Workplace: Should you Keep the Faith?

First, Neil Brooks’ medical assistant spoke glowingly to her coworkers of having been saved. Then out came the religious pamphlets. Next she was pushing overt invitations to her church.

“It wasn’t long before the born-again employee was starting to make others in the office feel really uncomfortable,” recalls Brooks, a retired physician and past president of the American Academy of Family Physicians.

Fortunately, after a little chat, Brooks’ enthusiastic employee stopped her evangelizing. “She was understanding about it,” he says.

But sometimes it takes much more than a private conversation to make everyone comfortable as far as religion in the workplace is concerned. When personal religious beliefs and professional responsibilities intersect, the result can be a complicated minefield rife with hurt feelings, anger, and First Amendment concerns, says Christina Puchalski, a physician and the founder and director of The George Washington University Institute for Spirituality and Health in Washington, D.C. Puchalski says she’s seeing an increasing interest in and expression of spirituality and religion these days - within the workplace and beyond.

So how can you ready yourself should such issues arise in your practice? Puchalski advises thinking about it ahead of time, learning what role the law plays when religion and work intersect, and deciding how you want to teach your employees what’s acceptable and what’s not in your office.

Have you heard the Word?

Is what Brooks’ employee did ever OK?

Not according to the experts.

“One’s personal beliefs should remain their personal beliefs - employees need to talk about them on their own time, not on practice time,” says Owen Dahl, a long-time healthcare consultant based in Texas. “Their goal while at work should be quality care and little else.”

And while it’s OK to mention your faith while participating in some light banter in the office, it’s never acceptable to make other employees feel uncomfortable about their beliefs.

“Lots of religious people talk about being ‘blessed,’” adds Dahl. “That’s OK as long as they don’t, in essence, turn it around and say, ‘And you haven’t been blessed.’”

Nor is it acceptable to say things such as, “‘Can I lay my hands on you and pray over you?’” adds Kathy Moghadas, president and founder of the healthcare consulting firm Associated Healthcare Advisors in Fern Park, Fla. She says this is something she’s seen more than once in the practices with which she’s worked.

Puchalski - a well-known leader in helping medical schools teach students how to deal with their patients’ spirituality - says religious pressure in the workplace can, in some cases, be considered abuse. “If you’re in an office and a person is making an effort to push their beliefs on you, and you can’t leave because that’s where you work, that’s potentially abusive,” she explains.

This is particularly true if the person pressuring you is your boss, adds Moghadas.

“Impinging on one’s beliefs - especially when the person doing the impinging is a boss - can be a form of harassment,” she says. “The owner of the practice would have to step in if such a complaint has been made.”

But how? The good, old fashioned way, suggests Dahl.

“Sit down and chat with the employee, letting them know their behavior was inappropriate,” he says. “Assuming the chat goes reasonably well, you monitor them. If it happens again, start a warning sequence, saying, ‘This is interfering with work in the office; I have to warn you to stop doing that.’ Next would be a written warning. Then a final warning.”

If such repeated warnings do no good, Dahl says it’s a good idea to obtain specific legal advice from an attorney before firing an employee.

Laying down the law

Can you guard against such situations by outlining in a staff policy document what’s acceptable and what’s not regarding religious evangelizing? Yes and no, says Puchalski.

Since freedom of religion and freedom of expression are First Amendment rights, she explains, restricting religious expression specifically through a company policy - depending on how you word it, of course - could be construed as illegal. It’s better to develop a practice policy that focuses on tolerance of all forms of diversity, Puchalski says.

“Having a policy on treating coworkers and all their differences with respect makes more sense, because we don’t just differ in religion,” she explains. “There’s politics, too. And sexuality. And race. You want to make sure employees get the message that they must respect each other on all levels.”

And, adds Chuck Wold, president of the healthcare consulting firm Wold Consulting Group in Phoenix, it’s best to ensure that all of this is clear when new employees are on their way in the door - not, say, two years into their tenure at your practice.

“You have to set the right tone in the beginning: ‘This is a two-way street; I won’t interfere with your practices or beliefs, but by the same token, you are not to interfere with the beliefs of patients or coworkers,’” says Wold.

Take regional differences into account

If you do choose to get specific in your policies, says Dahl, it’s wise to factor in the geographic region in which you are practicing rather than subscribe to some sort of nationally recommended staff policy. For example, he says, in the South - the Bible Belt, in particular - there’s far more talk about Jesus and Christianity in everyday conversation than in other areas of the country; it’s more accepted there.

Brooks says that where he lives in rural Connecticut, there are many Swiss Lutheran communities, so it’s not unusual to see women in conservative garb with their hair pulled into tight buns. Then there are the high concentrations of Amish in Pennsylvania and Mormons in Utah. All of this must be considered carefully when drafting a practice-specific policy.

