United States: Paid Leave For Medical Practices: Considerations For Setting Time Off Policies

Last Updated: August 21 2019
Article by Jason Flahive

In any business, staff members need the flexibility to take time off from work — whether for sick days, personal days or vacations. Some medical practices take a fairly casual approach, while others have more formal time-off policies. Whatever your current method, you should periodically review and reconsider what would be the most effective and efficient approach.

Casual or formal

Even if you want to keep your policies as informal as possible, you will benefit from setting up some sort of monitoring system. This can be as simple as a wall-mounted calendar on which all staff write their planned vacation and personal days. If you are using something that simple, you will still want at least a manual system to keep track of how many sick, personal or even late days a staffer takes. This will clarify the situation and prevent abuse.

On the other hand, if you want to adopt more formal time-off policies, a paid time-off (PTO) bank is one popular method to consider. This policy pools vacation days, sick time and personal time, allowing staffers to take those days off for whatever reason they see fit. It is important to note that PTO typically does not include paid holidays such as Labor Day, Memorial Day and Thanksgiving. If you want to include these holidays, you will need to increase the amount of PTO staff members receive to account for them.

PTO advantages

One advantage of PTO is that it gives employees control over why they are taking the time off without having to explain why. They can just say, "I need to take a day off," which provides both control and a sense of privacy.

Commonly, the PTO system allows days or hours to accumulate over the time a staffer stays with the office. For example, a new staffer may have 14 PTO days, while one with five years of experience might have 25 days, and so on.

It is an open question as to whether staffers should be able to carry over PTO days from year to year. Some practices allow staffers to carry unused days, or unused days up to a prespecified limit, into the next year. Part of the rationale is that PTO is part of employees' benefits package, and they should be allowed to carry days over. The flip side of this is that, as a benefit, it is accrued yearly — and staffers need to learn to manage their allotted time annually so they don't end up with an inordinate amount of PTO days.

Importance of consistency

Whichever approach is best for your practice, consistency is key. A written policy in the employee handbook is a must, even if you want to have a flexible work environment. Establishing a set policy and putting it in writing will help resolve any conflicts that may arise.

It is also important to track the number of hours and days staffers are taking off and how much time they have accumulated. This is particularly true if you are allowing carryover of PTO each year.

Payroll software often incorporates tracking systems that allow tracking of PTO hours, sick days and tardiness. This can provide support for why you might approve one person's time off and not another's.

Another aspect to consider when developing a program is how to handle maternity, paternity, adoption, surrogacy and bereavement leave. Some, all or none of these may become part of PTO, or they may be approached quite differently. Carefully define the parameters of PTO in your employee handbook.

Outside expertise

It is important to keep in mind that these types of policies are subject to state and federal regulations, including the Family and Medical Leave Act. After you create a policy, and before you add it to your handbook, ask a qualified employment law attorney to review it. Getting the benefit of outside expertise can ensure that the policy will go forward with minimal problems down the road.

Solo practitioners need time off, too

For physicians in multi-physician practices, the question of how to take time off without shutting down the practice is relatively straightforward. But solo practitioners have a more difficult challenge. Here are some helpful steps to take:

  • If You Just Opened Your Practice, Start Slow.
    Try a long weekend. This could even be every other week — for example, taking off every other Friday.
  • Call in Another Physician to Cover for You.
    Remember, if you are burned out from not taking any time off, you are not helping your patients or yourself. While you are gone, an on-call physician can handle emergencies while your staffers continue to take calls, make appointments and fill prescriptions, if qualified to do so.
  • Establish Boundaries.
    With email, text and cell phones available to nearly everyone, it is easy to think you can stay in touch with the practice or patients while you are away. But this also might lead to burnout and ruin your time off.
  • Plan for the Financial Impact.
    Particularly early in your career, a vacation might hit your pocketbook hard. Be prepared to lose some income caused by your time away, and allow for it in your budget.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

To print this article, all you need is to be registered on Mondaq.com.

