Annals of Internal MedicineEthical Guidance for Physicians and Health Care Institutions on Grateful Patient Fundraising: A Position Paper From the American College of Physicians

The Society Issues Guidelines on Physician Involvement in Patient Fundraising

The American College of Physicians (ACP) has released a comprehensive position paper outlining the ethical concerns surrounding “grateful patient” fundraising. The paper explores the complex issues that arise when physicians solicit charitable contributions from their patients, including the potential for conflicts of interest and the erosion of the patient-physician relationship.

HCN Medical Memo
The ACP’s position paper serves as a crucial reminder of the ethical responsibilities inherent in the patient-physician relationship. Although fundraising is important for the financial health of medical institutions, involving physicians in the solicitation of donations from patients introduces an array of ethical complications that can erode trust and compromise care. Physicians and healthcare institutions should heed these guidelines to ensure that fundraising efforts do not interfere with the primary mission of providing patient-centered care.

Key Points

• The ACP strongly advises against physicians soliciting charitable contributions from their patients, citing the need to maintain trust and prioritize patients’ best interests.
• Ethical concerns include pressure on patients to donate, potential for preferential treatment for donors, and the use of confidential patient information for non-treatment purposes.
• A 2018 survey found that academic medical centers in the US raised approximately $2.7 billion in 2017-2018 from non-staff donors, highlighting the financial importance but also the ethical pitfalls of patient fundraising.
• Perspectives from healthcare professionals indicate that the practice can undermine the trust at the core of the patient-physician relationship.

A 2018 survey found that 83% of respondents had concerns that fundraising might interfere with the patient-physician relationship.

Additional Points

• The ACP paper was developed by the Ethics, Professionalism and Human Rights Committee and approved by multiple ACP boards and councils.
• The paper also states that fundraising should not be a condition of employment for physicians, nor should it be a performance metric.
• Legal frameworks like HIPAA have been modified to allow certain fundraising activities, but the ACP opposes these changes.

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