Should physicians hire their family members?

This week, the Journal of Medical Practice Management posted a family-friendly podcast interviewing Jennifer O'Brien, a practice management consultant with Chicago's Karen Zupko & Associates called "Working with Family - Does it Work?"

Sometimes it doesn't work...

O'Brien first shared a nightmarish (yet real-life) thumbnail sketch of this employment strategy gone wrong. We hear about a solo practitioner who hired his 40-year old daughter to run the books, and evidently to handle part of the management decisions.

She was a "tyrant to the staff" who had screaming arguments with her father. And she wasn't much of a bookkeeper either. She failed to file tax returns (strike one), shared personal situation with the staff that calling her reputation - and her father's reputation - into question (strike two), raising severe tensions among the staff (strike three, you're outta there).

Upshot? A steady erosion of staff's respect for the physician as a leader, leaving them to wonder, "if the boss treats his daughter that way [and vice versa], what will he do to me?"

...And sometimes it does.

O'Brien also shared a story about a surgeon with a small practice who employed his wife to handle the bookkeeping part-time. In this case, the family-hire was qualified for the job and had the mental frame of reference to carry out the duties in a professional manner. O'Brien said this situation brought stability to the office and increased respect inside the physician family, as both spouses contributed to the bottom line.

Like father, like daughter?

O'Brien cites one case that worked out quite nicely: a physician's teenage child took a position in the practice both to gain a paycheck and to gain experience (yielding an excellent opportunity to stash some cash in her Roth IRA, too). In this case, the daughter was under the direct supervision NOT of her father, but the group manager. It was a clean-cut, professional relationship right down the line.

Is it really a good idea to hire family?

Considering the high divorce rate that pervades society today, as well as a me-based emphasis even inside close-knit families, a family hire might easily strain familial relationships that are already "intricate and delicate" according to Ms. O'Brien. She asks us to remember the "intense business with shrinking margins" that is medicine today, and leaves us to draw the conclusion that nepotism is not such a bright idea.

If you are already working for a family member, or you're thinking about it, here are the rules to live by:

  1. The family hire should be qualified for the position.
  2. The family member must display an acceptable level of respect and professionalism in the workplace
  3. There must be clear rules of management with NO special treatment.

Come to think of it, these are plain, old-fashioned best practices for hiring any employee, but especially a family member.

O'Brien sums it all up by saying, "Absolutely, in no uncertain terms, first do what is best for the family... What's best for the business will automatically follow."