"How do I handle a situation with an employee who's gone way over our quota of sick days as outlined in our employee manual?"

This question provides insight to the management style of the specific dentist or office manager who submitted the question. The fact that the office manual was referred to in order to handle this problem shows an office that is trying to follow policy, yet has a compassion factor in that the employee has been allowed to go over the sick day quota and is still employed. Compassion is a beautiful thing, but too much compassion may backfire.
Once a standard has been set, by deviating from the employee manual and allowing an employee to take additional sick days, it is difficult to return to a sense of normalcy. How fair is it to allow one employee to behave as he/she wants without letting other employees do the same?
At the end of this article I have included examples of how a sick day policy may be written. It details creative ways that an employer can help out the employee who truly needs time off because of illness. It is inevitable that employees will need time off due to the flu or to care for a sick child or family member. The general rule is be consistent with the written policy regarding sick leave and the number of paid and unpaid sick days allowed per employee.
The employee may need time off for an extended illness or injury, in which case a leave of absence may be more appropriate. Make sure the employee manual details a leave of absence policy for such occasions. Please note that the Family and Medical Leave Act will affect companies of 50 or more employees. The Act protects employment rights of individuals who are facing certain family situations requiring absence from work, such as childbirth or adoption, care of a seriously ill parent, child or spouse or their own serious illnesses. For companies with fewer than 50 employees, a fair and sensible policy is in line with good management.
The dental office relies on each team member to be present in order to function effectively. The office may no longer function as a well-oiled machine when a team member is absent or ill. Unfortunately, patient services may suffer as a result. Additionally, there is an added cost in finding a replacement on short notice; another little something that employers detest.
If an employee abuses the sick day policy, this can be considered misconduct and the dentist or office manager has a valid reason for disciplinary action. Oftentimes, in this day and age, discipline comes across as a negative action. Disciplinary measures should be instead thought of as a tool for learning and improving job performance. Without evaluating and providing feedback to employees, mistakes or poor work would never be addressed. Discipline should not be considered punishment, but rather guidance. The main goal is to guide the employee to satisfactory, and eventually excellent, job performance.
Employee discipline should be carried out as soon as possible, never put it off or hope that the problem was an isolated incident. If there is a significant time lapse between the misconduct and discipline, either the employee or employer may forget the specifics of the incident, or a message will be silently sent that the problem wasn't that serious. That being said, if one honestly feels that the misconduct was truly an isolated incident, out of character for the specific employee who normally performs well, the disciplinary action should be less severe than with an employee who has a track record of poor performance and misconduct.
Disciplinary actions should begin as verbal counseling. Direct communication regarding the office policies and how the employee is not meeting the expected standards should be a first. The initial verbal counseling does not have to come in the form of a warning, but rather to try and establish why the employee is behaving in a manner that is not acceptable. When situations like this arise, ask, "Why"; as in, "Why the behavior?"
After establishing with the employee that a change in his/her actions is needed, document the initial verbal counseling in his/her employee file specifying the topic and date. If the misconduct continues, more severe disciplinary action should be taken in the form of a written document listing the misconduct, actions that will be taken for improvement of the problem, consequences if the misconduct continues (termination) and concluding with the signatures of both the employee and the dentist. Part of the action phase should be an evaluation within a set time period for discussion between the employee and dentist regarding how improvement has taken place; make sure you follow-up! It is best to create an open dialogue regarding performance rather than slapping the employee with termination if the problem has not been resolved.
Effective employee managers catch and improve employee problems or shortcomings before they escalate into serious misconduct issues. It is always best to prevent the problem from snowballing. Be proactive!

Template for establishing Sick Days as an employee benefit:
A new employee must work for months before being eligible for paid sick leave. Prior to this period, an employee will not be paid for any time off work for illness.

Employees of more than months will be entitled to days off for illness per calendar year with pay. After an employee becomes eligible, a prorated amount of days is given until the beginning of the next calendar year.

Sick time will be cumulative up to a total of days. The {office manager/doctor} keeps records of sick leave. Unused sick days are not cumulative; they do not rollover or add onto the next years sick days. Unused sick days are not payable days upon termination from the company.

{OPTION}
Unused sick days {are/are not} payable at the end of the practice's fiscal year.

Days off for illness exceeding the number of paid sick days may be taken from vacation time, if any days remain. After those paid-leave days are gone, no compensation will be received. Persons ill for a period of time may take a leave of absence for up to days upon the approval of the Employer.

Dentist, doctor or other medical appointments which require an employee to come in late or leave early for a particular day will not count towards sick leave if scheduled and approved in advance. However, an employee must be at work at least hours during the day. The employee must present a written document from the attending doctor's office upon request. We encourage employees to schedule these types of personal appointments on days they are not scheduled to work, if at all possible.