One of my patients spoke this words to me “Always give thanks to the hands that help you” These words remind me of an interaction with a fellow patient during one of my clinical blocks. A patient came to me one day; she complained about a lower back pain. The patient told me she had been suffering from lower back pain for quite significant period of time. She was using analgesic as well as going for physio sessions, but none of the interventions were helpful. When I asked her why she came to physio again, her response was that she just wanted to give it another try.
I did my assessment thoroughly, and after I came up with the hypothesis, I treated the patient and also gave her home exercises programme. The following week, the patient came back for our second session, and she reported that her pain had subsided. She mentioned that before our first session, she had been struggling to sleep as well as doing some house chores. But now (second session) she could have some sleep because her pain is now bearable. As a way of appreciation (she said) she gave me a scarf. At first I had my reservations against accepting a gift but I ended up accepting it because I also wanted to avoid making the patient to feel offended. but also accepting the patients gift has it own issues such as what is the drive behind giving the gift? Is it a sign of appreciation or an attempt to receive preferential care?
According to Caddell, & Hazelton ( 2013) “Receiving gifts from patients that attempt to procure preferential treatment. Inappropriate attention or “jumping the queue” can have negative implications for both the gift giver and other patients.” On the day of our third appointment, she came straight to me asking for a favour, she wanted me to treat her first because she had another meeting to attend. She was way back on a queue. I agreed to help her as my way of also appreciating her sweet gift that she gave me. I also thought, if I refuse she might think that I am ungrateful. Five minutes after doing statistic for a patient I had before her, I called her in, we went to treatment table. I treated this patient being so passionate. I even spent a lot of time with her compare to the time I spend with other patient.
After this incidence, I knew that i had made some wrong decisions with regards to my ethical conduct towards this patient, which not only compromised me as a health practitioner but also disadvantaged other patients waiting to see me and having to rearrange their schedules because of my actions. However, there was nothing I could do as I had already helped the patient.
Davies (2015) states that “Understanding the reasons why a patient is giving a gift is key when considering whether to accept it. Patients may give their gifts out of genuine gratitude, other may wish to express feelings of affection, and a simple gift may be accompanied by a romantic letter or a more inappropriate gift. Patients may also use gifts to gain the attention of their physician or to attempt to manipulate physician into providing preferential services or treatment so it is very important to try to understand the reasons behind a patient’s gift.” However according to Eledrisi, & Elzouki, (2016) the American College of Physicians (ACP) proposes that “a small gift from the patient as a token of appreciation is not ethically problematic but should not accept the gift if there is any risk that it may influence their professional decision making.”
In conclusion, it is very essential to understand the motive of the patient giving a physician a gift a lesson I learnt hard in my case. I felt like the patient used her gift so that she can get favours from me. from my action I learnt that I shouldn’t accept gift from a patient without considering the consequences that comes with it which includes among others my professional decision making, the well-being of other patients and hospitals reputation. if i’d come across this situation again. i’d attempt to comprehend the patient’s motivation to give me the gift before accepting it and make it clear to the patient that i’d share it with the employees or donate it to the orphanage home.
References list
Caddell, A., & Hazelton, L. (2013). Accepting gifts from patients. Canadian Family Physician, 59(12), 1259-1260.
Davies, M. (2015). Should I accept gifts from patients? BMJ, 350, h617.
Eledrisi, M. S., & Elzouki, A. N. (2016). Patients’ Gifts: Should Physicians Accept Them?. Ibnosina Journal of Medicine and Biomedical Sciences, 8(1), 1-2. Picture retrieved from https://www.google.com/search?q=receiving+gifts+from+patients&source=lnms&tbm=isch&sa=X&ved=0ahUKEwjat_WOxLTiAhWHaVAKHbX6DvAQ_AUIDygC&biw=1025&bih=620#imgdii=DbDlBAEBtxdfoM:&imgrc=r-AJs9xXXP4n-M:
2 thoughts on “Receiving appreciation gift from the patient”
Hi Masindi
Thank you for your writing piece on excepting gifts from you patients. I enjoyed reading your piece as I often wonder what I would do in a situation where a patient wants to give me a gift, as this has not happened to me yet. I now have an understanding of how to judge when and why it would be appropriate to except a gift from a patient.
