It is common for doctors to be showered with a small token of appreciation from grateful patients but extravagant gifts or a large sum of money may come with strings attached apart from having serious moral and ethical implications in medical practice. The value of the gift is an important factor that should be taken into consideration.
HOW THIS SITUATION OCCURS?
Patient care is part of the physician’s job for which they get paid. Even so, patients often feel the need to express their gratitude in the form of gifts.
Patients may also want to date doctors, it is common that doctor and patient relationships to work well in our society.
On the other hand, patients may use gifts as a means to gain doctors’ attention or manipulate their doctors into providing preferential treatment. The exchange of gifts is acceptable culturally but coming from patients may raise some concerns. It also becomes difficult to differentiate between a simple respectable gesture and underlying vested interests.
PROS
With smaller tokens of appreciation, refusing it may cause embarrassment that could unnecessarily harm the relationship between a doctor and a patient. When accepting a gift, physicians should make it very clear to the patient that their standard of care will be the same with or without the gift. Doctors can accept the gift on the behalf of the care team such as the staff of the hospital. Rules regarding accepting gifts from patients may vary, but the most important factor to consider is how acceptance or refusal of the gift will affect the doctor-patient relationship? In some cultures, it is mandatory to gift the physicians as a gesture of gratitude. In such cases, refusal might hurt the sentiments of the patient.
CONS
Small gifts of thoughtfulness may be appropriate but if gifts are significant it could prove to be an issue. Doctors should never accept a gift if there is any risk that it may influence their professional decision-making. A gift arriving out of the blue should be treated with special caution as the doctor has done nothing to deserve it. Extravagant gifts like a huge sum of money can lead to doctors behaving differently toward patients who have given it. If a doctor becomes more of a friend to a patient because of some gift, the doctor-patient relationship is compromised by the possibility of a critical judgment being sacrificed. Personal gifts like jewelry or money should always alert the doctor.
WHAT KIND OF GIFTS A DOCTOR CAN ACCEPT
A small gift to a physician as a token of appreciation is not ethically problematic. However, it will be more appropriate to request the patients for prayers as a token of gratitude or they can accept a handwritten letter of thanks. If the gift is in the form of money, suggest your patient give it as a donation to the charity.
The refusal of a gift should include an appreciation to the patient for the gesture. The physician should choose words and a tone of voice that convey that the refusal is in the best interest of the patient-physician relationship.