Balancing a surgeon’s beliefs with the needs of the practice

Not long ago, we interviewed a physician for possible partnership in our practice. After showing him around our town, some of us partners had dinner with him to discuss business. He was a quite pleasant fellow, well trained, and seemed to be a good ‘fit’ for our practice. As dessert was being served, he said he needed to get one more thing off his chest: he prays aloud in the operating room before starting each surgical case. If we couldn’t allow him to do this, it would be a “deal-breaker.”

So, what would you have done?

Ultimately, there were a number of unrelated reasons why this doctor decided not to move to town and join our group. But it brought up an interesting topic of discussion: how does a medical practice balance the needs of the individual to express his beliefs with the needs of the practice to maintain a work environment tolerant to all? In part, it depends on just who that individual is.

According to federal legislation, reasonable accommodations must be made for employees to express their religious beliefs. Those accommodations can be considered reasonable if they do not have a significant impact on the functioning of the business. Unfortunately, this is wide open to interpretation.  Each state differs when it comes to employees’ rights – some states require greater accommodation than others – so you should consult with an attorney who specializes in labor and employment law in your state for specific advice.

The rules are different if you are the owner of a business. Using our story as an example, a physician-owner of a practice can, by virtue of expressing his religious beliefs, create a workplace which could be considered ‘hostile’ to an employee who doesn’t share the same beliefs. Hostile may sound like a harsh word, but that is the term used in this area of employment law. Interestingly enough, this does not apply to patients, since they have the freedom to walk and take their business elsewhere. Employees, on the other hand, are compelled to work in the environment created by their supervisors. To complicate things even further, employees who are in a supervisory role can fall within a gray zone: as employees they should have allowances made for their beliefs, but as supervisors they should not impose these beliefs on their subordinates.

To most doctors not acquainted with the issue of religious accommodation in the workplace, this might seem like employees get all the rights while the business owner gets none. In essence, this is true. Perhaps, like many things in this country, the pendulum has a habit of swinging to one extreme or the other. But, whether we like it or not, it is the reality of running a business.

All of this can put the physician-owner or administrator in a tough situation, balancing the needs of the individual with the need to maintain a ‘non-hostile’ workplace. The best advice is to get good legal advice. Following consultation, you should have a formal policy as part of your employee manual so that there are no misunderstandings or worse.

Peter J Polack is an ophthalmologist who blogs on medical practice management and electronic medical records implementation on Medical Practice Trends.

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