Dental Practice Insubordination

There can be confusion as to when an employee is truly insubordinate or is guilty of some other infraction. We commonly deal with this issue when a dental practice has a new policy/system and it is ready for implementation.

Insubordination may be described as “resistance to” or “defiance of” authority, disobedience, refusal or failure to obey reasonable and lawful instructions, rudeness, rebelliousness, disobedient gestures, dismissive gestures, walking away, abusive language or other negative behaviors that result in an actual work stoppage.

Disciplinary sanctions can include written warning, final written warning or even dismissal depending on the severity of the offense. In our experience, most of our dentists have weak or non-existent systems when it comes to implementing disciplinary systems. Every employee not only has the responsibility to come to work and be on time and so on, but also the duty to obey all reasonable and lawful instructions. In other words, to do as he/she is told, within the parameters of what is accepted as being a reasonable and lawful instruction is at the heart of “insubordination”.

Obviously, any instruction that can be carried out without breaking any statute, common law or practice policy is regarded as “a lawful instruction.” This would also be the first requirement of a “reasonable” instruction.

But for the instruction to be reasonable, there are other elements required. An instruction can quite easily be lawful, but at the same time it can be unreasonable. For example, it would be appropriate for a dentist to instruct an employee to clean her operatory at the end of the day. But it would be unreasonable if you telephoned her late at night to return to work to do this.

It is a simple matter to determine whether an instruction is lawful or not. But defining “reasonable” simply means that the employee must have the necessary knowledge, skill, capability and ability to carry out the instruction. Instructing an employee to do something that she cannot do is not only unfair and unreasonable, but it is also unlawful.

It is not always clear whether or not a particular task falls within the parameters of an employee’s job description, when not specifically stated in writing.  So it is a question of reasonable and rational judgment that must be applied here. Also worth consideration is whether the task in question is merely a “one time” thing, or is it likely to become a permanent element of that employee’s job description? An example may be asking a team member to arrange personal travel plans for the dentist.

Perhaps the best approach in those “one-time” situations is to use a bit of the old psychology, “Don’t assume, simply ask..”  However, if the task would now become a permanent part of the employee’s job, then you would have to consult and reach agreement on the matter.

Please note, providing there is no dispute about whether or not the task falls within the parameters of the existing job description, that the consultation with the employee is purely to discuss the new task, the reasons for it, how it must be done, what standards must be met and any problems or difficulties the employee may wish to discuss. The consultation is NOT a negotiation during which you have to offer an increase in salary or improved benefits because of the extra work.

A Job Description, by definition, is a written description of those tasks that the employee is expected to do. Therefore, the fact that a specific task is not mentioned in writing in the Job Description, does not give the employee the right to refuse to do it now or in the future. If the employee and/or others doing the same job have performed the task in the past, and it is lawful and reasonable, then the employee(s) must continue doing it now even if she has suddenly discovered that it is not written in her Job Description.

Resistance should be brought to the employee’s attention, and she should be warned, that her continued unreasonable refusal may lead to disciplinary action, and the dental office should proceed accordingly.

–For help with dental practice management, dental case presentation, hygiene as a profit center, business plans for the dental practice, dental continuing education seminars and more, go to www.SchusterCenter.com or call 1-800-288-9393