Paying your employees correctly to attend CE courses at the FNDC next month

       With the FNDC (Florida National Dental Congress) right around the corner, and many dentists offering to pay the course fees for their staff to attend CE offered in Orlando at this event, I wanted to take a moment to provide you all with the knowledge of how they should get paid. And yes, the vast majority of employees working in a dental practice should get paid an hourly wage to attend CE courses, according to the Dept. of Labor. This is the number one reason that dentists (and employers in general) get audited by the Dept. of Labor and sued by their employees (current of former). All it takes is one anonymous phone call made by an employee (who thinks they should have gotten paid to attend the CE courses) to the Dept. of Labor, and an audit is likely to ensue. This is an important topic with very little “wiggle room” that almost all dentists misunderstand, which is why it is the #1 reason they get sued. Learning and abiding by this information now will protect dentists for years to come, and I’m ALL about protecting dentists!

 

       Do I have your attention yet? Excellent! As always, I will provide you with the exact link to the exact wording from the Department of Labor’s Wage and Hour Division. This legal criterion is found within the Fair Labor Standards Act, and is located at this link under the heading of “Training and Seminars”: www.dol.gov/whd/regs/compliance/whdfs53.htm.  FYI-Keep this link handy because it is a great resource for dentist employers on compensating employees correctly!

       Here’s what I want all dentists to know and understand about the Dept. of Labor. They are there to protect employees; not employers. They will take the word of employees over the word of an employer, every time. In fact, here is the Wage and Hour Division’s Mission Statement from their website:  US Department of Labor: The Wage and Hour mission is to promote and achieve compliance with labor standards to protect and enhance the welfare of the Nation's workforce (www.wagehour.dol.gov). This is their main purpose; protecting and enhancing our nation’s workforce. Now that you know this in advance, we can move on to why and how the vast majority of dental practice employees should get paid a wage to attend CE courses. 

      The biggest issues that dentists have over this subject is whether or not the CE their staff is taking is considered Mandatory or Voluntary, and herein lies the problem. Dentists believe that if their staff attends VOLUNTARY CE that they should not get paid their hourly wages to attend the CE course(s) because it is not considered “working time” in the eyes of the dentist employers. Therefore, dentists usually indicate to their employees that they are “not requiring” this CE be attended by their employees, because it is not mandatory, and therefore, is not considered time worked. This is usually followed by the dentist stating that if their employees “WANT to attend, it is up to them” (employees), and some dentists’ then offer to pay for the price of the course registration and perhaps employees’ lunch, but no hourly wages. 

       This is the crux of the misinterpretation, in the eyes of dentists as employers.  Dentists believe that their version of voluntary CE, as stated in the prior paragraph, is any CE that dentists deem as “not required or mandated by dentists”, therefore, not considered “working time”. However, the Dept. of Labor’s interpretation of voluntary CE is very different, and basically, their wording and criteria is the legal standard for all employers to abide by regarding what THEY (the Dept. of Labor) say is “working time” that employees get paid their hourly wage for (plus overtime if the CE attended puts their weekly hours worked over 40 for that week). 

       Unfortunately, the criterion for true VOLUNTARY CE is very strict and very easy to misunderstand. Most dentists have a great heart when they offer to pay for the course and lunch, but don’t believe they are legally required to pay hourly wages for their employees.  The one thing I want all dentists to remember here is that voluntary CE must pass the Dept. of Labor’s legal criteria and it is strict. In fact, the vast majority of “voluntary CE” is incorrectly labeled, and employees know that they should get paid to attend CE, which is why they call the Dept. of Labor to ask them that very question. Hence, the audits and fines, penalties, and back pay, which can go back 2 years as the statute of limitations period permits. 

       Here is the EXACT WORDING from the Department of Labor regarding whether or not attending CE is considered “working time” for which employees get paid their hourly wage, and possibly overtime. Employees of a dental practice (hourly non-exempt) who attend CE (which includes training, seminars, lectures, meetings, & similar activities) must pass ALL of the below listed criteria to be considered voluntary, non-working time:

“Training and Seminars

Attendance at lectures, meetings, training programs and similar activities are viewed as working time unless all of the following criteria are met:

• Attendance is outside of the employee’s regular working hours;
• Attendance is in fact voluntary;
• The course, lecture, or meeting is not directly related to the employee’s job; and
• The employee does not perform any productive work during such attendance.”

