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Andrew M. Ball, MS, PT -> Re: Gifts of appreciation from patients. (April 29, 2000 4:56:00 AM)
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Forum,
Interesting question. Personally, I enjoy the opening monologue of the Quiton T. pre-Pulp Fiction flick, "Reservoir Dogs" where Mr. Pink goes on, and on, and on about how he doesn't tip. In short, he doesn't believe in it. Why are there some professions that are tip-worthy and others that are not?? The kid behind the counter at MacDonald’s works just as hard as the woman at the local diner . . . and I'm sure most Neurosurgeons are under a lot of pressure, but they are not tip-worthy.
I suppose that for healthcare, it all gets down to the issue of being a professional. I for one would like to be able to expect certain things of my healthcare providers.
1. I want them to be technically/clinically skilled
2. I want them to be up-to-date with the literature
3. I want them to have a friendly bedside manner, and finally . . .
4. I want to be able to pick out a toy when I'm done like I did as a kid when I went to the dentist!
Accepting tips somehow warps things a bit. Will this patient expect preferred patient status the next time PT is required? I can just here someone at a party talking about how lousy their PT was, not because they didn't get them better, and not because they had a bad bedside manner . . . but because they wanted that hotpack on their back just one last time, and "that %@#%ing PT said my insurance had run out . . . yeah, he was quick to take that $20 tip that I dropped on him though . . ."
Is this patient (or any other that tries to leave a tip) going to expect a BETTER level of care than outlined above??? Heck it's hard enough to find one of the four points listed above in any one individual. Does tipping entitle me to expect all four plus a few added expectations?
Tough issue though, how do you turn down a patient's tip without insulting what was intended to be a well-intentioned act of gratitude???
I don’t ever accept tips of any kind from a patient or family . . . but I did have an unusual experience recently. About a year ago, I volunteered some of my time to consult with a clinician in my area who was actually one of the inspirations for me to go back to school and get my Doctorate. She just defended and finished her EdD last week, so let me give a big "shout out" to her . . . you know who you are Dr. A.
This woman owes me nothing, and if anyone should be tipping it should be me. In any event, she had what she considered to be a particularly complicated orthotic case that I helped her out with. About 2 weeks later, I got a hand drawn picture from the child (which is framed on my wall), a picture of the child taking her first step using her new orthotics and a posture control walker, and a gift certificate for dinner from the parent.
I of course contacted Dr. A to discuss the situation. Even having volunteered my time, I still felt a little slimy about taking and using the certificate. Dr. A informed me that the child, had come up with the idea.
Great.
Now to refuse the offer would be insulting to the child. I went over options in my mind. Should I save the certificate and ask the family to join me for dinner sometime (no, that's WAY too personal). In hindsight, I should have asked Dr. A to join me for dinner and just used the certificate then. That’s not what I did either.
In the end, I went and got a steak with my ex-fiance. It tasted wonderful, and the evening was very relaxing . . . but the meal gave me indigestion for a few days . . . I'm guessing a food poisoning more powerful than salmonella . . . the guilt of compromising my principles perhaps?
If I were you, I'd explain that in order to ensure in your mind and the eyes of the public that all patients were treated equally, AND to eliminate the APPEARANCE of inpropriety . . . that you cannot accept this very gracious gift. I have however seen clinics take tips and put them into a special fund specifically set aside to pay for things for other patients that are not covered by insurance (like one more session, or ionto, or whatever). That gets tricky too . . . who's qualified to get this little perk????
I'ts just easiest to graciously refuse.
[This message has been edited by Andrew M. Ball, MS, PT (edited April 29, 2000).]
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