The Case
The holiday season is here and I certainly enjoy receiving gifts as much as anyone. We have been either educated about declining—or forbidden to receive—gifts from pharmaceutical companies, but these are not the only source of gifts. A few years ago, I discovered a private physical therapist was located only a few blocks from my office.
He did an excellent job, and as a result I sent him many patients. The first year he sent a rather extravagant gift, which I accepted. After a few weeks, I realized that the gift was a problem. When I referred patients, I would ask myself whether it was to receive another gift, or if the gift just made me feel good about the physical therapist.
I sent a thank-you note requesting no more gifts. The next year he sent a more modest gift and I am tempted to accept again (he really did give something I liked). Should I return the gift and risk offending a physical therapist who has taken excellent care of my patients, or should I keep the gift and reiterate my request to not receive additional gifts?
I love receiving notes from patients, but a gift poses a problem. Many of us are working harder for less money and feel underappreciated. How do you handle gifts? Is there a difference in someone baking you cookies or giving an expensive gift?
I know some patients feel grateful and want to give a little extra. What is your personal policy about accepting gifts?
Tell us how you would address these ethical dilemmas by e-mailing dantoline@wiley.com. We will publish some of responses in a future “Ethics Forum.”
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Dr. Meltzer is assistant professor of medicine at Thomas Jefferson University in Philadelphia. Dr. MacKenzie is associate professor of clinical medicine and public health at Weill Cornell Medical College, Hospital for Special Surgery in New York. Dr. Kitsis is director of bioethics education and a member of the rheumatology division at Albert Einstein College Medicine in the Bronx, N.Y.