The scenario

A foundation doctor working in a busy GP practice was surprised to receive a 'thank you' card and a box of chocolates from a young adult patient, who they’d seen a few times for minor health concerns.

Although the doctor thought the gesture was kind, they felt uneasy about the tone of the message in the card. Unsure whether to accept the chocolates, they left them at reception for everyone to share.

The patient returned to the practice later that day with a bouquet of flowers and asked the receptionist to pass it on to the doctor.

The doctor started to worry about what the patient might do next, so called the MDU for advice.

MDU advice

The MDU adviser explained that the GMC's core guidance - 'Good medical practice' (2024) - highlights the importance of maintaining professional boundaries.

Accepting gifts from patients is not forbidden, but doctors should be careful as to what they accept and how this is recorded.

The GMC states that doctors must not accept gifts from patients or colleagues if it is an inducement, gift or hospitality that may affect or be seen to affect the way that person is treated.

Sometimes it's clear that a gift is a token of appreciation, but in this case the wording of the card suggested that the patient was trying to strike up a personal relationship. Accepting a gift in such circumstances might be seen as the doctor being willing to start up a personal relationship.

If a patient pursues a 'sexual or improper' relationship, the GMC expects doctors to try to re-establish the professional boundary - or depending on the circumstances, end the professional relationship. Doctors must not pursue a sexual or improper relationship with a patient.

The doctor was advised to seek support from their supervisor at the GP practice and keep a clear note about the events.

Outcome

The senior partner at the practice wrote to the patient explaining that, while their gifts had undoubtedly been intended kindly, it had been decided that it would not be appropriate for them to be accepted by the doctor.

The senior partner's letter reminded the patient politely that all doctor-patient relationships must be kept strictly professional. The patient did not make further contact with the doctor.

What to do if offered a gift

If you receive a gift, consider:

whether accepting it could affect - or be seen to affect - the care you provide
how accepting the gift might be perceived by the patient or the public's trust in the profession
whether the gift could be an indicator that the patient wants to strike up a personal relationship, which would be inappropriate
whether you need to seek guidance or support with the situation.

Students and qualified doctors should keep a record of any gifts they receive for their appraisal and revalidation. Keep any 'thank you' letters and other tokens of appreciation, as they can provide useful feedback from colleagues and patients.

Help! A patient gave me a gift – should I accept?

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