Dr. Joseph Sirven: How Doctors Feel About Thank-You Gifts

Published: Wednesday, July 10, 2019 - 8:16am
Updated: Wednesday, July 10, 2019 - 9:15am
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Dr. Joseph Sirven

A patient and his grandmother I had never met greeted me in the clinic with “I’m Grandma Tammy and I love you!” She continued, “I have read everything about you; I think you’re amazing.”

I turned red with embarrassment. The entire reason for the visit was to help her grandson regain his driver’s license after being seizure free. Fortunately, the patient would qualify to be able to drive. However, Grandma Tammy decided to leave nothing to chance. She brought out a large cooler filled with a buffet of food that could feed an army.

I said, “This is not necessary." To which I was met with, “Grandma Tammy will take care of everything!” and then she winked at me.

My Grandma Tammy encounter raised a big question for me. When can a doctor accept or refuse a gift from a patient? There are no clear statistics as to how often patients give gifts to physicians, but it’s very common. The U.S. government does have laws regarding gifts, which states that if a person giving you a gift is in the position to generate business for you or you have a financial relationship, you can’t accept it — end of discussion. But when it comes to patients, there’s no legal answer.

The American Medical Association has broad guidelines for doctors. Basically, a gift or the offer of one should never influence the patients’ medical care. Also, a physician should never accept a gift if there is reason to believe that accepting the gift would cause an emotional or financial hardship to the patient.

When I surveyed some of my colleagues on this topic, most of them asked me “What is the patient’s motivation?” Understanding that motive may make it easier to say, “no, thank you.” The AMA suggests a rule of thumb say is if a doctor feels embarrassed telling another colleague about the gift, then the doctor should refuse it. However, the AMA also suggests that if saying no to the patient’s gift harms the doctor-patient relationship, the doctor should accept the gift assuming it is not too big. A very ambiguous rule.

So, if you feel the need to thank your doctor personally, just saying so either in a card or verbally is the ultimate rush for any doctor. But if you insist on a gift, less is best! Because when it comes to gifting your doctor it really is the thought that counts.

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