My doctor and spouse have met once. My spouse can call my doctor if there's an emergency; yet, has never had reason to call. My doctor can listen to my spouse; yet, cannot break confidentiality by disclosing to my spouse.
My spouse trusts me to handle my life. If my spouse has concerns, we talk. if my spouse feels I need to call/see my pdoc, he tells me and I keep my spouse in the loop.
My spouse also sees a pdoc. We have an understanding and keep one another in the loop, while also giving one another lots of space to honor confidentiality.

WC