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Are Family Members Working in the Practice? Rhonda R. Savage, DDS

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by Rhonda R. Savage, DDS

Wishful thinking! It's complicated. Family members who work in the dental practice can be a tremendous asset. But even the most dedicated, hard-working family member can experience or create tension, stress and conflict in the practice. Can we really have the family history, emotions and knowledge of that person on a deeper level but also have a great working relationship?

I've seen family successfully work within the practice, but there are reasons behind why it works. What are the qualities that facilitate successful family working relationships? Here are the common issues that exist within practices that employ family.

Recognize that Loyalty Sometimes Leads to Micromanagement
Often, family members are more dedicated to the success of the other family member. The old saying, "family is thicker than blood" is true, and yet too much caring can cause conflict.

I remember when I met Bernadette. It was in the fall of 2001. As a hygienist, she worked for her son; a new practice owner and young dentist. Dr. Greggs had established his vision and goals, but he had trouble developing a consistent, fair style of leadership. He found the staff management and the business of dentistry to be much harder than actually doing the dentistry. His mom, Bernadette, in her eagerness to help him succeed, was openly voicing her concerns and opinions during business hours and also outside the office.

She felt the front office staff wasn't diligent enough in collecting at the time of service and inconsistent in their insurance processing methods. Bernadette was clashing with the lead front office person. She also clashed with the dental assistant in charge of supplies. She felt they weren't doing a good job and needed to have more attention to detail. Dr. Greggs had difficulty enforcing his policies because of the conflicting views between Bernadette and the other team members. His mom was a micromanager. She told everyone how they should be doing their jobs, in detail. The stress drove the morale of the practice down.

Acknowledge It's Easy to Take Work Home
Dr. Collins has been in practice for 26 years. His wife is part of his front desk team and he says, "I love working with my wife!" Dr. Collins is a very nice, quiet, reserved person. He dislikes conflict and struggles to grow his team and his practice. He's worked very hard through the years, taking a lot of continuing education. His primary goal is to educate his patients and provide quality dentistry. His wife, Emily, is concerned that the team members aren't held accountable for their work. The assistants and hygienists aren't actively communicating and educating the patients, despite training and continuing education.

Because the doctor is sensitive to conflict, he avoids team meetings, coaching and performance reviews. This stresses his team and his wife. She's quite verbal about her feelings during off hours, which causes him discomfort as he's sensitive to criticism. Emily is always very respectful to her husband and defers the decision making to him, but is upset by the team performance level. The built-up frustration comes through unintentionally in her tone of voice and her look, and the tension in the practice is palpable.

Both Bernadette and Emily have skills, talents and strengths; they are incredibly loyal to the doctors and want them to be successful. But their strengths, if overdone, will create problems that should not be ignored. Deferential passive-aggressive behavior and the opposite, micromanaging, will create conflict and tension in the dental practice.



Don't Hire Someone You Can't Fire!
There are many complex issues in practices that occur when family is involved; there is no single solution to the problem. There are many layers that need to be peeled back to resolve the issues and change behaviors… if change is possible. Both doctors will need to change to some extent or their practices will continue to struggle.

Do you find yourself hesitant to talk about a problem within the office because of how it might impact you on the personal/home front? Are you walking on eggshells at work, worried about how he or she might respond if you treat them as you would your other employees?

To be successful as a team member, Bernadette and Emily need to know their role in the practice. It can be a tough job, being a family member and an employee. Other employees, no matter how hard you work at being a great employee, will look at you differently. Because of this, your family member employee will always need to hold him or herself to the same (or even higher level) of accountability than employees who are not family members.

Be Aware Family Tend to Get Paid Too Much or Too Little
Some dentists try to help their family out by paying more than the average wage for that employment category, which can impact the total staff overhead. When calculating staff overhead and whether you have room for raises/bonuses, subtract out any additional pay that is above and beyond the norm. It's not fair to neglect the rest of the team's income; you'll see resentment and unhappiness build if this is the case. Remember, when morale goes down, productivity goes down! The opposite of too much pay is too little. If your family member is paid at a lesser rate, is there a concern about resentment? Honest, open discussions are important to be certain this isn't the case.

In addition to pay, gender difference or age differences that impact your relationship with your team might feel intensified with your family employees. Recognize that some conflict develops due to these differences and work at learning about better communication and leadership. Read about leadership and communication and put what you read to use.

If family employees and your employees just can't seem to get along, you must resolve the issue. If you don't, you'll be "anti-marketing" your practice. Patients will sense the tension.

Look at the Situation Through the Eyes of a Child
Most of us don't like to talk about these sensitive areas; it's easier to sweep them under the rug. Yet talking about these issues is exactly what you'll need to do in order for your office to have the harmonious atmosphere that patients seek. Sometimes looking at these uncomfortable discussions with the eyes of a child can help! Children are often quite blunt and have the uncanny ability to say what needs to be said in just a few words.

As an example: My parents bickered at each other for years, creating uncomfortable moments for those around them. We always tiptoed around these tension-filled moments, hoping they'd go away. One summer when visiting my parents, we sat down for a lovely dinner. My mom snapped at my dad. "Bill, eat your salad!"

"No!" he replied, angrily. And the conversation died as the two began to argue. Kaitlyn, our then six-year-old daughter, leaned back in her chair, arms crossed, and with a big grin on her face said, "Oh! Dinner and a show!"

After a great belly-busting laugh, mom and dad apologized and acknowledged they hadn't realized how their bickering made us feel. Our relationship deepened with the open discussions that followed through the years. As adults, we often worry about putting our foot in our mouth. Hurt feelings build up, layer upon layer, until silence or unexpected anger result.

If your office is experiencing this kind of tension, encourage the conflicting parties to work out the problem on their own. The key to a successful employee/family relationship is that everyone in the office is treated the same. You need the same level (or higher) of accountability, timeliness and dedication to patient care from all of your employees, especially family members.

If you find your employees don't get along, send them to lunch with your credit card! If this doesn't work, facilitate the discussion. There are two questions that you can ask yourself that will help take the emotional side of the problem out of the equation:

Is "whatever is happening" in the best interest of the patient care?

Is "whatever is happening" in the best interest of maintaining a healthy practice?

Look at the problem with the directness of a six-year-old and resolve the issue. Working with family doesn't have to be a problem as long as intentions are apparent, there is a general attitude encouraging open and honest communication and issues are addressed abruptly after surfacing.
Author’s Bio
Dr. Rhonda Savage began her career in dentistry as a dental assistant in 1976. After four years of chairside assisting, she took over front office duties for the next two years. She loved working with patients and decided to become a dentist. Savage graduated with a BS in biology, cum laude, from Seattle University in 1985; she then attended the University of Washington School of Dentistry, graduating in 1989 with multiple honors. Savage went on active duty as a dental officer in the U.S. Navy during Desert Shield/Desert Storm and was awarded the Navy Achievement Medal, the National Defense Medal and an Expert Pistol Medal. While in private practice for 16 years, Savage authored many peer-reviewed articles and lectured internationally. She is active in organized dentistry and has represented the State of Washington as president of the Washington State Dental Association. Savage is the CEO for Miles Global, formerly Linda L. Miles and Associates, known internationally for dental management and consulting services. She is a noted speaker who lectures on practice management, women's health issues, periodontal disease, communication and marketing and zoo dentistry. To speak with Dr. Savage about your practice concerns or to schedule her to speak at your dental society or study club, please e-mail rhonda@milesglobal.net, or call 877-343-0909.
Dentaltown Magazine
September 2025
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