Is it ever OK to accept gifts from patients? Medicolegal expert weighs in

Medicolegal

By Geir O'Rourke

17 Feb 2023

Receiving gifts from grateful patients may be one of the perks of practising medicine, but it can land doctors in hot water, specialists are being advised.

The issue has been raised by lawyers at Avant, who say they have advised a number of doctors in recent years who have been reported to regulators for taking money and other gifts from patients or family members.

They point to a recent case involving a GP who was investigated by the NSW Health Care Complaints Commission (link here) over an alleged breach of professional boundaries with an elderly patient who occasionally gifted him wine after their consultations.

Initially given at Christmas time and on the GP’s birthday, the gifts of wine became more frequent, adding up to two bottles about three or four times a year.

On one occasion, the patient gave the GP a meal voucher to celebrate his wife’s improved health and the fact he had received an unconditional driver’s licence, Avant said.

Another time, the patient offered the GP $1,000 in cash, which the GP said was refused.

When the case came before the Professional Standards Committee, the commission argued that while some level of gift giving would not breach the law, the gifts of wine and the voucher were too much, too often.

The GP was also accused of breaching the Medical Board of Australia’s code of conduct, which proscribes “encouraging patients to give, lend or bequeath money or gifts that will benefit you directly or indirectly”.

The committee ultimately found the GP had not breached the code because he never encouraged the gifts.

“However, they noted it would have been desirable for him to have held a conversation with the patient about why the gifts were given and reinforcing to him that they were not necessary,” said Avant senior solicitor Harry McCary.

“In this case, the committee believed that failing to do so could not be described as improper or unethical based on the context of their relationship and the patient’s desire to give gifts.”

In an advisory posted on its website last week, the MDO added that doctors should be especially cautious in accepting a bequest in a patient’s will.

“As the essence of the doctor-patient relationship is founded on trust, it can be difficult for a doctor to accept a bequest without the question of undue influence arising,” it wrote (link here).

“In situations where a doctor is seen to be personally benefiting from providing care to a patient, it can affect the public perception of the doctor and the profession.”

In the case of a significant and unexpected bequest, doctors would need to use their own judgement but may want to consider suggesting the gift be donated to charity or be given to a specific medical service or organisation, Avant said.

Questions to keep in mind


Patient bequests can be tricky even for the most seasoned doctors. When deciding whether to accept a bequest, bear in mind the following:

Did you encourage the bequest?

  • Doctors should not encourage patients to give, lend or bequeath money or gifts that may benefit them directly or indirectly.

Does your workplace have a policy on accepting gifts?

  • If so, check and adhere to the policy.

What is the value of the bequest?

  • If it is significant, you might feel more comfortable returning it to the deceased’s estate or suggesting it be donated to a charity.

How would you feel if your acceptance of the bequest was public?

  • If this would make you uncomfortable, you should decline the gift.

source: Avant, 2023

 

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