Click to Login as an existing user or Register so you can print this article.

In association with
Related Topics
Related Articles
Related Video
Up-coming Events Search
Font Size:
Mondaq on Twitter
Mondaq Free Registration
Gain access to Mondaq global archive of over 375,000 articles covering 200 countries with a personalised News Alert and automatic login on this device.
Mondaq News Alert (some suggested topics and region)
Select Topics
Registration (please scroll down to set your data preferences)

Mondaq Ltd requires you to register and provide information that personally identifies you, including your content preferences, for three primary purposes (full details of Mondaq’s use of your personal data can be found in our Privacy and Cookies Notice):

  • To allow you to personalize the Mondaq websites you are visiting to show content ("Content") relevant to your interests.
  • To enable features such as password reminder, news alerts, email a colleague, and linking from Mondaq (and its affiliate sites) to your website.
  • To produce demographic feedback for our content providers ("Contributors") who contribute Content for free for your use.

Mondaq hopes that our registered users will support us in maintaining our free to view business model by consenting to our use of your personal data as described below.

Mondaq has a "free to view" business model. Our services are paid for by Contributors in exchange for Mondaq providing them with access to information about who accesses their content. Once personal data is transferred to our Contributors they become a data controller of this personal data. They use it to measure the response that their articles are receiving, as a form of market research. They may also use it to provide Mondaq users with information about their products and services.

Details of each Contributor to which your personal data will be transferred is clearly stated within the Content that you access. For full details of how this Contributor will use your personal data, you should review the Contributor’s own Privacy Notice.

Please indicate your preference below:

Yes, I am happy to support Mondaq in maintaining its free to view business model by agreeing to allow Mondaq to share my personal data with Contributors whose Content I access
No, I do not want Mondaq to share my personal data with Contributors

Also please let us know whether you are happy to receive communications promoting products and services offered by Mondaq:

Yes, I am happy to received promotional communications from Mondaq
No, please do not send me promotional communications from Mondaq
Terms & Conditions

Mondaq.com (the Website) is owned and managed by Mondaq Ltd (Mondaq). Mondaq grants you a non-exclusive, revocable licence to access the Website and associated services, such as the Mondaq News Alerts (Services), subject to and in consideration of your compliance with the following terms and conditions of use (Terms). Your use of the Website and/or Services constitutes your agreement to the Terms. Mondaq may terminate your use of the Website and Services if you are in breach of these Terms or if Mondaq decides to terminate the licence granted hereunder for any reason whatsoever.

Use of www.mondaq.com

To Use Mondaq.com you must be: eighteen (18) years old or over; legally capable of entering into binding contracts; and not in any way prohibited by the applicable law to enter into these Terms in the jurisdiction which you are currently located.

You may use the Website as an unregistered user, however, you are required to register as a user if you wish to read the full text of the Content or to receive the Services.

You may not modify, publish, transmit, transfer or sell, reproduce, create derivative works from, distribute, perform, link, display, or in any way exploit any of the Content, in whole or in part, except as expressly permitted in these Terms or with the prior written consent of Mondaq. You may not use electronic or other means to extract details or information from the Content. Nor shall you extract information about users or Contributors in order to offer them any services or products.

In your use of the Website and/or Services you shall: comply with all applicable laws, regulations, directives and legislations which apply to your Use of the Website and/or Services in whatever country you are physically located including without limitation any and all consumer law, export control laws and regulations; provide to us true, correct and accurate information and promptly inform us in the event that any information that you have provided to us changes or becomes inaccurate; notify Mondaq immediately of any circumstances where you have reason to believe that any Intellectual Property Rights or any other rights of any third party may have been infringed; co-operate with reasonable security or other checks or requests for information made by Mondaq from time to time; and at all times be fully liable for the breach of any of these Terms by a third party using your login details to access the Website and/or Services

however, you shall not: do anything likely to impair, interfere with or damage or cause harm or distress to any persons, or the network; do anything that will infringe any Intellectual Property Rights or other rights of Mondaq or any third party; or use the Website, Services and/or Content otherwise than in accordance with these Terms; use any trade marks or service marks of Mondaq or the Contributors, or do anything which may be seen to take unfair advantage of the reputation and goodwill of Mondaq or the Contributors, or the Website, Services and/or Content.

