Mara
Welcome to Shorr Solutions: The Podcast. I’m one of your hosts, Mara Shorr. I’m a partner in the medical practice management company. Yes, Shorr Solutions. Who’s the other host you may ask? Easy answer. That would be my father, our founding partner, Jay Shorr. Together we have an amazing team and clients from across the country. Listen, as we chat, converse, strategize, and commiserate over life and the aesthetic medical industry.
It’s time for you to listen, learn, and be inspired as we help you kick start your practice, because who doesn’t want a little more help? Welcome to Shorr Solutions: The Podcast.
Welcome back to another episode of Shorr Solutions: The Podcast. We are your co-hosts. I am Mara Shorr, one of the partners here at your favorite practice management consulting company and the aesthetic and cosmetic industry. I am here with not only our co-founder of Shorr Solutions and Shorr Solutions: The Podcast, but also my father, my pops, Jay Shorr.
We are here today to go ahead and get started with a topic. We are getting this question a lot, Jay. And yes, in the professional setting, I call you Jay. Having breakfast and coffee together, just you and I, or amongst family, obviously, you’re Dad.
Jay
I actually like that a whole lot more.
Mara
Yes. Yeah, me too. Me too. So, anyone that’s ever worked with a family member, understand the dynamic.
Mara
But with that, we’re getting this question a lot right now because it’s summer, quite honestly. And as people are planning their summer vacations, they’re in the midst of planning summer vacations. We also get this question a lot around spring break. We get this question a lot around Christmas and Hanukkah and all of the winter holidays as well. So, let’s get started and talk about… and we could certainly break this up because I’m sure there are a lot of questions. Can I say no when an employee asks me about PTO? And Jay for the sake of the conversation, we can certainly, if you want, break it up into whether they are an employee or an independent contractor. But let’s get into can I say no to PTO? Somebody asks.
Jay
Okay, well, in our world I always believe in the education side is define what acronyms are defined, what three letters are defined, what four letters are, because whether it’s in drugs, whether it’s in operations administration, there’s always these three-letter words and PTO.
Mara
And you won’t hear us using a lot of four-letter words, by the way, we’re more three-letter word kind of people.
Jay
I’m more of a three-letter word kind of guy. That’s a fact, but PTO is commonly known as paid time off. Now, here is the very interesting thing about paid time off, because paid time off can be broken up into two segments, a benefit that is earned or a quasi-benefit that is mandated.
Jay
So, what do I mean by that? Well, in many states, Florida, and Texas, for example, there are no physical and legal requirements for paid time off. It is a practice decision.
Mara
And by that, you mean that the state doesn’t tell you or doesn’t tell a company how much time off they need to give their employees. Right? That’s what you mean by that?
Jay
That is correct. Unlike Arizona, which bifurcates a mandated PTO with under a certain number of employees and even more for over a certain amount of employees. And I never to this day understand why that is. I don’t understand why the more employees you have in your practice, the more PTO you have to give somebody just doesn’t physically make sense to me, but I don’t make the rules. I just follow them. All right?
Now, California has its own with a minimum of three days of PTO. And I don’t want to get into individual states. All right? And commonwealths.
Now there is earned PTO. And I love the earned PTO, and I don’t think it’s a bad idea to have minimum mandates. I just don’t like the bifurcation of X amount of employees you give more or less but I like it because people are entitled to time off. All right? In this day and age, in this world. But I don’t believe in having the separation between sick time, and vacation time. I just want a day off, I believe, to make it all-inclusive. So, if, for example, in the state of California, if you give more than the minimum mandates, then you are within compliance, for example.
So, if I say I want to give you one hour for every 26 hours that you work, you know, to give you two weeks off in a year, which is ten days at a 40-hour-a-week employee. All right? 20, 80 hours in a year. How do I come up with that 40-hour time? 52 weeks is 2,080 and if I want to give you ten days off or two weeks, I divide that by 2,080, by the ten or the 80 hours, and it will come up with a formula. All right? Whether it’s one for every 26, one, forever, 13, or whatever it was. So as long as you exceed the minimum mandates by the state, you’re covered.
I like sick vacation and PTO all to be world up into one non-inclusive of paid holiday.
