Family Ties

Throughout its history, Chiropractic has had a reputation as a family profession. Founder D.D. Palmer practiced with his son B.J., and generations of Palmers soon followed. Especially for those who grow up in chiropractic families, entering into the family business is natural, or even expected—in practices all over the country, wives work with their husbands and children work with their parents.For some DCs, working in the family business can be a sustainable way to practice, but for others, striking a balance between healthy familial relationships and professional boundaries can be overwhelming. Three DCs who have familyworked with their families share their experiences on managing conflict, finding your niche and formulating an exit strategy.

The Family Business

Whether it’s a parent, grandparent, aunt or uncle, many DCs follow in their family’s footsteps when it comes to choosing a career in Chiropractic. “I can remember filing cards at the end of the night and listening to my father or mother giving the new patient orientation,” recalls Denise Rassel, D.C., who co-owns Rassel-Daigneault Family Chiropractic in Lansing, Mich., with her husband. “I am from a family of more than 25 chiropractors by marriage and generations. I have two sisters who are also chiropractors.” Rassel started working in her family’s office at age 11. At age 20, she married and left Chiropractic to pursue a career as a manicurist. After her first marriage ended, Rassel worked her way back to Chiropractic and the family practice. She graduated from Life University, where she met her husband. “We were given an employment offer we could not refuse by my mother, Dr. Linda Rassel,” she explains.

Like Rassel, Kreg Huffer, D.C., owner of Huffer Chiropractic in Jackson Center, Ohio, grew up surrounded by chiropractors. “I knew early on I wanted to be a DC, because I’d seen my father help so many people throughout the years,” explains Huffer. After his graduation from Palmer College of Chiropractic, Huffer went into practice with his father, who had owned his own practice for 13 years. A couple of years later, Huffer’s brother joined. When their father passed away at age 96, the brothers took over the practice.

For Jackie Legault Valcourt, D.C., and her brother Marcel Legault, D.C., their path to Chiropractic seems to have been preordained. Their mother and father practiced together at Legault Chiropractic Health Center in Hollywood, Fla., until their father retired. “Chiropractic was the only thing we knew,” says Legault. “It was a normal transition.” Legault Valcourt agrees, noting that she went straight to the family practice after her graduation from Palmer. “When you get out of school, you’re broke. With your family, you know they’re going to work with you, and you have a place to stay,” she says with a laugh.

Building a Foundation

No matter what the relationship between practice members, the key to any successful practice comes down to communication. “I tell my associates and my kids, it comes down to two simple letters: C and A, communication and appreciation,” explains Huffer. “Communicate clearly what your desires are and what you want to accomplish, and if you’re open and honest, people will want to help you.” Especially in a family-based practice, it is important to not take your relationships with people for granted, since you are all working together toward a common goal.

In addition to communication, respect is another important aspect of maintaining a successful practice. For families, that can mean not blurring personal and professional boundaries, even on simple things like how you address one another. “When we were kids and we called the office, we asked for ‘Dr. Virginia,’” explains Legault. “Outside of the office, it was ‘Mom.’” His sister notes that their practice operates by a set of rules that is understood by all staff members. For example, arguing in the office is against the rules. “We kept the respect,” she says. Legault also notes that, when it comes to the level of necessary communication, working with one’s family is similar to being married. “You have to get everything out in the open,” he says.

As someone who has worked with her mother, husband, three children and a niece, Rassel understands the need for respect. Especially in the case of children working for their parents, there may be an expectation that the rules will not apply, however, it is important that this not be the case. “I have to say, they were truly hard workers and my best employees,” Rassel says of her children. “I basically rode them hard, did not accept excuses and expected them to do every task in the office. I would recommend clear expectations … and do not give them an inch. In fact, expect more.” As a child who worked for her parents, Legault Valcourt says that it is especially important that children respect the history of the practice and not try to change the way it is structured. “I bent and broke some of the rules,” she says. “But after fighting, I came to realize that the way they had their practice was smart … why should I try to change it?”

