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TCMPiGifts to Physicians and Others: Lessons in Ethics

By TCMPi

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For most of us, the ethical issue of gifts to physicians from members of the healthcare industry is a moot point. However, we can all appreciate and perhaps emulate the ethical guidelines set forth by the American Medical Association when it comes to avoiding even the appearance of a conflict of interest, whether we are giving or receiving a gift.

Way back in 1847, the American Medical Association set down some pretty strict guidelines regarding what it calls “gifts to physicians from industry.” Over the years the guidelines have been updated and upheld a number of times in order to keep pace with changing social standards and expectations regarding transparency and influence associated with gifts to doctors.

While most of us are not doctors or members of an industry that deals with them, there are still many valuable lessons in the AMA’s guidelines. In Opinion 8.061, as the AMA calls it there are many examples and details. Here’s an abbreviated overview you may find helpful whether you are considering giving or receiving gifts.

Patients first

Opinion 8.061 puts first things first by stating “Any gifts accepted by physicians individually should primarily entail a benefit to patients and should not be of substantial value. Accordingly, textbooks, modest meals, and other gifts are appropriate if they serve a genuine educational function. Cash payments should not be accepted.”

LESSON: If the gift is intended to influence the recipient beyond normal business considerations, it should not be given or accepted. Nominal gifts need not be “cheap” but quality, brand name products need not be overly expensive, either. Strive for a reasonable limit on spending and stay away from giving anything that is overtly compromising.

Work-related gifts

The guidelines go on to state “Individual gifts of minimal value are permissible as long as the gifts are related to the physician’s work (e.g., pens and notepads).”

Since doctors often attend healthcare-related conferences and meetings, the AMA guidelines spend quite a bit of time defining what constitutes a legitimate conference or meeting and what aspects of attending them are appropriate for doctors to receive as gifts. For instance, travel costs, lodging and so forth are most often not permissible gifts under the AMA rules. When permitted, these costs are subject to very strong scrutiny.

LESSON: Work-related items are good choices for clients and business partners. From the most basic (the pens and notepads mentioned in the guidelines) to the more substantial (briefcases, iPad covers, desk accessories).

No strings attached

Regardless of the value of the gift, physicians must make it clear to the giver that the gift will in no way influence the doctor’s prescribing practices. In other words, if a doctor accepts the gift it is purely as a gift and never as an incentive to prescribe a medication, recommend a procedure or strongly suggest a provider.
Lesson: Transparency is essential to good business relationships and to corporate gift giving. If you are going to give a gift, make sure you express your gratitude for a good business relationship and do not expect favoritism. If you’re going to accept a gift, be certain the giver understands that while you appreciate the gift, future business will be based on merit, not gifts.

The latest versions of Opinion 8.061 were passed in 1992 and have been updated several times since then, along with an extensive array of clarifications – what today we often call “FAQs.” You can read the entire list at the AMA website.

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