compared borrowing handbook policies to borrowing someone else’s toothbrush).

There are so many factors that go into determining which employment laws apply to your business that using policies written for someone else can prove disastrous. If the business you borrow from is in a different county, city, or state, for instance, it might mean that they are subject to different laws than your business. The same can be said if your businesses don’t have the same number of employees, as that could affect which employment laws apply to you as well as how they are enforced.

Leaning on the wrong “expert” to check your handbook for legal compliance.

Employment law is a complicated and constantly changing subject. In fact, we employ an entire team of experts here at CEDR just to keep an eye on the ever-shifting employment law landscape.

That said, unless it’s an employment law attorney, don’t expect them to know enough to check your employee handbook for legal compliance. For a compliance check on your handbook, reach out to an HR expert like those at CEDR or contact a local employment attorney. If you need roofing done on your home you wouldn’t call a landscaper. So, don’t call your friend-of-a-friend’s divorce lawyer to review your employee handbook.

Having no handbook at all.

Sometimes, doctors and managers are under the impression that having NO handbook is a better option than maintaining a document that will require regular updates. Sometimes that advice comes straight from an attorney or colleague. Unfortunately, this couldn’t be further from the truth.

Often, your employee handbook is the ONLY EVIDENCE you have that your company at least makes an effort to comply with state, federal, and local employment laws. When signed by all of your employees, your handbook also eliminates the opportunity for any one employee to claim ignorance about your business’ specific policies.

Not having a handbook in place means answering all of your employees’ policy questions as they arise on a 1-to-1 basis, which can turn into a major waste of time in the long run. Not having a handbook also means you risk accidentally deviating from your standard practices in a way that may be construed as discriminatory (offering extra leave to one employee that wasn’t offered to another, for example).

Most employment laws are written to protect employees rather than employers, but you can use the policies in your employee handbook to transfer some level of responsibility to your employees, and, ultimately, you won’t gain any protection from policies that aren’t officially in place.

Including Illegal Policies in Your Employee Handbook.

Oftentimes, relying on advice from colleagues, using boilerplate handbook templates, sampling policies from third-party sources, or writing your handbook on your own can mean adopting policies that not only fail to protect you, but that actually outline employment law violations by your business.

Including any of the illegal policies presented below is the equivalent of teeing up an employment attorney’s case against you. Here are some of the most common illegal policies we’ve seen included in actual employee handbooks:

“Don’t say anything negative about the business on social media.”

We’re paraphrasing here, of course, but we have seen this sort of policy in more than a few DIY employee handbooks. The problem is that, under the National Labor Relations Act (NLRA), employees’ right to unionize in an effort to improve working conditions is protected, and this can include their right to talk about issues facing them at work on social media.

“Discussing salaries or other payment and compensation information with other employees is prohibited.”

This is a policy we see in many DIY employee handbooks despite the fact that it goes directly against the NLRA. Salary discussions are protected speech for a number of reasons, and forbidding them outright could make your practice vulnerable to potential litigation.

“All bonuses are paid at the owner’s discretion.”

Though many employers are under the impression that including such a policy in their employee handbook will prevent them from having to factor bonuses into overtime calculations, this is incorrect. A bonus is only considered “discretionary” if it is in no way tied to performance or specific business goals. Calling an outcome-based bonus “discretionary” does not make it so, but it could cause your business’ overtime policy to be viewed as in violation of the Fair Labor Standards Act (FLSA).

“Employees will be clocked out automatically for mandatory breaks.”

Your non-exempt employees have to be paid for the time they spend working. Clocking them out automatically for breaks whether or not the employee is actually on a break is therefore in violation of the FLSA and could lead to legal claims for payment of back wages.

“Pregnant employees must (fill in the blank)…”

As an employer, you should make sure that all of your employees are aware of any potential exposure to hazardous materials while at work. You also must engage in an interactive process for pregnant employees who request temporary accommodations to help them perform the duties of their job.

