I refer many of my patients to specialists. I consider them my partners in practice, people who bring more to my patients than I can offer. They’re tools every veterinarian needs to learn how to wield wisely on their patients’ behalf. 

But sometimes, they’re our spouses, friends, and lovers, too. Which can sometimes raise eyebrows, along with some very obvious ethical concerns. 

After all, there’s a reason for the “no kickback” rules that govern how we work with specialists. We’re not to be remunerated by specialists because this kind of relationship means we might be sending you to someone because we know they’ll pay us...not because they’re the very best for your pet. Same goes for nepotism and cronyism. 

Sure, these rules aren’t exactly hard and fast ones. For example, it’s OK for you to hire a veterinarian to come to your practice and perform surgery or ultrasounds––because keeping your patients “in house” means you’ll earn more. And that’s unethical when you know your patients will receive better care––often for less money––when you refer them to a full-service specialty facility. 

But it’s not necessarily unethical. Not if you believe that it’s what’s best for your clients and patients. And it’s certainly not illegal.

Same goes for referring patients to your spouse or love interest. It’s not illegal, but it’s ethically fraught, to be sure. And that’s why I often find myself in a pickle: 

How can my clients trust that I’m sending them to the best surgeon in town for their pet’s specific needs?...when that surgeon happens to be my long-time boyfriend. 

Tough one, right? 

Though I confront this problem at least once a week, I typically know my clients well enough that they trust in me anyway. Whether I disclose the relationship or not, it’s a foregone conclusion (at least in my mind) that I’m doing my best for my patients by sending them to the best surgeon I know. 

After all, I’d been referring to this surgeon––exclusively––for two years before I ever met him in person. His results, my clients’ universal satisfaction with his work, and his responsiveness with written reports and telephone feedback gave him a leg up on every other surgeon I’d ever worked with...then or since. 

Which is why I asked him out more than five years ago after a friendly client suggested I’d be stupid not to. Sight unseen, I made the call. You can guess the rest. 

But yesterday’s new client raised the issue for me more acutely. They had no reason to trust me. They had no reason to believe me when I recommended they see the surgeon of my choice (for their lame dog with no clear site of pain or injury). 

So I disclosed the relationship and explained why I thought they should still consider him tops. They smiled...and told me their previous veterinarian had already recommended him. :-)