Practice Wisdon: Personal Appearance Problem

March 1, 2006
Dear Dianne, I have an employee who often comes to work looking disheveled.

Dear Dianne,

I have an employee who often comes to work looking disheveled. Sometimes her scrubs are wrinkled or her shoes are muddy. Sometimes her hair is fixed in an outlandish fashion, or she has on some kind of gaudy jewelry. Usually she wears makeup and looks presentable, but some days she comes in with no makeup at all, which makes her look sickly.

This employee is exemplary at her job, but her appearance is bothersome at times. How can I tell her that she needs to come to work looking professional every day without offending her? I’d really hate for her to quit!

Dr. Nonconfrontational

Dear Dr. Nonconfrontational,

There are two types of communication - verbal and nonverbal. According to some communication experts, our nonverbal communication speaks louder than the actual words we speak. Our nonverbal communication includes our many facial expressions, body language, how we carry ourselves, and most important, how we look.

Your staff members’ appearances reflect on you and your practice. Neat and well-groomed staff members give a practice a polished “with it” look. Disheveled or unkempt staff members can make a practice look sloppy, even though a doctor’s dentistry may be superb. Educational speaker and author Harry Wong says, “As you are dressed so shall you be perceived, and as you are perceived so shall you be treated.”

According to “On the Value of an Old Dress Code in the New Millennium,” written by Dr. Lawrence Brandt in the June 2003 issue of a journal called The Archives of Internal Medicine, the appearance of a health care provider is important to patients across all lines of population and geography. In study after study cited in the article, a more formal look projects professional competence and inspires trust among patients, whereas most patients disapprove of a casual look. A groomed moustache or beard gets high ratings, but excessive jewelry or long nails get low scores.

There is a casual look that is fine for outside the professional office and a professional look that is preferred for inside the office. When we blur the lines between these two entities, we send patients mixed signals regarding the level of professionalism in our practices.

Every business owner has a right to set specific standards of behavior, attire, and job performance expected from employees. Most well-managed businesses have written guidelines called policies and procedures that guide the day-to-day operations of the business. Dental practices should be no different.

Every practice should have a policies and procedures manual because:

The employer sets in writing the standards of behavior, performance, discipline, benefits, attire, etc., that are desired.

Employees will know the employment standards from the outset of employment.

There will be no ambiguity regarding office policies.

A well-written manual provides written guidelines that can serve as support in the event of an employment lawsuit.

A policies and procedures manual is a valuable tool in staf management. In the absence of an office manual, new hires are left to wonder about issues that come up, such as, “Do we get paid for Christmas when it falls on Sunday?”

Examples of specific categories that should be covered in an office manual include:


Practice mission

Practice history

Employee responsibilities (timeliness, personal appearance, personal behavior, salary/compensation, time off/overtime, job performance, patient confidentiality, job descriptions, and termination policy)

Benefits (vacations, holidays, well bonus pay/sick leave, personal time off, leave of absence, funeral leave, jury duty, group medical plan, pension plan, dental care, uniforms, and continuing education

Signature sheet

Leave of absence form

The problem you are experiencing is related to appearance. Your policy and procedures manual should clearly define how staff members are expected to look in the office. If an employee were not complying with your policy, you would arrange a private conference to discuss the issue. Give the staff member an opportunity to comply with your policy. Further, how is the staff member to know her appearance is a problem unless you tell her?

Because you signed yourself Dr. Nonconfrontational, I assume you are like most of the doctors I know who would rather walk across hot coals barefooted than deal with issues such as this with staff members. There’s no reason to be confrontational about this staff member’s appearance. Your conversation might go like this:

“Stephanie, thanks for staying a few minutes to talk with me this afternoon. I want you to know that I appreciate the good job you do here. There is something that has been bothering me that I feel the need to share. One of the most important factors in guaranteeing that our patients perceive us as highly competent and professional is our appearance. I’ve noticed that your personal appearance sometimes does not match the high level of competence you possess. I don’t think I’m the only one who notices muddy shoes, disheveled hair, wrinkled scrubs, gaudy jewelry, or the ghostly pale look when no makeup is worn. I want our patients to see us as serious health care professionals, and I need your help with this. Here’s a copy of our office policy manual, and in it is a section about personal appearance. I’d like for you to review that section, and let me know if you think there is something you cannot comply with. Do you have any questions or comments about my request?”

In the absence of an office policy manual, you need to be specific about what is bothering you and how you wish to see the problem rectified. Stick to the behavior you wish to change, and avoid you statements if possible.

Staff members who feel respected typically will give beyond what is expected if they know what the boss desires. Communication in a safe, open environment is what is needed here.

Best wishes,


Dianne Glasscoe
Glasscoe is a speaker, consultant, and writer for the dental industry with more than 30 years of experience. She is CEO of Professional Dental Management, Inc., in Frederick, Md. You may reach her at (301) 874-5240, [email protected], or visit www.professional