It's almost the best time of the year... Christmas! It's not unusual for patients to bring in gifts, such as chocolates, or a bottle of wine. But, can we accept these gifts? Where do we draw the line?
Consider the following scenarios:*
Most gifts are innocent gestures of goodwill, and patients don't give these expecting preferential treatment or something in return. However, beware the patients who may have other motives - some may think their gift entitles them to additional services, you squeezing them in during your lunch break or bending the rules just for them. If you accept their gift, you might find it difficult to refuse their demands and requests. If you reject a gift, remain tactful as otherwise the patient may interpret this wrongly and be hurt by the gesture. You could explain the rejection in terms of a general policy and/or ethical obligation, for example "I really appreciate the gesture, however our office policy doesn't allow me to accept such a gift.“
- Margaret is a long-term patient of yours that you see monthly for epilations. Just prior to Christmas she gives you a large box of chocolates and a card thanking you and the staff for your care.
- Ben is a new patient of yours and he comes in on a Thursday night with a very expensive bottle of wine and two Gold Class Event tickets, to thank you for the detailed eye assessment.
- John was a long term patient of yours and you were co-managing his glaucoma. Sadly he passed away, and his wife comes in and gives you $2000 in cash as a token of her gratitude.
Realistically accepting small gifts is reasonable, however monetary, large gifts or personal items might be considered unethical. Of note, the Medical Board in Good Medical Practice: A Code of Conduct for Doctors in Australia writes:
Doctors must be honest and transparent in financial arrangements with patients. Good medical practice involves… not encouraging patients to give, lend or bequeath money or gifts that will benefit you directly or indirectly.
So what happened in the scenarios?
- You thanked Margaret for the chocolates and shared them with the office.
- You thanked Ben for the gesture, however politely declined this. You felt uncomfortable with the gesture and after discussing this with another optometrist at the practice, they offered to take over the care for Ben.
- You told John's wife you were sorry for her loss, but could not accept the monetary gift. She decided to donate the $2000 to Glaucoma Australia instead.
Here's a great article from MDA National if you want to read more.