The real price tag: Wage and hour rules for free and discounted services
One of the great aspects about being in a health-care profession is the fact that it can help so many people live better lives. This can be as simple as their feeling more confident in their smiles, or by having better physical health—dental care is incredibly valuable in these ways.
Many dentists will also extend this part of their job to those in need. Whether hosting community dental days at their practice or joining up with other charity centers, they frequently give back to those who need it most, which is really quite remarkable.
Often, one of the perks of being a dental employee is getting discounted, sometimes free, dental care. It’s generally considered a win-win for everyone involved—great advertising and happy employees.
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In terms of specifically providing dental benefits to employees, sometimes employees simply get scheduled when patients cancel; other times there are designated “staff dental days.” In general, dental practice owners can decide how best to provide this benefit to their staff.
But individual dentists can’t be the ones deciding whether employees are paid for providing these services for charity events or as part of the dental benefit program. That’s where wage and hour problems can arise.
A complicated issue
To start to unravel this conundrum, we must look at what constitutes hours worked under the federal law. Since state law may be more stringent, it’s best to clarify those rules with your state to ensure compliance.
The Fair Labor Standards Act (FLSA) governs wage and hour rules. The FLSA requires all nonexempt employees to be paid at least minimum wage or higher for all hours worked, and at least one and one-half times their regular rate of pay for hours worked over 40 in a workweek. According to the US Department of Labor, hours worked “includes all time an employee must be on duty, or on the employer's premises or at any other prescribed place of work. Also included is any additional time the employee is allowed (i.e., suffered or permitted) to work.” This is a very broad definition.
The DOL further states that, “Work not requested but suffered or permitted to be performed is work time that must be paid for by the employer. For example, an employee may voluntarily continue to work at the end of the shift to finish an assigned task or to correct errors. The reason is immaterial. The hours are work time and are compensable.”
As a result, this broad concept of work means that all staff members who are providing or performing treatment must be paid. This is the only option, and not complying means dentist owners could run afoul with the law and end up with liability.
A dental employee who is “suffered or permitted to work” has to be paid even if the service provided is free to the person receiving the service; even if the patient is the employee’s family member; even if this happens at a charity event; and even if it’s for the benefit of staff members.
The reason for the work, the fees associated with that service, anything else that dental practice owners think means they don’t have to pay for services—it’s simply not the case. This applies to all levels of dental employee, including associate dentists.
In light of this, can the employees’ pay be reduced? While the law does allow for different rates of pay for different types of work, performing the same job hardly fits within that scope. A dental hygienist cleaning someone’s teeth is performing the same work whether or not the patient dynamics are different. However, if that same dental hygienist is at a charity event and is simply handing out brochures and promoting the practice to the greater community, then that job would be different from cleaning teeth and pay could be commensurate with those duties.
This information might come as a bit of shock to some, and it might mean that you need to reevaluate and revise the dental treatment program you offer, whatever it is. While that’s a good idea, we hope that it doesn’t result in your cutting these programs entirely—they’re good programs with sincere value to employees, to communities, and to those in need. Paying employees for their services shouldn’t hinder those efforts completely.
Editor's note: Originally posted in 2021 and updated regularly