Mara
Correct. And we also separate out obviously, things like jury duty, you know, those grievance things like that. Right. They are a little bit separate. And there are things that you may or may not end up using. But we say that part of the reason for that, is that we believe in as long as the state allows breaking and or not breaking up, rolling everything into one, it truly doesn’t make sense.
If you run out of vacation and then you have your sick, you should be able to take that time off if your time is best spent for you personally and for your family personally, as you know, on vacation. It also, quite honestly, really curbs the, you know, well, I had a vacation. I ran out of vacation time, but I do have sick time and I’m calling in Monday morning and I’m sick. Oh, by the way, I’m at a cruise port. Oops. When you could have planned for that ahead of time within your company, within your practice.
So, it just helps for planning ahead purposes.
Mara
So, with that, one thing that we always recommend is that during peak periods, so if you have brick and mortar locations, obviously like a medicine or a medical practice does- they have brick and mortar locations. And so that means that everybody is in the same geographic area. Kids are likely all in the same school zone. And so, bricks are probably taken at similar times. Right? Spring break is the same time for everybody. You know, Christmas break or winter break, the holiday break is going to be the same for everybody’s kiddos. Most likely. And so, we always recommend in your employee handbook stating how far in advance a team member needs to give that notice so that you aren’t stuck on December 15th, having everybody ask off before December 18th, for instance, and a week off December 18th, because you knew that that break was coming. So that is going to help juggle what those schedules look like. And it’s going to help planning ahead. It’s going to take the stress off of that planning ahead, quite honestly, and you can really make that much more effective. So, I think that is one component. It does not mean that things won’t come up and people get sick.
There have been several periods in the past few years where every single business has seen waves of COVID 19 come on through and they have taken out entire practices. You can’t always help that. Right? If everybody is sick all of a sudden.
Mara
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Mara
If somebody comes and says this is the time off that they need, can an employer say, “No, you are not allowed to have off?” and what does that conversation look like? Take it away, Jay.
Jay
Well, if you say no, the conversation isn’t going to look pretty, let’s put it that way. But let me try to differentiate between the two that you brought up between an employee, and an independent contractor.
An independent contractor has no rights in the business. They have no sick time. They have no vacation time. They’re an independent. They are an independent contractor. Whether it is an LLC or a corporation that is your independent contractor, even though it might be an individual, the individual might be acting as the LLC or corporation, and that is the entity that you are paying. Therefore, an independent contractor has no rights and obligations to PTO. They’re not earned. There’s not even true governance in any state or commonwealth.
Now let’s get to the employee. Can I say no? The answer is yes, I can. If you have your employee handbook you are requesting a minimum of two weeks or four weeks notification so that it doesn’t interfere here with your schedule.
Now, I don’t delineate between the position of the employee because everybody that knows me knows that I happen to feel that your front desk receptionist, which I don’t refer to as a front desk receptionist, are your director of first impressions are equally as important as any and every team member in my office. So naturally, I don’t want to have it in a larger practice. And I have three or four directors of first impressions. I don’t want two or three of them taking off at the same time because I’m not going to effectively be able to handle check-in, and check out, nor do I want my nursing staff.
Let’s put it to the surgical side for a second and then we’ll come back to the non-surgical side. If I have a surgical tech and I have a nurse in the O.R., either as a scrub, an SFA, or a circulating nurse, and then I have a recovery and then I have a pre-op. I mean, many times you may have your pre-op nurse also be your circulating nurse, also be your PACU post-op nurse in a smaller facility. All right? Or you may have multiple nurses, so you can’t have them asking off on a schedule that you are totally booked. All right?
Mara
Jay, to look at what the equivalent of that looks like in a non-surgical practice, it could be that your statistic is also your medical assistant. It could be like we look at it’s not exclusive to surgical practices when you have one person that is covering multiple positions, of course. So, continue on.
Jay
It makes it more difficult, but in my former practice, it made it a lot easier. I had three or four institutions and I had seven males. Every dietitian was also on me, but not every AMA was an institution because my dietitians were licensed. All right? They could also act as employees, but my employees were not licensed as dietitians. And therefore, you don’t want to get into the legal governance of what they could perform, what services they could perform. However, I do want to get into how it can create a hardship for the office. And that’s the worst that I really want to use hardship to the office. I never like to say no to anybody, but I had a very large staff so I could cover it.
