Simon Palmer, June 2006 - Working as I do in the field of Dental Transitions, I’ve witnessed several practices implode due to interpersonal tension related to an incompatibility between a dentist’s spouse and other associates. I suspect this scenario is not too uncommon and is worthy of some attention.

I grew up in a dental family. My father, uncle and cousin are all dentists and it seemed two out of every three family friends of ours were dentists too. Surrounded as I was by dentist families didn’t just expose me to dental jargon and the trials and tribulations of dentists themselves. It also exposed me to the issues of the Dentist Spouse in a dental practice. It seems to me that Dentist Spouses fall into two categories in a Dental practice: the visible and the invisible. Both play different but very significant roles in a dental practice that can make or break a dental associateship and neither category of dentist spouse can be ignored.

‘Visible’ dentist spouses
‘Visible’ dentist spouses are the ones that work in the dental practice on a regular basis, either as a front desk person, practice manager, another dentist or hygienist. My aunt is a visible dentist spouse having worked at the front desk of my uncle’s practice for over 20 years.

There are many advantages to having your spouse work in the practice. They almost always are trustworthy, hardworking, reliable and have your interests and the success of the practice close to their heart. However, as many will tell you there is a downside.

Lets assume that the spouse is trustworthy, hardworking, and reliable and that you will be able to draw a distinct line between your work and home lives so that neither one intrudes on the other (not an easy task for any family working together). Where does the dentist’s spouse fit in with associates and potential associates? What happens if you want to sell some equity in the practice to another dentist and become associates?

For a dentist with equity in the practice or looking to buy into a practice, another dentist’s spouse working there will raise many concerns. It could mean that:

• While on paper they will have an associate (you) and an employee (your spouse), in reality they have an employee with a very significant voice in decision making.
• It will be very difficult to criticise this employee for risk of ruining the associateship, friendship and practice life.
• There might be an employee in the practice that is overpaid. A problem if you are going to be sharing the costs of that employee.
• They will have an employee with the other associate’s needs at top of mind.

If you are the dentist with the spouse in the practice, an issue like this will be uncomfortable for the other dentist to raise, but will definitely be weighing on their mind. As the dentist with the spouse, raising the issue yourself can definitely help bring their concerns out into the open. Tell the associate/potential associate dentist that you realise this will be a concern and that you want them to feel comfortable discussing it with you. Show that you have thought about the issue and want to make an effort to eliminate concerns they may have.

There are many ways to ease the mind of an associate/potential associate dentist if you do want to have a spouse working there. For example:

• Show that the spouse has a clear job description and boundaries and that they and the team are aware of this.
• If it is at all possible, structure it so that the spouse becomes dedicated staff for you alone, as it will be difficult to show that a spouse has both associates’ needs evenly balanced.
• Make sure you and your spouse recognise the potential negative impact the situation can have on your workmates/associates. Be vigilant in addressing situations as they arise rather than letting them get out of control.

‘Invisible’ dentist spouses
‘Invisible’ dentist spouses are spouses that don’t work in the dental practice on a regular basis. Before my father retired from dentistry my mother was an example of an invisible dentist spouse as even though she was on the books as an employee. I’m not sure she even knew where the practice was.

As an employer or as an associate it is easy to fall into the habit of ignoring dentist spouses that don’t work in the practice and pretending they don’t exist. However, while they may not be present at the practice they can still make a huge impact. Particularly in decision making in matters affecting:

• Finances - any large financial commitment from an associate or employee dentist will almost always need to be discussed and unanimously decided with the spouse.
• Lifestyle - issues like a dentist’s hours of work, whether to move for work, whether to stay at a practice/ in an area after move.

It is important to recognise that life changing decisions for the dentist impact on their spouses. Usually if an employee or associate dentist’s spouse feels unappreciated or doesn’t like you they can and often will white-ant the working relationship.

An issue like this will be uncomfortable for the dentist with the ‘invisible’ spouse to raise but will definitely be weighing on their mind. This time it will be up to the associate without the spouse to be proactive in order to avoid having a problem.

• Try to maintain a regular social relationship with your employee or associate dentist’s spouses.
• Acknowledge the impact that working hours or moving will be having on their lives whenever you do see them.
• Offer dentists the opportunity to have spouses present when discussing financial matters. (Whenever you see a television bank commercial the manager talking about a home loan is always sitting down and talking to the couple). Many will choose not to take you up on this but the offer is always appreciated.

As you can see dental spouses:- ‘Visible’ or ‘Invisible’ can be the best thing that happened to your practice or the worst. The determining factor is usually the amount of acknowledgement you give this potentially contentious situation through preparation, and communication.

[Published in Australasian Dental Practice , May/June 2006]