Insights From Our Editors

Employee Attendance: How to Set Clear Policies that Lead to Easy Decisions

By Mark Wright, OD, FCOVD,
and Carole Burns, OD, FCOVD

June 9, 2021

Practice culture is one of those phrases that people rarely explain in a practical way. Let’s take one part of practice culture, employee attendance, and talk practically about it. Looking at the team attendance record for your practice gives great insights into your practice culture. It answers the question: Is your team dedicated to providing exceptional patient care?

A simple rule to have in your practice that helps practice culture is that clear policies lead to easy decisions.i Let’s see how this applies to employee attendance.

Here are examples of paid time off (PTO). PTO (some places use the terminology personal time off) can include sick leave, accrued time and vacation days. Other forms of employee leave include maternity/paternity leave, Family Medical Leave Act (FMLA) leaves, furlough and unpaid leave.

We’ve noticed a trend across the country with employee attendance. If, as an employer, you give your employees 14 days of PTO they can use for any reason – sick day, mental health day, vacation day, whatever – employees are taking the entire amount of PTO. That’s not a problem when it is scheduled appropriately. It’s part of your contract with your employees.

But when in addition to PTO, employees are unexpectedly taking a lot of unpaid time off for additional vacation days, mental health day or time off for medical appointments, this negatively impacts patient care. Employers are put into a situation in which we have to scramble to make sure we have enough coverage to just get through the day. This situation creates practice flow problems. This is also a sign of practice culture problems.
So, an important question is: Do you have a clear written policy about how much unpaid time off employees can take before some type of action occurs?

Legal Obligations
There are state and federal laws covering employers’ responsibility to pay for time off in situations such as medical leave, accrued time off and jury service. What about the question: Can you have a difference between what you offer full-time and part-time staff? The Fair Labor Standards Act (FLSA) has no definition for part-time employment, however, the Affordable Care Act (ACA) defines part-time employees as those who work less than 30 hours per week. Consult with your practice human resources attorney to define exactly what your obligations are and which employees get offered PTO (e.g.: hourly workers, part-time employees, only doctors or the entire team).

Don’t forget the core rule to document everything. Any time a team member is not present needs to be documented. This needs to be done for both exempt and non-exempt team members. It is required for everything from payroll calculations to disciplinary actions.

 Office Policy
To be clear, your written unpaid time off policy should specify:ii

• Do you offer paid and unpaid leave? (If you offer both, you need a separate policy for each category.)
• Which employees have access to paid and unpaid time off?
• What are the number of unpaid days employees can take and what happens when that cap is reached?
• What is the process for employees to request time off (e.g.: how much notice to give)?
• How employee hours and absences will be tracked (access cards, time sheets, attendance software, etc.).
• What happens if two or more employees from the same department request time off on the same day(s)?

The last thing you ever want to do when faced with a team member’s emergency or personal crisis is to wing it. That is a formula for failure. Remember the rule: clear policies lead to easy decisions. That rule is important because easy decisions lead to an improved office culture.

i. How to Confront an Employee About Taking Too Much Time Off | BambooHR
ii. Employee Unpaid Time Off: Tips, Facts & Legal Obligations – Factorial (

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