       As you can see from the wording above, the big “stickler” here is listed in the third bullet point. Most FNDC courses are directly related to a dental practice employee’s job. Therefore, it is not considered voluntary, and the employee should get paid an hourly wage. Going one step further, if the employee has already worked 36 hours that week and then heads off to the FNDC, and attends a full 8 hour day of seminars, they are now entitled to overtime at a rate of 1.5 times their regular rate of pay for hours worked over 40 in that week. Those hours worked, plus travel time back and forth to Orlando and course attendance time, all count towards compensated “working time” during that week. So sayeth the Department of Labor, and that is how dentists and employers are getting sued for this issue more than any other issue. Since most dentists are unaware of this strict criterion, I thought this would be a great time to ensure that all dentists have a FIRM understanding of this topic BEFORE the FNDC is here. 

       So, let’s take a look at some examples to further clarify this frequently misunderstood ruling. 

Example #1: Kathy is an RDH who is attending a course at the FNDC on Saturday on New Periodontal Techniques for Hygienists. Her dentist employer stated clearly that it is up to Kathy whether she wants to take the course or not, and that it is not required, or mandatory, according to the dentist employer. Kathy’s dental practice is closed on Saturdays normally. Her dentist employer paid for Kathy’s course registration, and told her she would get reimbursed for gas, tolls, and amount paid for lunch, but not her hourly wage, as long as she brought the receipts to her dentist employer on Monday. Is Kathy entitled to get paid her hourly wage for taking this CE course? 

Answer #1: Yes, she is entitled to receive her hourly wage for the travel time to and from the Orlando FNDC conference, the time of attendance at each course, and any other work and job-related activities such as attending a round-table discussion after the course on oral-systemic disease correlations. The course and the round table discussion are directly related to her job therefore, it is considered “working time” by the Dept. of Labor’s legal criteria. However, if Kathy wanted to attend the end of day yoga course that is offered at the FNDC, which is not directly related to her job, then she would not be entitled to be paid her hourly wage (or overtime) for attending the yoga course. 

       Should any dentists have any further questions about this topic, please feel free to email me at DrAnneliseDriscoll@gmail.com,  and I would be happy to answer questions. Knowledge is power, but more importantly, it is also protection. 

       Thanks for stopping by, and just remember; you only have to brush and floss the teeth that you ABSOLUTELY, POSITIVELY want to keep. That's all; nothing more. 

Dr. Driscoll

What's the Impact on a Dentist's License if an Unauthorized Person Prescribes on Your Behalf?

      

IMPORTANT Notice To Dentists:

 

       While reading a Tampa Bay Times article this morning about a doctor who left his prescription pad unsecured which allowed someone to forge the Dr.'s signature on the unsecured RX pad, I was so shocked to see that it caused a death to occur to the recipient of the forged, stolen RX pad. Here is the link to ABC Action News' FB Page, which reported this story this morning on the impact of a stolen doctor's prescription Pad. This is a very disturbing situation with a very disturbing outcome. 

       

       While this situation happened here in the Tampa Bay area with a doctor's family member stealing and forging the dr's signature on a prescription pad, it can EASILY occur in dental offices anywhere. I am reminded of how many times I visit dentist's offices and see the dentist's prescription pads in an unlocked cabinet, and sometimes at the front desk; both unsecured. I have also seen COUNTLESS staff members go into patients' digital charts and print out prescriptions for patients that the DENTIST should be doing. 

       

       I'll go one step further to state that I've seen dental practice staff members have full, unrestricted capabilities to type in and print out prescriptions anytime of any day because the dentist(s) have not restricted this capability through tight administrative controls of their dental software. Audit trails are rarely run to ensure the security of these important systems are in place. In fact, like the story above, doctors and dentists usually find out about these forged signatures, or digital prescriptions with a "signature on file" stamp automatically placed on them, when something awful happens and it is exposed. It is too late when that happens, and the negative outcome is something that impacts the doctor and dentist, for many years to come, sometimes. 

   

       So what happens to a dentist's license, or doctor's license when that happens? A number of negative actions can unfold and cause a series of penalties and potential sanctions from a few different agencies. Because the dentist or doctor could be considered to have been "negligent" in securing their prescription pads, which is a legal requirement for dentists and doctors, they may incur an investigation and potential charges by their governing Board (of Dentistry, for instance). Additionally, they may be subjected to an investigative action or sanctions (restriction or revocation) by the Federal government, HIPAA, and/or the DEA (Drug Enforcement Agency). Here is a short 6-page summary on Prescribing in Florida that provides specific statutes where the rulings can be found, and is a GREAT reference for dentists in Florida! I generally keep this document handy, but then again, I'm a well-known "Landfill of Useless Dental Information" as my sons call me. I prefer to say that I am a walking, talking "Plethora of Useful Dental Information" instead. It has a much better ring to it, don't you think? :)

 

Anywhoooo, I digressed here.....back to the sactions discussion!