The content of your piece reflects the content that is covered in class. I like how you gave a description of the event, how you felt at that time and what you learnt from it. You talk about patients giving gifts for preferential treatment, so perhaps you can introduce the concept of bribing to your piece. The image you chose also reflects your writing very well. You blend the course work with you personal experience well and displays good critical thinking. You are honest with your writing, you realised that you made a mistake and this will help you when you are placed in a similar situation in the future. The flow of the piece is good as you explain what happened and add references to that specific idea.
Good referencing.
A few grammatical and spelling errors I picked up:
Paragraph 1
line 2: “presents with lower a back pain” should be “presented with lower back pain”.
Also consider changing the sentence after this as it does not sound right.
Line 5: “she just wants” to “she wants”
Line 5: “I came with the hypothesis and I treated the patient” to “I came up with an hypothesis, treated the patient” and continue with the rest of the sentence.
Line 6: Add “The” before following.
Line 7: “Subsides” to “subsided” or decreased/is less.
Line 7: “Sees” to “Saw”
Line 8: “Appreciating” to “appreciation”
Paragraph 2
Line 1: Remove the “states” after the reference.
Line 2: The sentence is too long and does not make sense.
Line 4: “on a queue” to “of the queue”
Line 7: “Compare” to “compared”
Paragraph 3 also has lots of errors.
Good luck with your final submission
A few
Dear Masindi, I just finished reading through your written piece and I enjoyed reading about this experience which you have encountered.
Below, find my comments on your written piece. I aim to comment in a language that is respectful, friendly and open-minded conversation; using my own thoughts and feelings, and seeing how it influences your piece; that it should be non-judgemental; that it’s specific and not generic along with suggestions and lastly to suggest ideas for improvement based on the objectives for the final submission.
Feel free to contact me should there be any comment/s which you might disagree with.
Content:
I like how text does reflect the topic of our ethics writing assignment, as I can recall this being Prof. M. Rowe’s last lecture of the term prior to our draft submission date. This was a topic which I personally found rather interesting in his discussion, hence why I enjoyed reading about your personal encounter in a situation like this. Your text lacks supporting media (such as pictures, quotes, poems, etc. )that is related to your written piece, as this would make your writing piece more appealing to your readers.
You have made me think differently about accepting gifts from patients and then being in a predicament whereby there are expectations involved, thereby creating a feeling of guilt because you have already accepted a gift from this patient. Personally, I would have dealt with that by politely apologizing to the patient and explaining to her that there are other patients that had been in the queue waiting to be treated longer than her, and also trying to work on my time management when it comes to follow-up patients. Futhermore, I see no fault in accepting appreciation gifts from patients, although it depends on the relationship with my patient at hand as you do not want to give your patient the impression of allowing other friendly gestures that might not necessarily be appropriate within our professional practice.
If I put myself in that patients shoes judging by your post, I’m uncertain where she gave you the scarf by being genuinely appreciative of your rehabilitation techniques to decrease her pain, or if that was her way to sort of get preferential treatment from you. I will repeat that it is important that all patients get treated fairly and equally.
Argument:
Have you considered including knowledge claims being made in your text. I could suggest that you include some means of educating your readers on something which you have done on this patient for her treatment as you mentioned that she mentioned feeling better. As per our feedback rubric, I could suggest that you have your knowledge claims presented in a logical structure.
I found that it was easy to grasp your reflection which you have shared as you first mentioned that you successfully helped a patient with one of her physiotherapy related problems being back pain ,and your choice of treatment worked according to your reflection, thereafter your patient provided you with a token of appreciation, but also expected preferential treatment, which you assumed she was entitled to because of the gift, and your fear her being of the impression that you are ungrateful, as mentioned in your piece. I do think that your reflection should include an argument from your side. I could suggest something in the line of when it is or is not okay to accept gifts from patients; or even on fair and equal treatment of patients?
References:
There are references present in your writing piece, and they are correctly formatted.
Your references are also strong because it directly relates to your experience.
It does make me feel confident that your writing supports your position.
Writing:
There are a few grammatical errors and spelling mistakes in your writing piece. However, I am mindful that English is not your first language.