But, under the Pregnancy Discrimination Act, you MAY NOT force an employee to tell you they are pregnant or are trying to become pregnant, nor can you forcibly reassign them to duties you think would be better suited for pregnant employees, even if your intentions are to help or provide a more suitable set of circumstances for that employee.

Discriminatory Dress Codes

Having a dress code or set of protocols that is more restrictive to one gender or protected class can be construed as discrimination. In New York City, for instance, dress codes that single out specific hairstyles are now illegal as such policies often appear to single out natural African American hairstyles (Afros, braids, cornrows, etc.) more so than any other style or type of hair.

How to Use Your Employee Handbook

Though some business owners and managers simply leave their completed policy manuals to collect dust on an office shelf, a current and well-written handbook should be used regularly to train employees, provide legal protection for your practice, and save business owners and managers time.

Not all business owners are aware of just how much time and stress a quality employee handbook can save them. For this reason, we’ve compiled this list of some ways to get the most out of your practice’s handbook.

As mentioned in a previous section of this resource, you should use your employee handbook to introduce new hires to your company policies and culture. Set aside enough time for new employees to read your handbook in its entirety on their first day of work and have them sign the last page to acknowledge that they both received and understood the document. Not only can this provide a thorough introduction as to what it’s like to work for your company, but it also eliminates the opportunity for employees to later claim ignorance that a particular policy was in place.

Do you find yourself answering the same policy questions over and over for your employees?

Do we get Veterans’ Day off? Is it paid?
Can I take tomorrow off?
Who do I call if I wake up feeling sick?
How many vacation days do I get?
Not only can such repetitive questions be incredibly annoying, they’re also a waste of your time.

By providing each of your employees with a copy of your employee handbook and directing them to that resource to find answers to such questions on their own, with time and training, you can put an end to those repetitive questions (along with the expectation that you and your manager have your entire employee manual memorized).

Even better, make sure your employees have a digital copy of the document (preferably a PDF) so that they can quickly link to the section they need and/or perform a “find in document” search to get the information they are looking for quickly and efficiently.

HR Vault software allows every member of your team digital access to their employee handbook. You can use this free software to upload your handbook and collect acknowledgment forms with electronic signatures from your employees.

In addition to saving managers time by enabling employee self-service, professionally-written employee handbooks can also help provide guidance to managers and business owners who may not have a plan in mind for dealing with a particular HR issue.

The first time an employee at your business becomes pregnant, for example, you may not remember every specific detail regarding how your leave policy applies. Or, if an employee’s bad attitude is creating an intolerable work environment for the other employees in your office, you may find yourself in need of a roadmap for how to address the issue.

The language in your employee handbook should be structured in such a way that it both makes the specific details of your policies clear to your employees and provides a clear course of action to managers that need to address any particular HR issue as it arises.

Though you are not legally required to have an employee handbook for your business, oftentimes that document can serve as the ONLY piece of evidence that your business is aware of and makes an effort to follow all relevant employment laws (so long as the policies in that handbook are legally compliant and up-to-date). Making sure that each employee signs that document will serve as evidence that all of your employees are aware of the policies in place at your business.

By including standards of professional conduct as well as policies about how employees are expected to behave at work and enforcing them consistently with all employees, you can reinforce your handbook’s claim that you are an equal opportunity employer. Consistent policy enforcement with proper documentation can send a clear signal that you do not discriminate against protected classes of individuals, should you ever find yourself facing a potential discrimination lawsuit.

Though federal employment laws tend to be relatively stable, state and local laws change constantly. It can be difficult to stay on top of these changes while running your business, but ensuring that your employee handbook stays current and compliant with applicable laws is a must if you want to reap the benefits of legal protection. We highly recommend working with an HR professional or local employment counsel on a regular basis to ensure that the policies in your handbook stay compliant in the long term.

Your handbook should be updated whenever a relevant law changes in your jurisdiction, as well as reflect growth and changes within your business. You should have your handbook evaluated for potential changes and updates in the law at least once every year.