Do you have a general practice management question you’d like our opinion on? Share it here anonymously and we’ll respond with our view.

(Please note, this feature is for public questions, asked anonymously, and answered with our general viewpoint. If you’d like a private consultation about a specific problem at your practice, our “20 minutes, one question” service might be a better resource.)

Your question is saved and will appear when it is answered.

Here's what your fellow physicians and practice managers are asking....

  • Avatar Someone asked:
    Our practice has the opportunity to hire an experienced clinician in a tight market, but there's a catch: she's the wife of one of our physicians, who wants to return to work after several years off to raise a family. What do you think about hiring family members of other employees?
    • Laurie Morgan Laurie Morgan replied:
      As a general rule, we would recommend avoiding hiring relatives or close friends of practice employees or partners.
      Medical practice workplaces can be very busy and somewhat stressful. Maintaining policies that don't add to stress and drama is always advisable, and that starts with policies that give employees confidence they'll be treated fairly. A policy against nepotism helps in this way.

      On the other hand, when a practice (or any independent business, really) decides to go the other way (say, because the owners concluded that they can trust a relative more easily), there is a risk of many problems that tie back to the employees' relationship outside of work. For example:

      • Regardless of how hard the employees try to be neutral and fair, even if they're objectively quite successful at keeping their personal relationship out of the workplace, the rest of the team will be wary and could even perceive unfairness that isn't there. Convincing employees that there isn't favoritism can consume a lot of time and energy that could better directed elsewhere.
      • Regardless of how hard the two employees try to be fair and neutral and keep their relationship out of the workplace, they will probably not succeed, and that will cause legitimate concerns on the part of the other employees.
      • You will likely face a very thorny management problem if you hire a relative and that person doesn't perform as expected. Even criticizing an employee in that situation may cause tension in your relationship with their relative -- and if you have to fire the new employee, the one you originally hired (and liked well enough to hire their relative) may leave or start to underperform, compounding your problems.
      • The relationship between the two employees may sour, and that external drama will likely affect your workplace.
      • The employee or partner may think they know more about the skills or work personality of the spouse or sibling or cousin they want you to hire than they actually do.

      There are other reasons to avoid hiring relatives, especially into key roles, that vary depend on your individual practice situation. But the list above is a good starting point for thinking about whether your partner's suggestion that your practice hire her spouse is a lucky find or a potential trap.

      Final thought: there may be some exceptions that are less problematic -- for example, hiring a spouse to do a short-term, temporary project. But as a general rule, we recommend you have a policy that guards against nepotism, and that you uphold it consistently.
  • Avatar Someone asked:
    Is it better to outsource billing or keep it in-house?
    • Laurie Morgan Laurie Morgan replied:
      To give you a detailed answer, we'd need to know more about your practice. The specifics of your practice's situation would be crucial to this important decision. But a few things you might want to think about are:
    • Do you have enough volume to keep a full or half-time biller busy? Have you defined the job in detail?
    • Are qualified people available in your area? If someone on your staff is interested, are you willing to invest in training?
    • Are you satisfied with your software set-up, and is it flexible -- and, if so, how does that affect your hire/outsource options?
    • If you're considering outsourcing, have you thought through your requirements and do you know what you need to know to screen your options?
    • Also, regardless of whether you outsource your billing to a service, it's critical to stay involved -- now more than ever. Capturing every dollar for your practice is a team effort, not just the responsibility of your biller or billing service.

      If you would like more specific feedback on your situation, or are interested in a comprehensive review of your billing set-up and performance to help you decide, please contact us.

You may also like