Referral Etiquette

By Kenn Howard
[A Question of Ethics]

Dear Kenn,

A friend and fellow therapist went on a two-week vacation. He referred his clients to me during the time he was away and several of them came to me for massage. One of them complimented me and made an appointment for a second massage the next week. When that massage was finished, he said, “I like your massage better than his. I’m going to start coming to you for massage. Don’t tell him.” Is it OK for me to take on this guy as a client?

—Ricci

 

Dear Ricci,

Unless it’s a surprise birthday party, “don’t tell him” can only mean that something unsavory is going on. It might be easy to miss that implication in light of such a compliment. Your client—someone who has sampled different massages—prefers yours. How nice!

However, the compliment from your client, or the competition with your colleague, is not what this is about. This is about honor. When your colleague chose you to be his substitute therapist, he was saying a number of positive things about you. He believes that you do good work, you will be conscientious in your approach, your work is worthy of his clients, and, above all, he has reason to trust you. Yes, he is referring clients to you, but there are strings attached; this is not a straightforward referral. He expects you to be a great therapist to his clients only for the time he is away. Unless stated otherwise, the assumption is that you are a substitute and you are only filling in temporarily.

Looking at it this way, Ricci, the answer to your question is clear. Even though a client has the right to choose his or her therapist, this arrangement is an exception. As a trusted colleague, you have the ethical obligation to be trustworthy to your colleague, the one who trusted you. That is to say, as easy as it may be to rationalize making this client yours, don’t steal this client. William Shakespeare said it this way: “Temptation is the fire that brings up the scum of the heart.” Don’t bring up any scum.

In saying no to this potential client—and you are ethically bound to say no to him—are you thereby depriving this paying customer of your services? Yes, you are. But part of your agreement to adhere to your profession’s code of ethics is that you agree to honor your profession, as well as your clients. This is one time when the honor of the profession trumps the needs or desires of the client.

Is this an ethical dead end? Is there no way you can gain this client without the ethics police, or your fellow therapist, angrily slapping on the cuffs? There are a number of therapists who would disagree with my opinion here. (This is the nature of ethical discussion.) But in reality, you do have an alternative.

Any alternative involving “don’t tell him” opens up the future to a terribly awkward and potentially hostile encounter, not just between your colleague and the client, but between your colleague and you. No matter the intentions, any secrecy here looks like underhanded, or even devious, behavior.

This alternative takes the shape of releasing you from your ethical obligation. You, or better yet, your potential client could approach your colleague and tell him straightforwardly, honestly, and tactfully, that he prefers your massage to his. This will likely be awkward, but doing the right thing is not always comfortable. Now, honor abounds and, hopefully, feelings are not hurt. If your colleague is a true professional, he will understand that his massage, while most excellent, isn’t for everyone.

  Kenn Howard is a massage therapist, NCBTMB-approved provider of ethics workshops, and instructor of ethics for the past 14 years. Contact him at kenn@panaceainstitute.com.