Strategies for Developing Effective Vacation, Time-Off and Holiday Policies by Sue Kay

For many people, the word summer brings to mind warmer weather, a break from school, outdoor activities, backyard barbeques, and summer vacations. For office managers and practice administrators, though, summer vacation protocols and schedules can be stressful. Add to that the fact that there are also three popular holidays between the end of May and the beginning of September, and that stress turns into a major headache.

How should you handle vacation requests, paid-time off, time off without pay and holidays not only during the summer months but year-round as well?  Here are some tips and suggestions for handling these issues efficiently, effectively and correctly:

1.  Set policies and respond to employee requests with the patient in mind. Your goal is to provide the best patient care possible while ensuring that the patient leaves your practice with a positive perception. Meeting this goal should factor in (and oftentimes be the sole factor) in how you make decisions regarding practice policy.

For example, many office managers ask the question if it’s a good idea to close early on Fridays during the summer. Most times, they are thinking that this might be a nice perk for practice employees and perhaps reduce the number of employee requests for Fridays off.

The real question they should be asking is, “How will not being open on Friday afternoon affect our patients?” Many of our practices tell us that Friday afternoons are busy (especially pediatric offices, family practice offices and internal medicine offices) as patients who wake up not feeling well want to get in to be seen prior to the start of the weekend.

If you make decisions from the patient perspective, communication of your policies/decisions becomes easier as well.  Instead of sounding inflexible or simply saying no, you can truthfully tell employees “I’d love to honor your request for Friday afternoons off; but, it’s simply not in the best interest of our patients.” Or “I’d love to allow all three of you to be off on the same day; but, we have a lot of appointments that day and doing so would not be in the best interest of our patients.”

2.  Know the Federal, State and Local laws and regulations as they pertain to employee time-off, vacations and holidays. 

There are two resources you may use to determine if any such laws/regulations either exist or pertain to your practice:

  • Department of Labor – click on the link below and you will be directed to a map of the United States found on the US Department of Labor website. Click on your state and you will be directed to current information on labor laws in your area along with a link to your state’s Department of Labor website.
  • Society for Human Resource Management – while this is a membership-based organization/site, there are many valuable resources available to non-members as well. One such resource is the section of the website dedicated to “Legal Issues.” Click on the link below and then on the “Legal Issues” tab and you will have access to general employment law information, state and local resources, and federal resources.

3.  Have a written policy and follow this policy consistently.

  • Practice employees will appreciate having it in writing as oftentimes they simply want a clear understanding as to what your policy is so that they can plan within that framework.
  • A written policy keeps you from making decisions on the fly without having time to carefully consider their practice ramifications and/or precedence. When asked a question about time-off, you can answer the question with, “Our practice policy is [blank].” This helps you to respond to questions from a practice perspective and not a personal one.
  • It’s always a good idea to get new associates to sign-off saying that they have received and reviewed all of your company policies. You should then keep this form in the associate’s personnel file. This will help you avoid the “I never knew that” statements that employees sometimes make.

If you would like to see a copy of the standard template that we used at InHealth/Efficiency in Practice when developing our PTO/Holiday policy, please email me at and we’ll send you a copy. Many of our office managers find that simply having a template to use as a starting point for your own policy is helpful.

4.  Say “YES” as often as possible. Once you carefully consider and implement number 1-3 above, say “Yes” to employee requests as often as possible. This is good advice whether you are responding to a request for time-off or to some other employee request. Oftentimes, we simply get into the habit of saying “No” all the time. The next time you find yourself saying “No,” stop and ask yourself why you are saying “No.” Will saying yes negatively impact the patient? Will it break any law or regulation? Is it consistent with your policy? Then say “YES!” Doing so will create a more loyal and productive employee in the long run.

We welcome your comments or thoughts on the topic of employee vacation policies, paid-time off and holiday policies. Feel free to email us at

 © 2010 Efficiency in Practice

Sue Kay, Senior Consultant at InHealth, is the editor of Efficiency in Practice, the free eNewsletter for medical practice managers who want to save time, money and reduce risk.  For more information and to access your FREE report, The 8 Things You MUST Know About CMS’ RAC Program, visit  or check out our blog at

This article can be reprinted freely online, as long as the entire article and this resource box are included.

Comments are closed.