Newswise — Running successful family-owned businesses can be tricky. There’s usually a strong-willed founder who keeps tight control of the business, and there are often succession issues: Who in the family is able and willing to take over when the founder retires?

You can see that on TV—think of the popular show Succession—and in real life, especially now in New England, where conflict in the family that owns large and successful grocery chain Market Basket is now back on the front pages.

Market Basket made national news in 2014, when conflict between two feuding cousins—sons of the co-founders—led the board of directors who favored Arthur S. Demoulas to fire CEO Arthur T. Demoulas. The move brought the popular chain to its feet, as employees and customers loyal to Arthur T. boycotted the stores. Arthur T. and his allies—three of his sisters—eventually bought out Arthur S. and other family members, and the company continued to grow, with annual sales now topping $7 billion.

But last month, the company board, allied with the sisters, put CEO Arthur T. Demoulas on leave, accusing him and company management of ignoring the board’s directives and questions concerning succession issues.

“There are traps that happen with family businesses that cause them to derail, and I think Market Basket fell into one of those traps,” says Frank Apeseche, a professor of the practice at the Gordon Institute at Tufts. He teaches business strategy, finance, and enterprise management, and knows about family-owned businesses from his roles as an unrelated insider—he was brought in to be CEO of the family-owned Berkshire Group for a dozen years, and is currently chair of another family-owned organization.

“Most of the time, conflict deals with skillsets—family members not having the right skills for the job,” he says. “I think Market Basket has the right skillset, but they don’t have good governance.”

Traditionally, the founder of a large, successful family-owned business “is a patriarch, or less frequently matriarch, who is really good at starting something up, is super creative, usually extraordinarily charismatic—very, very powerful,” Apeseche says. “But it takes a different personality to scale it up. Often founders just assume that their children can do what they do—and it’s highly unlikely that anyone can do what they do.”

Smart founders, he adds, “are thinking ahead and are really interested in succession planning, usually bringing in outside experts who have experience to help set up an infrastructure and then probably be part of that infrastructure.”

It’s About Good Governance—and Personality

Typical family business challenges center on the skillsets and mindsets—can they do the work? do they have the drive to do it?—of the second or third generation, says Apeseche. “Do they want to work the 80 hours a week, go through the grind, have to deal with a multitude of balls in the air, and be extraordinarily diplomatic?”

Successors also have to deal with the founder. “That’s the extra challenge, because most of the time, a very powerful, very controlling patriarch or matriarch keeps challenging them and doesn’t give them enough space to grow,” he says.

A way to avoid family disputes is through good corporate governance, Apeseche says. That means having a board of directors for the business, usually with outside directors and a clear division of roles. “In the case of Market Basket, governance was apparently never really agreed upon,” he says.

Arthur T. Demoulas, who was first appointed CEO in 2008, “is talented, knows the operations, and successfully grew the business. He probably was saying to himself that he was doing all the work, and deserved to take control,” Apeseche says. “But governance was not set up, not agreed on—and there are certainly other family businesses just like that.”

Apeseche says that well-run family-owned businesses rest on what he calls four pillars of success. Family members running the business “need the skillset to do the work, the mindset to be fully engaged in the demands of the work, a personal agenda that conforms to the mission of the business, and the political dexterity to deal with people inside and outside of the company,” he says.

“I think with Market Basket, first the personal agendas are off—the individuals are not putting the business interest first. Second, the political dexterity is missing,” he says.

“When I was the CEO of a family-owned business, I think my special talent was that I had good political dexterity,” he says. “I could read the room, I could understand all the family members, I could pick up what they weren’t talking about, but what they were very much feeling. And I was good at managing multiple stakeholders simultaneously while keeping the business moving forward. But that’s not a skill everyone has.”

Some family businesses bring in outsiders like Apeseche to run things, and some founders hire outsiders to help mentor their children to become successors. One way to do that, he says, is to bring children into the business, but not start them at the top.

“Bring them in at a role that they can be successful at,” he says. “This is what founder Ned Johnson did with current CEO Abigail Johnson at Fidelity Investments—brought her into a number of different roles to learn more of the business and then slowly elevated her.”