Jay
When you have a small practice and you only have three or four people and two of them want to take off, it creates a hardship. Now, let’s be fair for a second. You are a smaller practice, mid-sized practice, and it is the holiday, it is spring break. It is the Hanukkah/Christmas holiday break. All right? At the end of the year.
Now, we’ve got to be fair. All right? That these people, even in our office, are our staff. You have children. All right? We have three women who have children and their elementary school up through junior middle school, and high school. And, you know, they’re all going to take off and it’s unfair. So, let’s say I would try to stagger them or even as an employer. How about if we try to be fair to our staff and maybe modify our schedules a little bit as the employer? Now, I know on the other end, people are going to say to me, “Jay, but that’s my money.” I understand what you don’t want is your staff just calling in sick or saying, if I can have it, because I’ve known people that said, “if I can’t have the time off, I quit” and you don’t want that to happen.
Mara
Correct. And I will say that in today’s job market, the flexibility. And while the majority of physicians in a medical spa, in a cosmetic or plastic surgery practice, or whether we’re talking surgical or non-surgical, the majority of your positions are not able to work from home. Your injector, quite honestly, cannot work from home five days a week and bring in that income. Right? They have to be in person. And if you’ve managed to come up with the way that injectors can inject from, you know, remotely, let me know. I didn’t mean injectors injecting from home I mean where they can work from home and the patient can be in the office. That nobody’s working from home. Sorry to everybody. I want everybody to be clear with that, though, because the majority of physicians are not able to work from home, then the flexibility needs to look differently and how we are and how we accommodate needs to look different than an agency that’s able to have people working from home.
So, the flexibility are those staggered schedules during the day, during peak times, are there, you know, are we looking at having somebody come in to assist from outside? I will say if you have a strong work environment planning ahead of time, is number one. So, you know who’s going to be out and have those team meetings.
Who’s going to be out? What does cross-coverage look like? Are some team members willing to cross cover for others? Because I will tell you, I see again and again here within our own company and people that anyone has heard me speak to know how proud I am of our culture here at Shorr Solutions. And time and time again, they’re willing to step up and cross cover for each other when something comes up with one team member or another. So, I think that’s something that is always an option.
Concluding Remarks
Jay, as we wrap up this glorious episode, due to time, within the last 30 seconds–
Jay
I don’t want to go. I don’t want to leave.
Mara
I know, I know. And for those of you, nobody would know, but I even texted Jay this morning to confirm the podcast episode, and I even said it’s just a fun way for us to kick off our morning. Quite honestly, I like being able to just talk about this. We’re geeky like that. What can we say?
Is there anything else, Jay, that you would want to add in the last 15 seconds of the podcast episode?
Jay
There certainly is. Don’t be cheap, don’t be thrifty. Allow your staff to earn PTO. I don’t believe in giving people anything. I want them to all earn it. It’s appreciated much more and even in those states and Commonwealth doesn’t have mandated PTO. I believe it is. Those practices like yours, like ours, like mine. Was that giving above and beyond what others don’t want to give? Your employees will appreciate it a lot more and not want to stick you into a bind by being appreciative of what you offer them. These are my keywords of wisdom because it has never, ever failed me.
Mara
And with that, Jay, thank you for all the wisdom that you impart not just to the podcast, but to all of our clients, because we get questions like this, true to our listeners, we get questions like this all day, every day. And so, to be able to answer these and give you the answers to the questions that we hear again and again all day, every day. Truly, the goal of the podcast is education. Jay loves to teach.
So, with that, everybody, thank you so much for joining us for another episode of Shorr Solutions: The Podcast. We are so glad to have had you back, and for any other questions, you know where to find us. Have a great day and thank you for another episode!
Mara
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So that wraps up today’s episode of Shorr Solutions: The Podcast. If we mentioned any links in our show notes, be sure to check them out for the easiest way to discover your best solutions. You can find them, yep, in our show notes.
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