The Time Dilemma: Office Hours and Overtime

Here’s an interesting dilemma that many healthcare providers are facing into the coming year.

With patient satisfaction becoming increasingly more important, many providers are investigating the possibility of extending office hours, to not only allow more time to see patients but adding a level of convenience for patients who may not have flexible work schedules.

The catch, however, is a new overtime rule issued by the Department of Labor that may make extending office hours extremely challenging … although that rule has been placed on injunction by a federal judge in Texas, so it may never be implemented at all.

Confused? Let’s break it down.

The new overtime rule

If the new overtime rule is ever put into effect, it makes significant changes to who is eligible for overtime pay. It would require anyone who makes less than $913 per week (or $47,476 annually) eligible for overtime pay. In addition, it makes them ineligible to be classified as an exempt employee.

To clarify further — an exempt employee is one that is paid a salary that takes into consideration any overtime hours. Exempt employees (for the most part) have flexible hours that allow them to answer quick questions after hours, run out to a quick personal appointment if necessary without having to report it, or even shift working hours as needed. A non-exempt employee is one we typically think of as an hourly employee, meaning that they are required to “clock in and clock out” when they’re working, including time after hours and overtime.

So, with this new salary guideline for exempt status … this could mean that many of your employees would need to be shifted to non-exempt … meaning you would be required to pay them for all overtime hours.

Of course, the other option is to calculate how many overtime hours each of those employees works each week and determined whether it may be in your benefit to raise their salaries accordingly to qualify them for exempt status again.

But … this is all on hold, thanks to the injunction. And with a new federal administration set to take over in January, it is questionable as to whether or not any of this will ever be implemented at all.

Extending office hours

And that brings us to extending office hours. Yes, the argument can easily be made that extending office hours would be a good thing. It would allow more patients to be seen each day as well as more convenience for patients who may not be able to take an appointment between 8 a.m. and 4 p.m. on a weekday.

“Our patients’ number one complaint is that they can’t get in when they’re sick,” says Kathy Severa, a practice administrator, in an article in Medical Economics. “Number two, they don’t like waiting.”

So … here are several options that may be feasible if you’re considering extending your hours in some way.

Stagger shifts: If your practice has more than one physician, consider having different start times. Maybe one physician starts at 7 a.m. while the other doesn’t come in until 9 or 10 a.m. This would allow you to have practice hours that start earlier and end later.

Consider weekend hours: Is it worth closing early on one day of the week to have a few hours in the office on Saturday morning?

Stay open through lunch: This may mean that someone doesn’t get a true lunch break, but is it in your practice’s best interest?

Of course, these options also impact the rest of your employees as well … so be sure to give consideration to their time and work balance. Do you have the proper amount of support staff to handle additional operational hours?

How to prepare

So, if you do decide to increase your office hours, here are some things to consider … in case the new overtime rule does take effect eventually.

Review your employees’ statuses: See who is exempt and who is non-exempt … and evaluate who may need to change statuses based on the new overtime rule. You should prepare as if the rule were to be implemented at any moment. (Remember: It was supposed to go into effect on December 1.)

Review your handbook: “Does (your) handbook address that all overtime must be approved by a supervisor? If not, now is a good time to make changes to your policies,” writes Carol Gibbons, a healthcare consultant, in Medical Economics. It’s also a good time to evaluate how the amount of time each employee works is documented, she writes.

Review on-call expectations: Are you asking your employees to be on-call? Don’t forget to include that time in your overtime estimate, Gibbons writes. Even the simple tasks of answering an email or a phone call have to be documented as after-hours time worked … and thus will require permission.

“So, if you are a boss that expects employees to be available after hours,” she writes, “you may want to modify that behavior.”

So, before deciding to extend your office hours, be sure to think through the impacts on your staff … especially regarding the new overtime rule if it is implemented. It’s always better to be prepared just in case.