Sarah Lawrence, RDH
Dealing with absent employees is a common challenge for dental practices. It can be a struggle to have employees take over the role of a missing coworker on short notice. This is especially true for offices with small staffs, where there are usually just enough people as it is. But what about in cases where part-time employees are involved? What happens when these employees become ill and have no paid sick leave? In these situations, part-time employees are faced with a dilemma. Their choice is this: Do I stay at home and cut my paycheck, or do I go to work sick?
The pressure to work sick
As dental professionals, we are in the business of helping people. Our jobs are designed to improve patients' oral and overall health. So the last thing we should feel is compelled—or even encouraged—to come to work with an illness that could be passed onto patients. But many of us work part-time and have minimal, if any, benefits. So if we miss a day because of illness, we will not get paid.
What kind of dilemma does that place on a hygienist? Let's consider a hygienist who works two days a week. In this situation, if the hygienist misses one day, she will see a decrease of 25% in her biweekly paycheck. If she misses two consecutive days due to illness, this will result in the the loss of 50% of her usual wages. Does she decide to stay home another day to recover and lose half of her paycheck? Or does she go to work, which could affect the health of patients and coworkers?
The effects on the business
Additional pressure to work sick—whether intentional or not—may come from the business owner. The owner may think, "If I have employees who are not producing, why should I pay them? I'm not making any money from hygienists when they are at home."
This is a true statement. However, the long-term effects of a contagious employee coming to work and knowingly spreading illness to coworkers must be taken into consideration. When a bug spreads through the office, it will cost the business more money in the long run, as there will likely be even more missing staff. Viruses can easily make the rounds in dental offices between coworkers.
For example, when a dental assistant gets sick, it can directly impact production, as it will interfere with the treatment procedures that he or she is able to help with. Procedures can still be completed but not as efficiently. If an administrative employee gets sick, the phones can still be answered but not with the same cheerful voice as a healthy, happy employee. There are times when an illness can be severe enough that the dentist may not be able to come to work. When the dentist doesn't come to work, the whole office is impacted, and production can be nonexistent. When you look at the problem from this perspective, one hygienist coming to work while ill has now caused more loss of production than it would have cost to pay her to stay home.
Effects on patients and their families
We also need to consider the perspective of patients. Patients know when someone at the practice isn't feeling well. When an employee has a stuffy nose, watering eyes, and is coughing, patients will suspect illness. Some patients will ask directly, but most patients will not. They will draw their own conclusions. Offices need to consider the image that they want to have when it comes to patient care—and the potential for negative online reviews.
Another perspective to consider is the health status of those living with the exposed patient. Let's assume that a virus is passed onto a healthy patient from a contagious hygienist. (Yes, this can happen even with personal protective equipment). The best-case scenario is that the patient recovers quickly with no complications. Now let's consider the possibility that the patient lives in a home with an immunocompromised person. That "simple" cold has now turned into a life-threatening condition for an elderly spouse, disabled parent, or newborn baby.
We can't possibly know the health status of everyone the patient will come into contact with, and some people may be thinking, "We can't live in a bubble," or "Illness is just a part of life." This is absolutely true. It is not possible to live in a world free from illness or to wrap employees up in a hazmat suits each day they go to work. But the point here is that we are knowingly putting patients at risk when we come in sick.
Consider this as well: Bacteria and viruses have varying incubation periods, and people can be spreading illness before they are symptomatic. In other words, they don't even realize they are sick yet. The ethical conflict comes into play when we know better but we don't do better.
Both staff members and practice owners fit into the solution
What is the solution to this problem? Having the right staff is the most important part of the equation. Trustworthy employees with a good work ethic will not take advantage of having a few paid sick days. Having those days available to use when they are truly needed will give employees the peace of mind to stay home when they are sick. It will alleviate the pressure and anxiety they feel when they have to make an ethical decision.
Most hygienists care deeply about their patients and want to do the best thing for them. The thought of putting people at risk can cause anxiety, but so can a decision to lose half of paycheck. Giving hygienists and other part-time employees the option to call in when they truly need it will be well worth the money that is paid out for a few sick days a year. Employees will feel valued, and patients will appreciate the high level of care that is shown to them.
For practice owners, managers, and employees, combating the problem of working while sick starts with being upfront about the kind of culture we want to have in our dental practices. If you are an owner or manager, commit to placing the health of your employees first. Equip all employees with a few days of sick leave per year. Otherwise, you are encouraging them to see patients when ill. Owners and managers should not underestimate the return on investment for a few days of sick leave for responsible and hard-working employees. When good employees see the investment you are making in them, they will not take advantage of it. But if you have someone on your team that you cannot trust and you fear they will take advantage of these benefits, reconsider their employment status with your office. Don't let one bad employee ruin it for the rest of your team.
Sarah Lawrence, RDH, has been a clinical dental hygienist for more than 10 years. She currently works at a pediatric dental office and is also a clinical representative for Young Dental. In addition to dental hygiene, she practices orofacial myology one day a week. Her interests include researching, writing, and speaking. She can be reached via e-mail at [email protected].