Mondaq reserves the right, in its sole discretion, to take any action that it deems necessary and appropriate in the event it considers that there is a breach or threatened breach of the Terms.

Mondaq’s Rights and Obligations

Unless otherwise expressly set out to the contrary, nothing in these Terms shall serve to transfer from Mondaq to you, any Intellectual Property Rights owned by and/or licensed to Mondaq and all rights, title and interest in and to such Intellectual Property Rights will remain exclusively with Mondaq and/or its licensors.

Mondaq shall use its reasonable endeavours to make the Website and Services available to you at all times, but we cannot guarantee an uninterrupted and fault free service.

Mondaq reserves the right to make changes to the services and/or the Website or part thereof, from time to time, and we may add, remove, modify and/or vary any elements of features and functionalities of the Website or the services.

Mondaq also reserves the right from time to time to monitor your Use of the Website and/or services.


The Content is general information only. It is not intended to constitute legal advice or seek to be the complete and comprehensive statement of the law, nor is it intended to address your specific requirements or provide advice on which reliance should be placed. Mondaq and/or its Contributors and other suppliers make no representations about the suitability of the information contained in the Content for any purpose. All Content provided "as is" without warranty of any kind. Mondaq and/or its Contributors and other suppliers hereby exclude and disclaim all representations, warranties or guarantees with regard to the Content, including all implied warranties and conditions of merchantability, fitness for a particular purpose, title and non-infringement. To the maximum extent permitted by law, Mondaq expressly excludes all representations, warranties, obligations, and liabilities arising out of or in connection with all Content. In no event shall Mondaq and/or its respective suppliers be liable for any special, indirect or consequential damages or any damages whatsoever resulting from loss of use, data or profits, whether in an action of contract, negligence or other tortious action, arising out of or in connection with the use of the Content or performance of Mondaq’s Services.


Mondaq may alter or amend these Terms by amending them on the Website. By continuing to Use the Services and/or the Website after such amendment, you will be deemed to have accepted any amendment to these Terms.

These Terms shall be governed by and construed in accordance with the laws of England and Wales and you irrevocably submit to the exclusive jurisdiction of the courts of England and Wales to settle any dispute which may arise out of or in connection with these Terms. If you live outside the United Kingdom, English law shall apply only to the extent that English law shall not deprive you of any legal protection accorded in accordance with the law of the place where you are habitually resident ("Local Law"). In the event English law deprives you of any legal protection which is accorded to you under Local Law, then these terms shall be governed by Local Law and any dispute or claim arising out of or in connection with these Terms shall be subject to the non-exclusive jurisdiction of the courts where you are habitually resident.

You may print and keep a copy of these Terms, which form the entire agreement between you and Mondaq and supersede any other communications or advertising in respect of the Service and/or the Website.

No delay in exercising or non-exercise by you and/or Mondaq of any of its rights under or in connection with these Terms shall operate as a waiver or release of each of your or Mondaq’s right. Rather, any such waiver or release must be specifically granted in writing signed by the party granting it.

If any part of these Terms is held unenforceable, that part shall be enforced to the maximum extent permissible so as to give effect to the intent of the parties, and the Terms shall continue in full force and effect.

Mondaq shall not incur any liability to you on account of any loss or damage resulting from any delay or failure to perform all or any part of these Terms if such delay or failure is caused, in whole or in part, by events, occurrences, or causes beyond the control of Mondaq. Such events, occurrences or causes will include, without limitation, acts of God, strikes, lockouts, server and network failure, riots, acts of war, earthquakes, fire and explosions.

By clicking Register you state you have read and agree to our Terms and Conditions