By Scott E. Palmer, V.M.D., Dipl. A.B.V.P., Eq. Practice

Chairman, AAEP Racing Committee

The unique and highly competitive environment of the racetrack presents a number of ethical challenges for the equine practitioner.  The ethical practitioner strives to make good decisions every day to provide for the health and welfare of horses in his or her care.  The ethical practitioner takes personal responsibility for his or her actions and is willing to be held accountable for the outcome of his or her decisions.  The criteria for all of our professional decisions should be whether our actions will be the best decision for the horse.

As veterinarians, we also have an obligation to uphold the dignity of the veterinary profession and adhere to the “Principles of Veterinary Medical Ethics,” the basis of which is the Golden Rule: “Do onto others as you would have them do onto you.”  We are obligated to obey all laws of the jurisdictions in which we practice.  In the racing environment, the equine practitioner is further obligated to comply with rules and regulations that are unique to multiple jurisdictions in which their patients may compete.

The veterinarian-client-patient relationship (VCPR) is the basis for interaction among veterinarians, clients and their patients.   In a racing environment this relationship becomes extremely complicated.   Owners hire a trainer to care for their horse and prepare it for racing.  Trainers hire veterinarians to help them provide preventive health care, treat injury and disease and to enable their horses to compete to the best of their ability.  While the veterinarian and trainer are in regular contact, all too often the owner and veterinarian do not communicate directly with each other.  In some cases, the trainer may actually insist that the veterinarian communicate only with him or her.  This lack of transparency often leads to misunderstanding, failure to meet expectations and conflict.  When racing syndicates are involved, a racing manager may assume the role of communicator.  This adds still another layer to the relationship and further insulates owners from interaction with individuals responsible for the daily care of the racehorse.

Choices of treatment of racehorses should be determined by the needs of the horse, the welfare of the client and the safety of the public.  Attending veterinarians are responsible for choosing the treatment regimens for their patients.  However, the reality of the racetrack environment is that the trainer is often the director of medical care for the horses in his or her stable.    In many cases the trainer employs multiple veterinarians in the stable (who typically do not communicate with each other).  In some situations, the trainer actually administers treatments without veterinary input or supervision.

According to the AVMA Principles of Veterinary Medical Ethics, when a VCPR exists, veterinarians must maintain medical records.  These records must comply with state and federal law and they are the property of the practice owner.  This information is considered privileged and confidential and must not be released except by court order or consent of the owner of the horse.  At the racetrack, monthly billing statements often define the medical record.  These statements usually do not include examination findings and patient assessment information, which ae ordinarily part of a valid medical record.  When multiple veterinarians are treating the same horse, the medical record is, of course, incomplete at best.

In some respects, the traditional culture of equine practice is in conflict with current reform efforts within the racing industry.  Equine practitioners have the opportunity to help direct this change for the better of our profession and the horse.  Open and transparent communication between owners, trainers and veterinarians is a worthy objective for all parties involved.  The creation of a convenient, yet comprehensive medical record is another goal for ethical practitioners to accomplish.  Equine practitioners must work hand-in-hand with regulatory agencies to create ethical medication policies that protect the safety and welfare of the horse and the integrity of the industry.

The AAEP Racing Committee recently drafted “Clinical Guidelines for Veterinarians Practicing in a Pari-mutuel Racing Environment.”  This document is designed to support ethical practitioners to make good decisions while practicing in a challenging and competitive environment.  In unequivocal terms, it addresses the use of medication as well as adjunctive and integrative therapies at the racetrack and training center.  It makes recommendations for changes in the veterinary business model and the owner-trainer-veterinary relationship that promote transparency and integrity.  This document sets a direction for ethical racing reform and serves as a model for practitioners working in other performance horse environments.

In the next few months, the AAEP Racing Committee will conduct a series of facilitated focus group discussions with Thoroughbred, Standardbred and Quarter Horse owners, trainers and veterinarians in a proactive effort to advocate for transparency and improved communication in the owner-trainer-veterinarian relationship.

The ethical challenges for equine practitioners in a pari-mutuel environment are many and include our own veterinary business model.  Our guiding principles include ethical practice as well as transparency and integrity in our relationships.  These principles are good for the equine practitioner, the trainer, the owner and the horse.  It is appropriate for all equine practitioners to conduct an “ethical audit” of our practices in order to see how we can do better to meet these ethical challenges.