A new instruction from physicians: "Please consider making a donation"

Patients show gratitude to their physicians in many ways. Increasingly, development offices at major cancer centers are teaching physicians how to narrow in on one such way: donations.

Of more than 400 oncologists at 40 leading cancer centers, nearly half have been taught to identify wealthy patients who might consider making a donation, according to a study published in The Journal of Clinical Oncology.

A third of the respondents said they had been asked to directly solicit donations, and half of them refused, according to the report. Three percent said they were promised payments if they got a patient to donate.

The study was conducted by Reshma Jagsi, MD, PhD, a radiation oncologist and ethicist at the University of Michigan in Ann Arbor. According to the New York Times, Dr. Jagsi said she had listened in on workshops, seminars, training sessions and department meetings that instructed physicians how to identify patients who are potential donors, how to direct them to the development office and ask them directly if they would like to donate.

Dr. Jagsi considered the ethics of the growing trend. While she was uncomfortable with the idea, she also knew many patients are grateful for their care and want to donate. And medical centers could use the financial support.

Arthur L. Caplan, head of the division of medical ethics at NYU Langone Medical Center in New York City, called the issue "extraordinarily important," and listed possible ethical pitfalls: "Patients may be emotionally vulnerable; doctors have very close ties to their patients, which can strain asking on both sides; and the fact that incentives to ask sometimes skew toward the doctor's own program rather than the most needy areas of the hospital."

However, the practice of physicians soliciting patients will likely continue and grow, according to Joseph A. Carrese, MD, a primary care physician and bioethicist at Baltimore-based Johns Hopkins, adding that patient donations are "an important source of resources when money is tight."

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