Working With Your Spouse or Child: Dangerous Problems

Shelly Reese


October 08, 2019

Physicians' family members, particularly when they're in the role of office manager, are a routine complaint in practice staff online forums and message boards. "The buck has to stop somewhere, but no one knows where," complains a physician assistant in the Medscape poll. One registered nurse cautions against taking a job in a practice where a husband and wife both work. "Mark my words, you will end up in the middle of a power struggle."

Another notes, "Where I work, the doc's daughter is the office manager, the son is the receptionist, and God help you if you have an issue."

Reaping the Rewards and Avoiding the Pitfalls

So how do you gain the benefits of hiring family while dodging potential problems? Experts such as Woodcock, Bauman, and Hertz say it's essential to lay the groundwork up front when a family member is hired. They offer these suggestions:

Be objective. Before you hire a family member, consider the job description and the expectations you would have if you were interviewing a non-family member for the position. Ask yourself honestly whether your family member meets those expectations. Do they have the necessary skills, experience, training and commitment?

Family members need to know what they're signing on for when they join your business.

Set clear expectations. Family members need to know what they're signing on for when they join your business. That means describing the job and your expectations. If you expect your new office manager to run the office and also keep up with the literature, join professional organizations, and participate in continuing education and training opportunities, say so. Discuss in advance how you will raise issues of concern or potential problems.

Establish boundaries. Make sure your family member knows the bounds of his or her role relative to other staff members.

Consider others. If you work with other physician partners, think very carefully before bringing a family member on board.

Conduct exit interviews. Have private exit interviews with departing staff members. It's an invaluable way to garner frank, unvarnished feedback that you might not otherwise hear.

"When people have high levels of emotional intelligence and an understanding of the risk that's involved, I think you can be successful," says Hertz. "These situations are difficult at best and impossible at worst, but occasionally you get an enlightened group of folks who can make it work. You have to go in with your eyes wide open and be aware."

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