Q: You are the manager of an acute care coding department, and you treat all staff with respect. Recently, you discovered that a coder is using Twitter to air her job grievances. She complains about her "menial pay" and the "boring" sessions she has to attend for ICD-10 and recovery audit contractor preparedness. The coder has never approached you about those issues.

Should you confront the coder about her negative tweets? It's her personal Twitter account, so do you have the right to tell her what she should or shouldn't say? What about the facility's reputation?

A:  In today's society, Twitter, MySpace and Facebook are only becoming more popular. Even though these Web sites are considered our "personal Web site" or "public space," they are not the place to air job grievances. It is true that a person does have a right to freedom of speech; however, the company's reputation and integrity still needs to be protected. Blogging in a negative manner could potentially create a hostile work environment, decrease morale and compromise the business.

Although an employer cannot prevent an employee from blogging, they can try to restrict what kind of information is blogged about and protect the company. If there is not a current policy and procedure in place regarding blogging, it is highly recommended one be put in place and communicated to employees. The employees may not even realize they are doing anything wrong.

It would be in the best interest of the company for the director/manager to approach the coder about posting negative comments online. Some rules of thumb for the coder to follow when blogging are:

• Use common sense.
• Respect the company's confidentiality.
• Be respectful to the company and other employees.
• Understand the company should not be discussed in this venue due to confidentiality or legal compliance reasons.
• Avoid offensive content.
• Avoid personal attacks.
• Ensure blogging does not interfere with work.
• If one is unsure of whether or not to post something, it is probably a good idea not to post it.

And last, but not least: it is always a good idea to follow the age old advice, "If you can't say anything nice, don't say anything at all."

--Stormy G. Roark, RHIA, CCS

A: My first thought regarding this was, "How did I find this information out?" As I pondered this further, I realized it does not matter how I acquired this information; whether I stumbled across it or someone told me directly, I consider this an item that needs immediate management action.

If the company does not have a social media policy, I would use this time to set one in place. Employees need to understand posting derogatory information on the Internet leaves a permanent company image, good or bad, that can be referenced for years. Not only can this hurt the company, but it can also be detrimental to the individual's personal career in the long run. The Internet has become a powerful source in going beyond the immediate image portrayed in a resume. When hiring future employees, a useful tool is to Google the applicant's name to get a more personal understanding of their work ethic and attitude.

I would also address her unwillingness to further her educational knowledge in this position. The field of coding is ever-changing. Staff members who are enthusiastic in expanding their coding knowledge will receive higher employee review ratings. Knowledgeable staff is of the utmost value to me as a manager. There is comfort in knowing your team is thinking through the process of their work, rather than just going through the motions. As her manager, I would express my concerns with her comments and advise her that the negative opinions will be considered when merit-based reviews are being composed. 

I would review each item of concern with her in a face-to-face formal meeting, and ask how we could make the required educational components more interesting. This would be her opportunity to air her concerns and possibly assist with ideas in training.

Allowing these personal grievances to continue and not address the issues would be a disservice to this employee, other staff members and the company. In my role as manager, respect comes not only from encouraging staff to grow, but also in redirecting negative attitudes.

--Lori Bettencourt, CPC, PCS

This week's panel:
Stormy G. Roark, RHIA, CCS, is director of HIM, Promise Hospital of Louisiana, Shreveport, LA.

Lori Bettencourt, CPC, PCS, is assistant director of operations, Pro-Medbill, Hampton, NH.