Hire your spouse? Tread carefully

You've been hearing and reading about doctors who hired their spouse to run the office. Some say it's the best thing you can do. Others say it could be a nightmare. Should you put your spouse at the helm? A lot depends on the structure of your business and on how long you've been in practice.

We polled some of our readers and a few consultants on whether they think it's a good idea to hire a spouse as office manager. Here's what they said.

In a group? "Don't go there" Most agree on one thing: Having your spouse at the helm is never a good idea in a group practice. You'll wind up with acrimony, bitterness, heartache, and jealousy, they say. When there's a conflict between doctors, there will always be a tendency to question the motives of the manager.

"It's a terrible idea," agrees another FP. "Nothing sows discontent and suspicion more than a spouse who controls the money flow. One of my partners forced his wife on the other three of us, and she turned out to be a scallywag. It caused a huge schism in my practice, and the doctor eventually left."

Another reader relates this story: "I once shared an office with a doctor who was married to the office manager. Our practice was in a resort area. To my dismay, I discovered that the manager was shepherding the new patients who were year-long residents to him, and I was getting the seasonal visitors. So, in the off-season, I had no work, and he was always busy. As soon as we broke up, my practice thrived. My current partner and I have a hard and fast rule: No spouses work in the office."

And getting a spouse out after she's entrenched can be problematic. "Which of your partners is going to be the one to tell her-or you-that it's not working out?" asks Jeffrey J. Denning, a management consultant with Practice Performance Group in La Jolla, CA. "It's hard enough to get group members to discipline a manager who's not a family member."

Frederic Porcase Jr., a physician in Jacksonville, FL, says that a partner once joked that he was going to offer to continue to pay one of the doctor's wives to stay at home. "She was supposed to be helping with the filing, but she was just in everyone's hair. Once they're in, you can't get them out without creating a huge mess. It's best not to begin."

Another problem: You could jeopardize your referral base. "For the most part, I avoid offices where the spouse runs things because they're very difficult to deal with," says FP Peter Bentivegna in Cape Cod, MA. "I rarely refer to them because of the hassles."

Solo? Just starting out? That's a different story But for the solo practice, the raves outnumber the nays. A spouse will work cheap if need be, and you'll never have to wonder about your spouse's motives.