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Office “families” require work, no matter the makeup

By Steve M. Cohen  bio

Medical offices are a unique brand of organization that frequently face their own challenges and opportunities.

A good example involves situations where one or more relatives work together in the office. This “nepotism” is not always as negative as that may sound, but it does raise several possible concerns. I would not avoid the situation automatically, but I would definitely enter it with my eyes wide open. If they’re smart, the relatives will acknowledge the potential for problems and set solid boundaries to avoid as many issues as humanly possible.

Let’s start with what is probably the most widespread form of family hiring in a medical office: the spouse of a physician working on the staff, perhaps even as office manager.

First, everyone, including the spouse or other relative, must recognize the potential for problems and questions. All parties will face a small but real burden of being on their best behavior. It need not be a big deal, but it needs to be acknowledged. Everyone also needs to remember that actions speak louder than words.

If a spouse is serving as manager, or a family member in another role, others need to judge them objectively. When such a manager must make an unpleasant decision, staff members must judge the action as if the manager were not a relative. “Is this decision necessary and fair?” are the only real measurements that count. If a staff member has been irritated simply because this person is related to someone at the office, then they are the ones engaging in unfair behavior.

Of course, family members must keep these potential issues in mind. From the start, it’s usually not a good idea to hire a relative simply because he or she “needs a job.” If the individual does not bring some solid credentials to the office, then there is a good chance there will be problems. Not only will other staff members have cause to feel resentful, but there is a good chance the relative will not perform adequately and cause organizational headaches.

Perhaps the biggest danger relates to communication. If a relative is not performing, other staff members and especially subordinates will be hesitant to complain. This is particularly true of situations where a manager or higher staffer is related directly to a physician or other managing partner. In this case, the physician or managing partner has accepted the daily obligation of watching for problems. That’s a difficult commitment and it’s one that many fail. I recommend relatives give serious thought and discussion beforehand. The organization may be able to keep the lid on complaints, but office morale and performance can suffer to the point that there are inescapable costs, up to and including bankruptcy.

Yet it’s also important to remember that “nepotism” is not simply the act of hiring a relative. Actual nepotism occurs when favoritism is applied to relatives without regard to merit of performance. Qualified relatives can in fact bring a high level of commitment and familiarity that can be a plus for the organization.

Because every individual and every situation is different, there is little widespread advice on this—other than to enter such a relationship with eyes wide open and fairness being a priority.

Steve M. Cohen, Ed.D., CMC is President/Partner of Labor Management Advisory Group, Inc. and HR Solutions: On-Call, both based in Kansas City, MO. For more information, visit or call (913) 927-0229.

The above information is shared by a guest contributor and does not necessarily reflect the views of Medical Office Manager.









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