“The employee population will help define what mores are acceptable in the office,” says Moghadas. “The medical practice has to be treated as a small community, and part of the selection process is making sure job applicants have the same basic values of that community - or at least that they respect those values.”

Indeed, Moghadas recalls interviewing a woman for a job at her healthcare consulting firm who realized that one of the doctors Moghadas worked with performed abortions. The potential employee became irate, declaring, “‘That’s not right,’” Moghadas recalls. The agitated job candidate then asked how she could gain access to that specific physician’s records. Moghadas simply replied, “Privacy is paramount.” The woman said nothing in response. Needless to say, she was not hired.

“I could see that wasn’t going to work,” says Moghadas. “Her culture was not the culture of my business.”

OK to display?

So say your very religious employee understands your policy about respecting diversity, and he gets that it means he can’t spread, say, Book of Mormon teachings to coworkers. And he doesn’t. He makes not a peep. But his desk is covered with pictures of Jesus and the Mormon prophet Joseph Smith.

What then?

Don Peder Johnsen, an employment lawyer with the firm Gallagher & Kennedy in Phoenix, explains that such an employee is free to express his religion unless it causes undue hardship to his employer. And pictures of Jesus and Smith at his desk are unlikely to cause undue hardship, such as costing the practice patients.

“A reasonable patient [if he or she saw such pictures] wouldn’t make too much of them or perceive them as reflective of the employer’s views,” says David Stephens, chief executive officer of the Bristol, Tenn.-based Christian Medical and Dental Associations. “But let’s say an employee wanted to put up anti-abortion posters in the lobby or anti-gay scripture at his desk. Yes, that would cause serious disruption.”

Which brings up a key issue: placement. Does the placement of an employee’s desk affect what she can display? It can.

“In a cubicle that patients can’t see, you have more discretion,” explains Stephens. “But when items are displayed in public view - like a nurses’ station or in view of the lobby - then you start to risk offending patients.”

Dahl says one approach is to tell employees who display reasonable religious items (reasonable = a cross; unreasonable = anti-gay scripture) at their desks that it’s OK to do so unless a patient or coworker complains. Once there’s a complaint - particularly if it’s from a patient - it could be argued that the practice is then facing an undue hardship, and it would be reasonable for physicians to ask their employees to remove the offending items.

Wearing religion on your sleeve

Regarding clothing, Johnsen explains that the actual requirements of a person’s religion must be considered when it comes to potentially restricting what your employees can and cannot wear. That’s because under federal law, employers have an obligation to “reasonably accommodate” their employees’ religious observances, practices, and beliefs. It follows that employers must attempt to accommodate employees who, for religious reasons, must maintain a particular physical appearance or manner of dress to adhere to the tenets of their religion.

Take as an example a case currently in the Arizona legal system. According to Johnsen, a Muslim woman working at a car-rental company refused to remove her head scarf during Ramadan, saying that wearing the scarf was required by her religion during that holy time. The company insisted that she remove it, as its policy states that nothing should be worn on the head by any employee. The incident occurred in 2001, just after the Sept. 11 attacks, when public mistrust of Muslims was running particularly high. The case has not yet been decided, but Johnsen says the plaintiff will most likely prevail, as Islam does require that women wear head scarves during Ramadan. The woman would have compromised her religious beliefs had she removed the scarf.

Puchalski concurs.

“To ask a Muslim woman to remove her head scarf at work is the same thing as asking a nun to remove her habit,” she explains. “You just wouldn’t do it. You can’t draw these lines so hard that you don’t let people be themselves. It’s not what you wear to work - it’s how you behave with colleagues.”

So when it comes to religious apparel, a good rule of thumb is that - within reason - only safety concerns can constitute “undue hardship” for an employer.

What about you?

If an employee’s mention of religion or display of a religious item on a desk irks you more than it seems to bother other staff or patients, it’s time to examine your own feelings on the subject, says Wold.

“It’s important to guard against one’s own prejudice,” he says. “I might think, ‘My goodness, my receptionist is wearing a cross - that’s going to offend people!’ But then I need to step back and carefully take into consideration whether it actually will or whether, deep down, I am offended because I’m, say, Jewish, and this employee is Catholic.”

The bottom line, for staff and physicians alike, says Moghadas, is this: “It’s our responsibility to respect everybody’s religious freedom - not just the ones we agree with.”

Suz Redfearn is an award-winning healthcare writer based in Falls Church, Va., who has written for a variety of publications, including The Washington Post and Men’s Health. She can be reached via editor@physicianspractice.com.
This article originally appeared in the April 2007 issue of Physicians Practice.