Dear Dr. Rosenberg: Is this veterinarian getting a kickback?
A reader considers the moral implications of an out-of-state veterinarian collecting commission on local cattle producers' distributor purchases-and turns to our ethics expert for an answer.
QUESTION: There's a veterinarian in a state more than 1,000 miles away from me who has signed up many local cattle producers for what is called the "Veterinary Advantage Program." This allows a producer to purchase any products other than perscriptions directly from the distributor.
Both the producers and veterinarian must sign a form that confirms the veterinarian has a state license (it does not specify which state) and asks the producers how long they have had a "relationship" with the veterinarian.
This particular veterinarian doesn't have a license in the state where the producers live and has never even set foot on their farms, but he makes a small commission on their orders. Technically no laws are being disobeyed, but what about the ethics of this type of activity?
I know how I feel about it. I feel it is unethical and morally wrong. The veterinarian does not and cannot help these producers make the best decisions in purchasing preventive healthcare products for their herds.
As I was looking over the form, it appears that it was meant for dairy, feedyard and other consulting veterinarians who make regular visits to the businesses so that they can guide the veterinary healthcare decisions in these operations. I believe that the original intent of this program is being abused.
I have to agree that your instincts are correct. It always gives me reason for concern when a veterinarian is making a commission on the indirect sale of pharmaceutical products. The word "kickback" may be harsh, but how else can you describe a fee paid to a veterinary healthcare professional who simply puts a drug distributor together with a cattle producer and has no legitimate veterinary-client relationship with the cattle producer and the needs of the herd?
I agree that it sounds like the intent of the program is to facilitate the cattle producer's pharmaceutical purchases with veterinary guidance based on herd health needs. Unfortunately greed can often taint a well-intentioned program. "Immoral" may be too strong a condemnation, but "unethical" does fit the bill.
Any veterinarian who has practiced for a period of time has encountered colleagues who flirt with unethical and unprofessional behavior. One can only hope there are enough veterinary professionals who recognize ethical practice parameters, honor the profession and allow pet and livestock owners to fully trust their veterinarians' recommendations.
From time to time, Dr. Marc Rosenberg, who writes the dvm360 ethics column "The Dilemma," answers reader questions. Do you have a question you'd like Dr. Rosenberg to address? Send it to email@example.com.