Doctors urged to consider implications of patient gifts

PRESS RELEASE

For immediate release: Monday, 16 December 2013

Doctors should consider potential ethical dilemmas before accepting gifts from patients this Christmas, warns UK-wide medical defence organisation MDDUS.

Christmas is a time for giving and many patients may express their gratitude to their doctors with a gift to thank them for their care. This gesture of goodwill may seem perfectly harmless, but it can have implications for the treatment doctors provide – or the treatment patients expect in return.

“In all probability, patient gifts may be a genuine expression of appreciation for the care or treatment they have received,” says MDDUS medical adviser Dr Barry Parker. “Even so, the complexities of the doctor-patient relationship mean difficulties can occasionally arise if the doctor accepts a gift from their patient.

“In some cases, it might be entirely appropriate to accept a small token of gratitude, but there are times when a gift can represent something more.

“By accepting a gift, a doctor may feel that they are indebted to the patient, influencing their clinical judgement. This may impact on the doctor-patient relationship and make objective decision-making more difficult.

“Ultimately, doctors should consider whether by accepting a gift, they are altering their relationship with the patent. Factors that may influence the decision include the size of the gift and whether the patient is vulnerable or may be trying to influence their care. It is also worth considering how acceptance of the gift may be perceived by the public in general.

“If doctors have any of these concerns, then they should be prepared to refuse the offer of the gift.”

MDDUS has encountered cases where members have been offered gifts of substantial value and are placed in a difficult situation.

“Some doctors might feel obliged to accept a gift for fear of offending the patient,” adds Dr Parker. “However, doctors should be very cautious about accepting a high value gift in such circumstances. It is usually possible to avoid offence by showing appreciation for the kind thoughts and gesture, and politely explaining why the gift cannot be accepted.

“Whilst it may not be necessary to keep a record of small, low value gifts, a gift register should be kept for all items of a significant value.”

The GMC offers guidance on this topic in Good Medical Practice - Financial and commercial arrangements and conflicts of interest, stating: ”If you receive a gift or bequest from a patient, you should consider the potential damage this could cause to your patients’ trust in you and the public’s trust in the profession. You should refuse gifts or bequests where they could be perceived as an abuse of trust.”

The acceptance of gifts by general practitioners in all four UK countries is subject to statutory regulation. General Medical Services contract regulations state that a register should be kept of gifts from patients or their relatives which have a value of £100 or more unless the gift is unconnected with the provision of services. The register of gifts should include the donor’s name and nature of the gift. NHS trusts set their own policies on gifts.

“If in doubt, doctors should seek advice from a senior colleague or medical defence organisation,” says Dr Parker.

Ends

For further information contact Richard Hendry on 0845 270 2034 or 07976 272266, or email rihendry@mddus.com.

Note to editors

MDDUS (The Medical and Dental Defence Union of Scotland) is a medical and dental defence organisation providing access to professional indemnity and expert medico- and dento-legal advice for doctors, dentists and other healthcare professionals throughout the UK. For further information on MDDUS go to www.mddus.com.