Delegate, Delegate

One way to avoid unnecessary conflict when working with one’s family is to establish clear roles and expectations for those roles. Huffer’s advice for people in a family practice is to recognize and acknowledge each member’s strengths and weaknesses and delegate tasks accordingly. “Because I had been in practice longer, I was married with a family, there were certain aspects of my life that put me out front to be that natural leader,” he says. “I stepped into those roles even before my brother was in the practice.” When his brother did come on board, Huffer made sure that they communicated about their respective roles. That level of communication is important even outside of family practices. In his current practice, Huffer works with a husband and wife, and he has had the same conversation with them that he had with his brother. “You have to establish certain standards and acceptable behavior in the office,” he says.

Rassel’s experience working with her mother demonstrates the importance of negotiating roles at the outset of a family partnership. She and her husband came into her mother’s practice during what they thought would be a transitional period prior to her mother’s retirement. “Although she had good intentions for us to learn and take over the business, Mom soon realized she did not want to retire and things got challenging real fast!” says Rassel. “It’s comical now, but at the time it really strained our relationship and [caused us to] move on shortly after starting there.” After they left her mother’s practice, Rassel and her husband worked out of her father’s practice.

Eventually, Rassel set up shop with her husband and encountered some of the same issues that she had with her mother. “We had struggles because of not having clear-cut ‘hats’ with clear-cut responsibilities for those roles,” she says. As an example, even though Rassel was considered the go-to person for staffing concerns, practice members continued asking her husband when they needed time off or had to leave early. “This led to resentment and arguments and hurt our relationship,” she says. As a solution, Rassel and Daigneault put together an organizational chart that detailed everything from their titles to their day-to-day responsibilities. As vice president, director of office operations, office manager and marketing manager, Rassel knows she is responsible for the front desk and back office, among other jobs. When issues do arise, Rassel and Daigneault have a meeting in neutral territory, if possible, or behind closed doors in the office.

At Legault Chiropractic, the family easily fell into their niches. Legault is the IT guy, and his sister describes herself as the employee manager, while their mother takes care of the financials. The benefit of clarifying roles also extends to other, non-family practice members. “I realized it was an issue for the associates to have four bosses,” says Legault Valcourt. Rassel notes that it is also important to not be disrespectful to one another in front of other employees.

How to Get Out

While there are plenty of tangible and intangible benefits to working side by side with family members, it may not work for everyone. Learning how to recognize that a business arrangement is not working, and extricating yourself from that situation without damaging relationships is vital. For Huffer, that involved several conversations with his brother. “After a few years, it became evident that we had different management styles,” he explains. “We came to an agreement on who would buy whom out. It was a learning process for both of us.” With the benefit of hindsight, Huffer recommends creating this agreement ahead of time. “Recognize that no relationship is going to last forever,” he says. “Start from the end and pre-arrange a buyout.” Huffer says he was doing two thirds of the work, yet his brother owned half the business, so that played into their negotiations. His advice is for people to discuss things they think may never happen and put everything in writing. In the end, everything worked out for Huffer and his brother. Huffer now runs his own practice with two associates, and his brother moved to a new town and is doing well in his own practice.

Rassel’s experience taught her the importance of transition planning, especially in the case of a family member’s retirement. “If you are retiring and your child is taking over, let them,” she says. “Meaning, give them encouragement, have a transition period of no less than two months where you observe and comment in front of the patient that your child did a great job, great adjustment and that you have full confidence that they will take good care of that particular patient.” Her father implemented a clear plan for himself when he retired, and Rassel notes that three years after his retirement, 30 percent of his patients are still her patients. Her mother, on the other hand, is nearly 70 and still works six days per week.

For many DCs, the built-in trust that comes with working with family members is enough to sustain a practice. After all, as Huffer notes, “[That trust] extends into patient care as well. Patients trust they can depend on that family heritage.” But for others, the closeness can impede patient care, especially when different methodologies and techniques conflict. In those cases, it is better to reach a mutually agreeable exit strategy in order to preserve the most important relationships in your life: those with your family.