Docs Ought to Keep Away From ‘Grateful Affected person’ Fundraising

Photo of author

By Calvin S. Nelson

Physicians mustn’t have interaction in fundraising efforts that immediately solicit sufferers for donations — a follow generally known as grateful affected person fundraising — attributable to moral issues, in line with a place paper from the American Faculty of Physicians (ACP).

Main moral issues can come up when physicians have interaction in fundraising actions, corresponding to direct solicitation or misuse of sufferers’ confidential medical information, which may injury belief between sufferers and their physicians, famous Lois Snyder Sulmasy, JD, of the ACP, and colleagues within the Annals of Inner Medication.

The authors highlighted three key positions that physicians — and healthcare directors — ought to observe, together with:

  1. Any participation by physicians in healthcare fundraising must be guided by the most effective curiosity and wishes of their sufferers
  2. Physicians are answerable for defending affected person privateness and confidentiality and will by no means use that data for fundraising efforts
  3. Physicians shouldn’t be requested to solicit their sufferers throughout fundraising efforts and fundraising ought to by no means be a situation of employment for physicians

Additionally they spotlight the ways in which the patient-physician relationship can grow to be strained when physicians search contributions from sufferers for his or her healthcare establishments, noting that stress on sufferers to donate can result in potential expectations of preferential care, the misuse of confidential affected person data, and conflicts of curiosity for physicians.

“Over the previous two to a few many years … we now have even seen personal fairness get into the healthcare house, so {that a} majority of the physicians now are a part of healthcare methods,” Omar Atiq, MD, the president of the ACP, informed MedPage Right this moment. “Subsequently, we needed to be sure that we do not lose sight of the truth that every time a doctor sees a affected person, that relationship stays paramount, and no different consideration supersedes that.”

Atiq famous that there was an growing sense that healthcare directors wish to use the optimistic relationships that physicians have with their sufferers — particularly those that have the monetary means to donate — to request philanthropic donations for his or her establishments.

He mentioned that the place paper shouldn’t be a direct response to any particular tendencies in medication; the ACP simply desires to make the moral implications of doctor fundraising practices “crystal clear” to all physicians.

“We do not need them to really feel that they’re alone on this and that the biggest specialty group of physicians within the nation is completely behind them,” he added. “[ACP] is encouraging them to protect that patient-physician relationship, regardless of potential pressures from directors and company executives and the like.”

Atiq additionally famous that the moral issues round doctor fundraising might be a problem each methods. If sufferers are offering funds to the healthcare system, then these sufferers might develop an expectation that their doctor ought to begin to give them precedence over different sufferers.

“We expect all sufferers have precedence, and there must be a degree enjoying discipline as soon as they grow to be our sufferers,” he mentioned. “The opposite circumstances mustn’t matter in provision of care.”

The objective of the paper, which was developed by the ACP’s Ethics, Professionalism and Human Rights Committee, was to offer physicians with clear outlines of the potential strategies that physicians is perhaps recruited for fundraising efforts, in addition to the particular moral implications of participating in these efforts.

For instance, the doctor’s data of the affected person’s medical historical past and scientific standing, private data, and monetary circumstances could possibly be the reason why administrative officers may consider physicians are sturdy potential fundraisers.

Snyder Sulmasy and staff additionally detailed how physicians ought to have interaction with sufferers, their households, and healthcare directors when questions on fundraising come up.

They urged that physicians direct sufferers and their households to healthcare directors when requested about charitable donations, and will spotlight concerns that stretch past monetary funds. For instance, they famous that collaborating in actions corresponding to talking at occasions, attending galas, or giving public talks might be “ethically acceptable” methods for physicians to interact in fundraising efforts.

The authors additionally burdened that physicians ought to at all times preserve confidentiality of their sufferers’ privateness. “ACP opposes the use and disclosure of [protected health information] for fundraising functions,” they wrote, even when its use is allowed by HIPAA.

Lastly, Snyder Sulmasy and colleagues emphasised that fundraising from sufferers or their households shouldn’t be a situation of employment or part of an incentive program for physicians.

“Philanthropy is, in fact, crucial for the healthcare system,” Atiq mentioned. “However philanthropy that has the potential to jeopardize patient-physician relationships is counterproductive to what that relationship should be.”

  • Michael DePeau-Wilson is a reporter on MedPage Right this moment’s enterprise & investigative staff. He covers psychiatry, lengthy covid, and infectious illnesses, amongst different related U.S. scientific information.


The event of this paper was financially supported by the American Faculty of Physicians (ACP) working finances.

Snyder Sulmasy reported being an worker of ACP. A co-author reported receiving help for journey from Kansas College Medical Middle and the ACP; serving on the boards for the ACP, the ACP companies PAC, GEHA, and the Kansas Metropolis Medical Society Basis; and proudly owning inventory in Intercept Pharma.

Major Supply

Annals of Inner Medication

Supply Reference: Snyder Sulmasy L, et al “Moral steering for physicians and well being care establishments on grateful affected person fundraising: a place paper from the American Faculty of Physicians” Ann Intern Med 2023; DOI: 10.7326/M23-1691.

Please allow JavaScript to view the feedback powered by Disqus.

Leave a Comment