Market Basket isn’t alone in its troubles, Apeseche says. Governance is generally difficult with family-owned businesses. Even having an agreed upon business governance and succession plan doesn’t always work.

“The planning is super complicated, and then when you actually have to implement it, it’s all about relinquishing appropriate control at the right time,” he says. “Many times I faced patriarchs who basically said, no, I won’t do that. All of a sudden behind the scenes, they had changed their minds.”

Getting a family-owned business to work well “is hard,” he says. “It’s really hard.”

https://now.tufts.edu/2025/06/06/succession-battles-are-not-just-tv-trope

While the tests can make it easier for people to access health care and can be helpful for those who have extreme anxiety about sensitive or invasive medical exams, experts warn that most of the tests cannot replace an actual in-person visit.

You can now do self-administered tests for everything from thyroid function to HIV in the privacy of your own home — and that list continues to grow, as the Food and Drug Administration recently approved the first at-home cervical cancer test.

The doctor is in — the mailbox, that is.

Here’s what doctors say you can test for at home, and when you should make the trek to your physician’s office.

What kinds of at-home tests are available?

There are two kinds at “at-home tests.”

In one type, the patient collects the sample and sends it off to a lab; the new cervical cancer test is like this.

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The other gives an instant result — think COVID-19 and pregnancy tests.

What are the benefits of at-home tests?

HIV home-testing kits can improve rates of diagnosing sexually transmitted infections in rural communities and help people who are nervous about going to the doctor to seek a sensitive test, said Dr. Joseph Cherabie, an infectious diseases specialist in St. Louis.

“You really want to get people to care as quickly as possible, but some people could be very anxious about that results as well,” Cherabie said. ”And they have very negative reactions.”

Labs are required to report a positive HIV test, instead of putting the onus on the patient who took the test, Cherabie said, and and, often, the patient is matched up with HIV support services.

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“If you are part of a sexual and gender minority community, going to a doctor’s office can be full of a lot of historical trauma, and you may prefer to just do testing at home without anyone judging you or asking you invasive questions about your sex life,” Cherabie said.

The new cervical cancer test — which tests for strains of human papillomavirus, or HPV — involves a testing swab that’s like a tampon, said Dr. Susan Modesitt, a gynecologic oncologist at Emory University in Atlanta.

It is not, Modesitt said, a replacement for a Pap smear, the exam in which a metal speculum is inserted in the vagina to scrape cervix cells. A doctor’s visit also involves a pelvic exam, a chance to talk about abnormal bleeding — a sign of endometrial cancer — and other symptoms and issues, like menopause or STIs.

“There are so many other reasons to see your doctor and get an exam outside of a cervical cancer screening,” she said.

This photo provided by Teal Health in May 2025 shows the company’s Teal Wand self-collection device for at-home cervical cancer screening. Nicole Morrison/Associated Press

I live in a rural area — can I take an at-home test?

Some at-home tests can replace a trip to the doctor’s office. That’s especially true in rural areas, where it can be difficult to get a colonoscopy.

“The colonoscopy requires a pre-op, and you have to drive maybe 70 miles for it,” said Dr. Steven Furr, board chair of the American Academy of Family Physicians who practices in rural Alabama. “You get anesthesia. It’s actually almost like a surgical procedure in many ways.

“So, for a lot of people, that’s pretty arduous. That’s where an at-home test can come in handy.”

But, Furr said, if your test reveals issues, you need to go to your doctor. Plus, patients should always discuss test results with their physician instead of interpreting them on their own, he said.

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Who shouldn’t do at-home tests?

If you have symptoms of what you’re testing for, go to the doctor.

At-home colon cancer tests aren’t the right option for people with a history of colon cancer or high-risk conditions, such as inflammatory bowel disease, said Dr. Zachariah Foda, a gastroenterologist at Johns Hopkins. He added that they’re also not recommended for people who are having GI symptoms.

While there are tests for many things — running anywhere from $15 to $400, depending on what is being evaluated — Furr said it’s essential to make sure that your test is FDA-approved so you can better trust the results.

“Anytime we get people involved in their own health care and help them understand what’s going on, I think that’s a good thing and it gives us a chance to talk,” he said. “Any kind of screening is better than no screening.”