Category: Gifts

Top oncologist says gratitude pays off

In an interview for the Oldie magazine, oncologist Prof. Karol Sikora has recommended being as nice as possible to those that treat your health conditions. “If someone is particularly helpful be appreciative – everybody likes positive feedback,” he told John Sutherland. Sikora is promoting his new book The Street-wise Patient’s Guide to Surviving Cancer in which he advises patients to charm their doctors if they hope to persuade them that they are worth ruinously expensive cancer drugs. NHS staff are “dedicated and remarkably caring”, he said, “and they naturally respond well to pleasant patients.” His advice,though to “tell someone they have a lovely smile,” might come across as a bit obsequious though, not to mention downright creepy in some situations.

Doctors’ views on gratitude

A few weeks ago I had the opportunity to present some of my work on the gratitude expressed in the Frimley correspondence to GP trainers and trainees from West Middlesex Hospital, whose two days away were delightfully themed around ‘happiness’. It was a nice way to hear some stories of gratitude from the frontline.

We had a lively discussion about whether patients are morally obliged to feel grateful. Lots of the delegates were uncomfortable about the word ‘moral’, although most agreed that patients had lots to be grateful for. The overwhelming majority felt that patients should be grateful for the NHS in general, rather than specific practitioners.

What price a box of turkish delight?

Jonathan Tomlinson is one of the most eloquent, sensible defenders of the NHS today. Writing on his blog, A Better NHS, he recently tackled the embarrassment doctors feel about accepting gifts. Entitled Giving and Receiving, the post takes the form of a reconstructed dialogue between Jonathon and an erstwhile colleague who says, “Accept the presents graciously, it means a lot to them and it should mean a lot to you too. Your patients care about you, and caring for others is one of the things that makes a hard life a bit more bearable. For some of course, you’ll have gone the extra-mile or diagnosed them with something really important, and for others there’s precious little kindness in their lives and you’ve been a part of that.

Say it with cake…

These amazingly creative cupcakes were made by the aunt of a young tonsillectomy patient for the surgical ward and theatre team. It meant a great deal to the staff. Dr Ruj Roplekar, who was one of the recipients, said, ‘I was delighted that someone had shown that degree of appreciation for all those involved in the care of someone she loved.’ When Ruj posted this image on Facebook, it was interesting to see that one of her fellow medics urged her to save the photo as evidence for the ARCP of the ISCP (that’s Annual Review of Competence Progression for the Intercollegiate Surgical Curricular Programme).

BMJ Careers dispenses some advice on doctors accepting gifts…

… and concludes that it is not a good idea. The article, which cites this blog, is here. It looks like sensible research on gifts from patients has not been done since the 1980s. The ethics of accepting gifts are well rehearsed and there are clear guidelines. An understanding of why gifts are offered, however, is lacking. There is much speculation about cultural reasons, or potential bribery, but getting the heart of the supererogatory actions that inspire acts of gratitude would help to inform policies on these issues, and also give us an insight into what patients think about the issue.

Patients bearing gifts

The online journal Hektoen International has an article this month by Anthony Papagiannis on unusual gifts he has received from patients, which includes a knitted waistcoat, a wooden model of temple, an icon and several signficant books.

He says, ‘the unselfishness of the act speaks louder than words. It is behavior like this that makes me forget the injustices of the system, the small and large tragedies that I encounter daily in the practice of medicine, and keep going.’ Gratitude for gratitude.

Gifts as commodities in the NHS?

I have been reading an influential essay by Arjun Appadurai, ‘Introduction: commodities and the politics of value’ from Appadurai, A. (ed.) (1986) The Social Life of Things: Commodities in Cultural Perspective. Cambridge: CUP, pp. 3–63.

Although focused on ‘commodities’ which implies an economic context that is missing (overly at least) from the NHS context, points in the essay have made me think about how one might frame a critical study of gratitude and the giving of gifts to healthcare professionals.

It is not customary to give gifts in the NHS (although this needs further research). Most anthropological studies of gift-giving are focused on the trajectory of gifts within relatively isolated, small-scale societies.