Paragraph 1: “She was using analgesic as well as going for physio sessions, but none of the interventions were helpful. When I asked her why she came to physio again, her response was that she just wanted to give it another try.”.
She was using (pre-scribed or over the counter?) analgesics which is used for _____, as well as receiving physiotherapy intervention/treatment for ______ (How long and how often), but according to ____ (her/me) none of the interventions had improvement on this patients condition/presentation (Your choice of word). When I had asked her why she returned to seek for help at physiotherapy again, her response was, “to give it another try”.
paragraph 2: “I did my assessment thoroughly, and after I came up with the hypothesis, I treated the patient and also gave her home exercises programme. The Following week, the patient came back for our second session, and she reported that her pain had subsided. She mentioned that before our first session, she had been struggling to sleep as well as doing some house chores. But now (second session) she could have some sleep because her pain is now bearable. As a way of appreciation (she said) She gave me a scarf. At first I had my reservations against accepting a gift but I ended up accepting it because I also wanted to avoid making the patient to feel offended.”
I conducted a thorough assessment and thereafter formed a hypothesis. Thereafter, I was able to treat this patient and give her a home exercise program. The following week, this patient returned for her second appointment and she reported that her pain had subsided. She mentioned that prior to our first appointment, she had been struggling to sleep and do household chores such as ______ (list the house hold chores which she has been struggling with because it describes the movements that she struggles with E.g Active lumbar spine rotation, or active lumbar flexion. ). Now, at her second physiotherapy appointment at the _____ (hospital of CHC that you were working at) she reported being able to sleep ____ (with/without pain) (Consider using pain scale. On the first appointment she rated her pain 7 or 8 / 10 and she now rates it 5 or 6 / 10) due to decreased pain. According to this patient, as a means to show her appreciation for my _____ (mention how you were able to help her), she gifted me with a _____ (description of the scarf: colour, patterns, how it felt, whether you liked or disliked the scarf) scarf. Initially, I felt hesitant to accept the gift _____ (explain why you were hesitant here), but I opted to accept it to avoid offending the patient.
paragraph 3: On the day of our third appointment, she came straight to me asking for a favour, she wanted me to treat her first because she had another meeting to attend. She was way back on a queue. I agreed to help her as my way of also appreciating her sweet gift that she gave me. I also thought, if I refuse she might think that I am ungrateful. Five minutes after doing statistic for a patient I had before her, I called her in, we went to treatment table. I treated this patient being so passionate. I even spent a lot of time with her compare to the time I spend with other patient.
The day that her third appointment was scheduled for, she walked up to me in the _____ (where?) to request a favor from me, whereby she requested that I treat her first as she had to attend a meeting. Unfortunately for her, there was a great amount of patients in the queue that were ahead of her. _____ (how you felt at that moment) I agreed to assist her in aid of my appreciation for her gift which she so kindly gave me, and once again fearing the patient having the impression that I am ungrateful (Explain what makes you feel that the patient would find you being ungrateful. Past experiences? Culture? Your upbringing?). _____ (Add that you were busy assessing and/or treating a patient, then you were busy with her statistics? or was it recording your findings from your assessment and documenting your treatment?) thereafter I opted to please the patient by calling her into my treatment area, whereby I continued to treat her with great passion and even prolonging the treatment as compared to the average time spent with my other follow-up patients (mention how much time you spend with her, and how much time you would spend with your follow-up patients)
Paragraph 4: After this incidence, I knew that i had made some wrong decisions with regards to my ethical conduct towards this patient, which not only compromised me as a health practitioner but also disadvantaged other patients waiting to see me and having to rearrange their schedules because of my actions. However, there was nothing I could do as I had already helped the patient.
After this incident, I realized that I made wrong decisions relating to my professional and ethical conduct not only towards this patient, but towards my other patients whom had been waiting for a lengthy time period too. This has not only compromised me as a health practitioner (Please be more specific in this line), but it was also a unfair professional and ethical practice towards my other patients whom had been waiting to be seen by me, resulting in patients rescheduling their appointments due to my poor decision-making.
I hope that this could be of some help,
All the best with your final submission
Kindest regards,
Carla Everton