As an accountant or financial advisor you are likely to have a range of different clients who run their own business, some of them may be doctors who run medical practices. Not dissimilar to other industries, the medical profession is not immune to issues with employees.

Given you are in a position of trust with your clients, it is not uncommon for you to be one of the first people to hear about concerns within a practice. In this article, we take a look at how you, as one of their trusted advisors, can steer your clients in the right direction to support them as practice owners when employee issues arise.

Common Employee Issues in Medical Practices

As you will know, employment issues can take place in any practice regardless of their shape or size. These issues can be about anything, from terms and conditions of the engagement, to whether a lawful and reasonable direction has been given to the team.

For example, recently a client of ours, a medical practice, had a doctor who could not practice anymore due to their anti Covid-19 beliefs. The doctor's values diverged so heavily from the practice owners'. We started with reviewing the agreement, having a meeting, providing the employee with adequate notice, and doing what was possible to arrange for them to leave on good terms. The overarching goal was to do this correctly and promptly to allow the practice owner to find another doctor that was a better match, and minimise the impact of that exit on their patient.

Another matter we had involved a junior doctor bullying the practice owner, who spoke English as their second language. This issue needed to be resolved quite urgently to protect the practice owner's mental health. In this instance, we helped the client through the dismissal of the doctor.

Other situations we often see arise is staff being promoted into a role, beyond their capabilities, and they are consequently not doing the required tasks. It is quite common in many practices for staff to work their way from reception through to admin through to practice manager, without having any of the formal training that might help them excel in those roles.

Situations like these can see disputes arise because the staff member is not the right person for the job despite having worked there for a long time. Consequently some feelings may arise that they are 'working their way into the job', even though they are not really ready for it. This can be complex for practice managers and owners to manage, especially when it is somebody that has been a team member for a long time and has shown great effort and dedication.

Employment disputes can take a huge mental toll on all involved and of course, can impact the business overall. In your role as their trusted advisor, being alert to what they can do in these moments will be valued.

Recommend revisiting the contract

However obvious it may sound, one of the first steps a practice manager needs to take if an employment dispute arises is to look over the team member's contract. Depending on whether the team member is an employee or a contractor, this may be their employment contract or contract of services respectively.

In the contract, dispute resolution mechanisms, also called 'grievance procedures' or 'complaint process'', will likely be set out. If specified, that is the procedure that should be followed. The first step is for the practice manager to familiarise themselves with whatever mechanisms are already in place. It is also at this point that it is wise to seek the advice of lawyers like us, who specialise in employment law for medical practices.

Given the slippery slope that can ensue, your clients can avoid any unnecessary drama by seeking the advice and services of lawyers like us, early on. Below are some other recommendations we encourage you to offer your clients when they are facing these issues:

Recommend the Practice Manager be prepared

The practice manager or owner needs to know where the business stands and what their legal obligations are. They will also need to be sure of what they want the outcome of the dispute to be, and what they will accept. This is why it is imperative to seek legal advice when your client finds themselves checking the terms of the contract.

If they have the intention of dismissing the staff member, there is a large body of law, with very strict rules dictating how they should proceed. They will need to be aware of these so they do not unintentionally put their practice at risk of an unfair dismissal claim (for an employee) or a breach of contract claim (for an independent contractor).

Ongoing advice is not necessarily needed for all matters. It may suit a certain situation perfectly well to seek initial legal advice, wrap their head around what needs to happen, become familiar with other steps that might be needed afterwards and then have a conversation with the doctor or team member.

When a conversation with the doctor or team member might be helpful

The conversation could be as formal or as informal as the practice manager wants, and it will likely depend on their relationship with the doctor or team member.

It is valuable to spend time talking about the dispute and getting an early understanding of where they are coming from. Encourage them to be prepared to listen as well as talk. Ideally, this discussion could be the end of the issue. Trying to resolve the conflict to avoid it escalating further can be a smart course of action however, what is said in those conversations, from the business' perspective, can be brought up later on, so caution is recommended.

When to suggest a more formal procedure

There are more formal ways of resolving disputes which may be necessary when serious issues arise, or if it is clear that a resolution is unlikely through less formal channels. For example, the owner and practice manager could participate in mediation, they could begin an investigation into a complaint, or they may not wish to address the complaint or issues that have occurred between the parties without an independent third party.

Recommend they leverage an expert to assist

If a formal procedure is required, then you could recommend that your client should consider using a lawyer who is an expert in the medical industry to either work with them in the background or engage more formally to communicate on their behalf with the doctor or team member.

This can help take the emotion and 'hurt feelings' out of the communications, whilst ensuring the correct process and procedures are followed as required by law.

Recently we had a matter where a receptionist had to be let go during her probation period. The practice owner really wanted moral support as well as legal advice in knowing that they were doing the right thing by the person, as well as by the business. Given that it is hard to find medical personnel currently, it could even be that people are putting off having these hard conversations because they are afraid they will not be able to replace staff. However, having the wrong person in a role can be more damaging than having no person at all. An expert can help deal with these issues and get to a resolution faster.

Important reminders

A team member cannot be victimised for making a complaint, nor can they make a frivolous or vexatious complaint, so how this issue is managed in a practice, is important.

If your client is unsure of what procedure to follow, encourage them to seek advice about the best way to resolve it. These are situations where they really cannot afford not to, as the consequences for getting it wrong are serious (and often more costly than seeking advice in the first place).

Putting off having hard conversations with employees and legal services can lead to more issues for practice managers and owners and add stress and anxiety by not dealing with the situation in a timely fashion. By engaging specialists like us, your client will have the confidence and clarity knowing they are doing the right thing.

Importantly, ongoing advice is not necessarily needed for all matters. It may suit a certain situation perfectly well to seek initial legal advice, wrap their head around what needs to happen, become familiar with other steps that might be needed afterwards and then have a conversation with the doctor or team member.

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.