Ethical Issues and Recommendations in Grateful Patient Fundraising and Philanthropy.

Grateful patients provide substantial philanthropic funding for health care institutions, resulting in important societal benefits. Although grateful patient fundraising (GPFR) is widespread, it raises an array of ethical issues for patients, physicians, development professionals, and institutions. These issues have not been described comprehensively, and there is insufficient guidance to inform the ethical practice of GPFR. Consequently, the authors convened a "Summit on the Ethics of Grateful Patient Fundraising," with the goal of identifying primary ethical issues in GPFR and offering recommendations regarding how to manage them. Participants were 29 experts from across the United States who represented the perspectives of bioethics, clinical practice, development, law, patients, philanthropy, psychology, and regulatory compliance. Intensive discussions resulted in articulating ethical issues for physicians and other clinicians (discussions with patients about philanthropy; physician-initiated discussions; clinically vulnerable patients; conflicts of obligation and equity regarding physician's time, attention, and responsiveness and the provision of special services; and transparency and respecting donor intent) as well as for development officers and institutions (transparency in the development professional-donor relationship; impact on clinical care; confidentiality and privacy; conflicts of interest; institution-patient/donor relationship; concierge services for grateful patients; scientific merit and research integrity; transparency in use of philanthropic gifts; and institutional policies and training in responsible GPFR). While these recommendations promise to mitigate some of the ethical issues associated with GPFR, important next steps include conducting research on the ethical issues in GPFR, disseminating these recommendations, developing standardized training for clinicians regarding them, and revising them as warranted.

A randomized trial to evaluate methodologies for engaging academic physicians in grateful patient fundraising.

PURPOSE: Donations from grateful patients can support medical education, research, and clinical programs. This study sought to compare the effectiveness of three approaches to educating physicians about grateful patient fundraising. METHOD: In 2010, the authors conducted a randomized trial at an academic health center to compare the effectiveness of three educational strategies that encouraged physicians to participate in grateful patient fundraising. The authors randomized physicians into an "e-mail arm," a "lecture arm," and a "coaching arm." All participants received weekly e-mail articles describing philanthropy processes and outcomes. Those in the lecture arm also attended a single, one-hour training session taught by a physician with prior fundraising success, and those in the "coaching arm" received personalized, one-on-one communications with development professionals. The intervention period was three months. The primary outcome was the number of "qualified referrals" (i.e., individuals capable of making a ≥$25,000 gift) whose names participants provided to the development team during the three months of and three months following the intervention; dollars received was the secondary outcome. RESULTS: Participants in the e-mail arm (n = 14) generated 0 referrals and $0, those in the lecture arm (n = 18) generated three referrals and $0, and those in the coaching arm (n = 19) generated 41 referrals and $219,550 (five gifts). Of the 19 physicians in the coaching arm, 17 (89%) generated at least one qualified referral. CONCLUSIONS: A process in which development officers give one-on-one coaching to physicians can effectively enhance collaboration on grateful patient philanthropy.