The Good and the Bad of Hiring a Nanny for a Doctor’s Household
Apr 21, 2025📝 This Week’s Real-Life Lesson:
The Good and the Bad of Hiring a Nanny for a Doctor’s Household
There was a season in my life—more than two decades ago—when I was living the perfect storm. I was a full-time rural family physician, still reeling from the grief of becoming a widower, and trying to raise two beautiful children under the age of four.
Faced with the demands of clinic hours, hospital rounds, and never-ending charts, I made the decision not to hire a nanny. Instead, I leaned into the love of my parents, who graciously stepped in to help raise my kids.
At the time, it felt like the best decision. My parents were devoted, trustworthy, and always available. But in retrospect, I now realize that what seemed like a practical, loving arrangement ended up causing long-term emotional and relational challenges.
Let’s explore the good, the bad, and the practical truths of hiring a nanny—especially as a doctor navigating the daily tightrope walk of career and family.
✅ The Good: Why Hiring a Nanny Could Be the Best Decision You Make
1. You Buy Back Time
As a physician, your most precious commodity is time. A nanny gives you the gift of time—not just for work, but for yourself. Whether that’s charting uninterrupted, making it to your kid’s play, or grabbing an extra hour of sleep, the return on investment can be enormous.
🔗 Want to start buying back more of your time? Download our free e-book: Every Doctor is a Business: 7 Business Hacks for Modern Physicians
2. Customized Childcare
A nanny can tailor care around your unique needs and schedule, including early mornings, evening shifts, or weekends. They can integrate into your routines, support your parenting values, and offer consistent presence during developmental years.
3. Burnout Prevention
Hiring a nanny can be a thoughtful and proactive decision that serves as a crucial step toward preventing burnout. In today's fast-paced world, where balancing work commitments and personal responsibilities can feel overwhelming, enlisting the help of a nanny provides an emotional safety net. This support system ensures that the demands of home life do not become an additional source of stress, potentially undermining your mental health or affecting your professional performance. By taking on tasks such as child care, meal preparation, and even light household duties, a nanny allows you the space to recharge emotionally and mentally. This respite from daily pressures can lead to more quality time with your loved ones when you are at home, fostering stronger family bonds. Moreover, knowing that your children are in capable hands while you're at work provides peace of mind that allows you to focus more intently on professional tasks without distraction or guilt. This support not only safeguards your well-being but also enhances your ability to thrive both at home and in the workplace. Ultimately, hiring a nanny is about creating a balanced environment where personal fulfillment and career success coexist harmoniously..
Read More In my PEA E-Book: Healing the Healers: Overcoming Physician Burnout
⚠️ The Bad: What I Learned the Hard Way
1. Family as Nanny = Blurred Boundaries
In my case, asking my parents to fill the nanny role created confusion about who was ultimately parenting my children. Over time, this blurred role made it harder to transition as my life evolved. Years later, when I remarried, it led to complex emotional entanglements that strained relationships and delayed healthy family integration.
2. Long-Term Attachment Ripple Effects
What began as a temporary solution evolved into a deeply rooted attachment dynamic. My kids adored their grandparents—but that bond sometimes created tension with their stepmother and made it difficult for my parents to “let go” of their surrogate parenting role.
3. Emotional Dependency Can Undermine Autonomy
Though unintentional, my reliance on family care prolonged dependency patterns that might not have emerged with a professional nanny. And it reinforced the idea that I couldn’t manage both parenting and profession without family sacrifice.
🧾 “Is This Deductible?”
📷 Is This Deductible? Yes, hiring a nanny can qualify for tax benefits—if structured correctly.
🧠 Learn how to maximize childcare tax credits and deductions:
- 🔗 Nannies for Doctors: Your Guide to Smart Childcare and Financial Savings
- 🎓 PEA Builder Membership includes tools to track and optimize these expenses.
💼 The Tax and Business Side of Hiring a Nanny
1. You Are a Household Employer
Once you hire a nanny, the IRS sees you as an employer. You’ll need to:
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Get an Employer Identification Number (EIN)
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Withhold Social Security, Medicare, and unemployment taxes
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File Schedule H and possibly Form 941
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The $2,800 Rule (2025): If you pay your nanny less than $2,800 annually, you’re not required to pay employment taxes or file additional paperwork. However, if you exceed $1,000 in wages in any quarter, you’ll need to comply with IRS rules for household employees.
You may not be running a business with your nanny, but you are running payroll.
2. Use a Payroll Service
Services like SurePayroll or Poppins Payroll or HomePay (by Care.com)can take this off your plate for around $50/month.
🔍 Want more help with payroll, expenses, and deduction strategy?
Explore our The Ultimate List of Business Deductions For Professional Micro-Corporations.
3. Explore FSAs and Childcare Tax Credits
Even though high earners phase out of some tax credits, you may still qualify for:
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Dependent Care FSA: Up to $5,000 of pre-tax funds per year
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Child and Dependent Care Credit: May offset a portion of your nanny’s wages
But remember, these are not deductible like business expenses. You can’t write off your nanny as a “medical staff expense” unless they’re caring for a disabled dependent or structured through a compliant business arrangement.
👩👧 Case Study: Dr. J’s Nanny Made Her Practice Thrive
Dr. J, a PEA member and telehealth internist, shared how hiring a full-time nanny for her two young children completely changed her professional and personal trajectory. After burnout nearly pushed her to quit medicine, she restructured her work around micro-business principles—including outsourcing childcare.
She now practices 3 days per week, runs her own cash-only virtual weight loss clinic, and says hiring a nanny “literally gave me back my identity as a mother and doctor.”
🛠 Ready to build your own ideal micro-practice like Dr. J?
Take the PEA Medical Side Job Matchmaker Assessment to discover your best-fit side job.
🧘♂️ A Word of Encouragement
Looking back, I wish I had allowed myself to embrace a professional caregiving solution sooner. My parents’ love was unconditional—but our roles were too complex to stay healthy long-term. Hiring a nanny might have given me more emotional and relational margin—not just for myself, but for the family I would one day rebuild.
So if you’re weighing this decision, know this: you’re not selfish. You’re being strategic. Choosing a nanny doesn’t mean you’re outsourcing love—it means you’re protecting it.
📬 Join the Movement
Thousands of clinicians are breaking free through micro-business ownership. Ready to join them?
