Making room for faith: Handling religious expression at the office

You might have office staff or colleagues who want to display signs of their faith on jewelry, clothes or desks, discuss their religion's tenets, or even openly proselytize fellow staff and patients. You might have just as many office staff or colleagues who would rather not be bothered about religion or are openly hostile to it.

So how are doctors supposed to deal with that conflict without upsetting employees, ending up in court, or appearing on a cable news talk show as the latest example of the "war on Christmas"?

The legalities of handling religion in the workplace require that you make reasonable accommodations for people's religious beliefs, but there can be a fine line between what is reasonable and what is not. Experts say allowing people to express themselves through religious displays and conversations, while allowing nonbelievers their space, is as much about good management as being aware of the law.

The law governing religion in the workplace is Title VII of the Civil Rights Act of 1964, which prohibits employers from discriminating against individuals because of their religion. It mandates that companies make reasonable attempts to accommodate employees' religious practices.

The federal law applies to businesses with 15 or more employees, but some states apply the requirements to smaller firms. And, experts say it is not clear whether doctors who are partners would be counted. In any case, except for a solo or perhaps a two-person practice, it's best to play it safe and assume you're required to comply with the law, experts say.

The first part of the requirement -- the prohibition against religious discrimination in hiring, firing and promotions -- is generally familiar to doctors and is straightforward enough to be easily applied. The second part -- accommodating reasonable religious practices -- is more problematic, said Stephen Fink, a labor law attorney with Thompson & Knight in Dallas.

"The thing doctors sometimes get hung up on is the concept of reasonableness. It's hard to define. But most people know what reasonable means when they look honestly at the practice," Fink said.

For example, if a Muslim employee wants to be able to say midday prayers and there is a storeroom the adherent can use without disturbing anyone, the group should make that accommodation, he said. On the other hand, if the prayer has to be done in an office where other people are working, the disruption to the smooth flow of work would probably render that accommodation unreasonable, Fink said. And a group wouldn't have to accommodate an adherent of a religion that requires prayer, but doesn't mandate specific times, he said.

The same accommodation rule applies to time off for religious holidays. Few groups would be able to accommodate frequent days off, such as a Sabbath on which the office is open. But groups should try to accommodate less frequent holidays, attorneys say.

Groups don't have to pay employees for time off for religious holidays. But Peter Lucash, CEO of Digital CPE, a medical practice training and consulting company, suggests combining all paid days off -- vacation time, sick days, personal days and religious holidays -- into one package. "Giving staff people a set number of days, which they can use any way they want, makes life much easier for administrators and staff," Lucash says.

The allowance of religious dress relies on the same accommodation rule. Kevin Zwetsch, an attorney with Fowler White Boggs Banker in Tampa, Fla., points out that it's important to distinguish between apparel actually required by the religion, such as yarmulkes and turbans, and that which is merely decorative, like jewelry depicting a cross or Star of David.

Groups are required to allow religious dress unless it presents a safety or hygienic danger or hampers the office workflow. Groups are not required to allow religious jewelry, but Zwetsch and others suggest that doing so can be good for morale. "No one will be offended if someone else is wearing a small cross. There's no need to make an issue of it," he said.

From preaching to harassment

While groups are required to try to accommodate religious practices, they are under no obligation to allow religious-related activity not actually required by the religion, such as displaying religious items on a desk or proselytizing co-workers.

Diana Scott, the Los Angeles-based co-chair of the national labor and employment practice at Greenberg Traurig, says that proselytizing can easily be perceived as harassment. "The implication is 'my religion is better than yours,' and that attitude can spark trouble in the office," she said.

Of course, most groups would not want to create an atmosphere where someone is afraid to, say, invite a co-worker to a church supper. Scott says the line is similar to the one that groups should draw when it comes to sexual harassment. "It's fine to compliment someone's hair. But if you do it every day, or to people you don't know, or too loudly, it can be harassing," she says.

Most experts say there are two areas where even gentle religious-based invitations should be forbidden. The first is with patients. "Many patients who are unhappy with something that happens in the office just won't come back rather than complain. So you won't have an opportunity to rectify the situation," Lucash said.

The other area of concern is when the invitation comes from a manager or doctor to a staff member. Fink said, "If an office manager invites someone to a church function and they don't go, they may think it will affect their job standing. And if later they are passed over for a promotion, they can claim that was the reason."

The display of religious items on someone's desk may or may not cause problems, depending on the size of the items, whether the office is shared, and the attitudes of the people who have to look at it.

Scott says groups should have written policies about what can be placed on worker's desks. "This should be a general policy, not aimed specifically at religious items." She suggests that the policy state something like, "In order to maintain a neat and uncluttered office, the only personal items an employee may keep on his or her desktop is one small photograph of a family member, friend or pet."

Scott also believes that groups would be better off prohibiting all bulletin board postings that are not business-related.

Lucash agrees that many general medical office best practices can prevent problems related to religious issues. For example, giving receptionists a script that specifies what to say when greeting a patient will eliminate the possibility of such potentially offending phrases such as "Have a blessed day," which the Seventh U.S. Circuit Court of Appeals in 2001 ruled an employee of a logistics firm could say to fellow workers but could not say to customers and other outsiders.

"In general, you want to standardize customer service as much as possible," Lucash says.

Physicians are legally placed under the same restrictions as administrators or managers. But doctors who have ethical or religious-based qualms about performing certain procedures or prescribing certain drugs represent a separate issue.

Scott says groups should create detailed job descriptions listing some of the procedures the group handles. Because in many cases the controversial issues will be abortion and birth control, they should be specifically addressed in applicable job descriptions. Newly hired doctors should be required to sign a statement that they can perform the duties specified in the job description.

If a doctor, after working at the group for a time, has a religious conversion and can no longer fulfill the duties specified in the job description, the group can, depending on the employment or partnership contract, fire the employed doctor or buy out the partner. Or, if some accommodation can be made to keep the doctor, the group might try that route. "That will depend on many different business issues, such as whether there are enough doctors to fill in," Fink said.

Patients, new and existing, who call to make an appointment with a doctor should be told if he or she does not perform certain procedures.

Fortunately, most people of faith want their religions to be a source of comfort, not conflict. But even employees with the best of intentions can sometimes create problems. Experts say standard rules for the workplace, careful observance of the law, and a dose of sensitivity will help groups avoid those issues.