 

       Doctors and dentists who have had sanctions from their Board, and/or the DEA, with restrictions or revocations for prescribing schedule and legend drugs, can be found on the website Florida Controlled Substance Prescriber Registration. This is where you can look up a "Practitioner Profile", or look up "A License" and of course where doctors and dentists in Florida must "Register".  I always recommend that dentists look up their own profile and license to check that all is accurate and correct, but also to check on the licenses and profiles of other dentists within their office or immediate area. Why, you ask? Because many times dentists who are sactioned by their Board and the DEA have restrictions on their licenses that don't allow them to prescribe medications, and it is important for all to know, for the sake of safety (first and foremost) and secuirty. The situation below is the perfect example of this.

 

       Recently, I spoke to an associate dentist who was very upset about how the dentists and directors of the "practice management"- owned (which violates the Dental Practice Act, but that's a WHOLE other story) office he/she worked in were not complying with different laws, rules, and statutes. This dentist was wondering what the impact might be to his/her license by being associated with such a dangerous, non-compliant office. After speaking to the Chairman of the Board of Dentistry here in Florida, I was able to pass on important information on who to contact, and how the situation needed to be handled by the associate dentist. In addition, we reviewed all of the licenses of the dentists that own and/or work within the same dental practice and we were FLOORED by what we found. What we found (sit down, this is a mind-boggling result) is that NOT ONE of the OTHER dentists who owned, nor were currently practicing dentistry on patients with complicated treatment plans, had a DEA prescribing license!!! 

 

       This associate dentist that had the "bad gut feeling" about the dental practice they contracted with after graduation to work for, was the ONLY dentist in the practice with a current, active, and unrestricted DEA license for prescribing schedule and legend drugs, and treating "chronic nonmalignant pain" as defined by the Florida Controlled Substance Prescriber Registration!!! How can that be? Well, we discussed that (drug abuse, prescription negligence, frequent violations that lead to revocation, suspension, etc.) and it suddenly dawned on this dentist that they CAN'T possibly be the only person to prescribe schedule and legend drugs since the OTHER dentists in the office were SEEN and KNOWN to be prescribing schedule and legend drugs in the practice during the short timespan this poor associate dentist was working there!??!! This naturally led us to wonder who's name and/or prescribing license number were being used by those other dentists who had NO DEA license to prescribe them. Did this associate dentist leave his/her prescription pads in an unsecured location or with the capability of anyone accessing them, stamping "signature on file" and printing/digitally delivering them to whomever? We don't know as of this date, but the possibility exists.  "Things that make you go Hmmmmmmmmmmm......."

 

       The moral of this story is still unfolding as this situation continues to proceed on and follows the correct channels to legally follow by this associate dentist.  Dentists who are working for larger, or corporate practices should absolutely, positively review DAILY what prescriptions have been written and issued and by whom. If a large group practice or a corporate practice tells a dentist that they should just "worry about their clinical skills and not worry about tracking reports in the dental software" (such as a daily report on prescription activity within the practice), then my recommendation to that associate dentist is: RUN FOR THE HILLS AND DON'T LOOK BACK!!!!!  This is YOUR license, and YOUR legal responsibility, and NO ONE else is accountable for following the laws on Prescribing in Florida, except YOU, the dentist.

REMINDER TO ALL DENTISTS: 

       Secure your prescription pads in a locked cabinet for which only you have the key to! For digital prescribers: Do not allow ANY staff members except you, the dentist, to create prescriptions in your dental software. ALWAYS run a daily report on Prescriptions Written in the practice and by whom, at the end of EVERY day, as a basic accountability tool, and SAVE those reports in a secured, locked file cabinet or in a password protected desktop computer file. Ultimately, the dentist, and the dentist's LICENSE is at stake here ALWAYS and it is a LEGAL responsibility for ALL dentists and doctors to keep them secured. 

 

So, The Bottom Line Here is: DON'T let this happen to you!

 

       Well, that's it for me for today. Thanks for stopping by, and remember; you only have to brush and floss the teeth that you ABSOLUTELY, POSITIVELY want to keep. That's it; nothing more. 

 

Dr. Driscoll