Why Your Practice Needs an Employee Handbook Before Hiring Your First Employee

If you are a dentist or doctor buying or starting your practice and preparing to hire your first employee, you might wonder: Do I really need a formal employee handbook for just one or two staff? The answer is a resounding yes.

HR experts emphasize that no matter how small your business is, an employee handbook is essential to define your policies up front and prevent conflicts down the line. This is especially true in the dental and medical fields, where a single misstep in office procedures or regulatory compliance can have serious consequences. Below, we explore why having a handbook from day one is critical and the pitfalls of not having one. Then, we outline how you can get your own handbook in place (with options ranging from DIY to professional help).

Pitfalls of Not Having an Employee Handbook

Failing to establish a handbook early on can expose your practice to numerous risks and challenges:

• Legal Vulnerabilities: Without clearly defined policies (e.g., anti-discrimination rules, harassment prevention, and at-will employment disclaimers), defending your practice in a dispute becomes much harder. The lack of documented rules makes you vulnerable to wrongful termination claims or discrimination and harassment lawsuits. Practices without a handbook are often seen as “low-hanging fruit” for employee lawsuits, since the absence of formal policies can signal negligence in other areas. A handbook, by contrast, is one of the simplest and most effective tools to deter a disgruntled employee (or their attorney) from pursuing legal action.
• Regulatory Compliance Risks: Medical and dental offices must follow strict regulations (HIPAA patient privacy rules, OSHA safety standards, state labor laws, etc.). An employee handbook helps ensure your team adheres to these laws by outlining required policies. Without a handbook, you risk inadvertent violations of healthcare or employment laws, which can lead to hefty fines, penalties, or damage to your practice’s reputation. In a small practice, you may not have a full-time HR manager, so writing down all these compliance policies is crucial to avoid things slipping through the cracks.
• Inconsistent or Unfair Practices: A handbook promotes consistency in how you (and any managers) apply office rules. If you rely on verbal guidelines or a “we’ll figure it out as we go” approach, you might enforce policies unevenly. This opens the door to employee confusion or perceptions of favoritism. Inconsistent management hurts morale and can trigger claims of unfair treatment or discrimination if one staff member feels another is getting special treatment.
• Miscommunication & Conflict: With no single reference for workplace rules, misunderstandings about expectations or procedures are almost inevitable. Employees may have different personal assumptions about things like acceptable behavior, attendance, or time-off, which can clash with your expectations. These misunderstandings can lead to decreased productivity, frequent conflicts, and higher turnover. As one dental office expert bluntly put it, “Without a well-written handbook, you’re putting your practice in a vulnerable position... Just like any other legal situation, if it’s not documented, it didn’t happen.”
• Difficult Employee Management: Onboarding your first team member is much smoother when you can hand them a guide to “how we do things here.” Without a handbook, even basic processes – like how to clock hours, request time off, dress code, or how performance issues are handled – remain unwritten and unclear. This makes training new hires and addressing behavior or performance problems far more challenging. You may find yourself improvising rules as issues arise, which is stressful and inefficient. On the other hand, a well-crafted handbook sets clear expectations for conduct and performance from day one, making it easier to hold employees accountable if problems emerge.

How to Create an Employee Handbook for Your Practice

Step one is recognizing you need a handbook – step two is actually creating it. There are a few approaches, ranging from do-it-yourself to fully outsourced “white glove” services:

• Do-It-Yourself (DIY) with Templates: There are online templates and handbook builder tools that can help small businesses outline basic policies. This route can be tempting to save money, but if you choose a DIY template, proceed with caution. Any generic template must be customized to reflect your specific office policies and state laws. Crucially, you should have an employment attorney review it before you put it into use. Skipping legal review could result in a handbook that inadvertently violates laws or omits critical policies.
• Payroll/HR Service Assistance: Many payroll companies and HR outsourcing services offer help with handbook creation as part of their packages. For example, providers like ADP include an Employee Handbook Wizard that walks you through creating a customized, professional-quality handbook based on the latest federal and state employment laws. Leveraging your payroll or HR service’s resources can be a convenient middle-ground – you get a properly formatted handbook with up-to-date policies, saving you a lot of time. We at The Phillips Group often recommend letting your payroll/HR provider assist with the handbook (if they offer that service, such as through a platform like ADP or a provider like Premier HCM) because these companies continuously update their templates for compliance.
• Professional “White Glove” Service (Hire an Attorney or HR Expert): For the most customized and legally sound handbook, consider engaging an employment law attorney or a specialized HR consultant to draft it. This is the most hands-off option for you as the owner, and it ensures every policy is written specifically for your practice’s needs. At The Phillips Group, we hired an attorney to develop our employee handbook – ensuring it was done right from the start. Given the potential liabilities in the medical/dental field, this investment can pay off by preventing costly issues later.

Best Practices

No matter which route you take, a few best practices apply:

• Tailor it to your practice and include policies unique to dental offices (like HIPAA, OSHA, or patient privacy).
• Keep it updated as laws and regulations change.
• Require signed acknowledgments from employees.
• Enforce policies consistently and fairly.

By investing a bit of effort before your first employee comes through the door, you’ll set the tone for a professional, well-run practice from day one. You’ll avoid the common pitfalls that plague many small offices that try to “wing it” on HR policies, and instead create a workplace where everyone knows the rules and expectations.

Disclaimer

This article is for informational and educational purposes only. We are not attorneys; the information provided should not be construed as legal advice. Employment laws vary by state and are subject to change, and every dental or medical practice has unique circumstances. For guidance specific to your situation, consult a qualified employment attorney or HR professional before creating or implementing an employee handbook.