My doctor friend objected to his hospital's fundraising tactics. Did management go too far?

By Quentin Fottrell

'This shocking program was exploiting doctors and the trust inherent in their relationships with patients'

"The doctor in question had no idea that funds were being solicited or contributed in her name - and she was incensed." (Photo subject is a model.)

Dear Quentin,

You are quite correct in your assessment that hospitals engage in fundraising from former patients because they are routinely short on cash ("I had gallbladder surgery. After I got home, the hospital asked me for a financial donation. Is this ethical?").

However, I am connected to a doctor whose name was used to solicit contributions to a hospital. It was a campaign called "Best Doctors Week" and the hospital requested donations from patients who had been admitted under many different doctors.

Patients often have a very special relationship with their doctors, and some owe their lives to them. The patients I know who contributed to the hospital to "honor" their doctor were certainly not coerced.

There was a catch: The doctor in question had no idea that funds were being solicited or contributed in her name - and she was incensed. She understands that while hospitals may be underfunded, the administration is often quite well-funded.

To make matters worse, the doctors whose patients contributed the most were featured, again without their prior knowledge, on a wall labeled "Best Doctors as Selected by Patients." This "wall of honor" further upset my friend.

How could the hospital display a doctor's picture without the doctor's knowledge, you may ask? The hospital requires doctors to carry ID cards and provides the photographs used for them, so the images are entirely under the hospital's control.

Thus, this shocking program was exploiting doctors and the trust inherent in their relationships with patients, and it was also divisive among the many hardworking physicians. There was a contribution threshold for inclusion on the "wall of honor."

To add to it all, patients who were simply trying to recognize and thank their own doctors for providing expert care may not have realized that their contributions primarily benefited the hospital rather than the physicians they wished to honor.

Friend of a Doctor

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The fact that the hospital was approaching patients without the knowledge of doctors shows a clear breach of etiquette, at best, and ethics, at worst.

Dear Friend,

Transparency and consent are key, particularly within a hospital environment.

Medical institutions, after all, live by such principles in order to help save people's lives. The hospital should absolutely inform physicians if their names and likenesses are being employed in this way, and they should also be told in advance what patients will be solicited in their name.

If you're using someone - whether it's a doctor, minister, teacher or candlestickmaker - to raise a few bucks, they should know about it. The fact that the hospital was approaching patients without the knowledge of doctors shows a clear breach of etiquette, at best, and ethics, at worst. I'm not surprised your friend was upset.

I can see why your friend felt betrayed. She must also have been embarrassed and possibly humiliated by her employer behaving like this behind her back. I'm guessing that you could trace this "wall of honor" back to a fundraising department with one or two people, who may have been under pressure to raise funds, pulling the strings.

They had goals to meet and, consciously or not, they did not adhere to professional and personal decorum in order to achieve those goals. Worse, the patients were the ones feeling emotionally blackmailed into donating money. It does, as you point out, damage the trust between hospital and patient. Once gone, it's extremely difficult to get back.

Hospitals need to walk a fine line with grateful patient fundraising (GPFR). Professional organizations such as the Association of American Medical Colleges and American Medical Association, a lobbying group for physicians and medical students, generally accept that charitable donations may be solicited from patients.

However, experts also say clinical care should not be conditional on donations, patient privacy must be protected, and participation should not create pressure on doctors to give certain patients - or friends/family of patients - preferential treatment. How do you walk that line between clinical care and fundraising? With great difficulty.

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Physicians are torn

In 2024, Kobie Alexander Smith wrote his dissertation about this kind of fundraising by hospitals as part of his Degree of Doctor of Education at the University of Pennsylvania. He interviewed 23 physicians at three nonprofit academic medical centers. My initial takeaway from his study: GPFR is now commonplace.

As financial pressures on U.S. healthcare systems increase, GPFR has become more common and, yes, more controversial, raising concerns about patient privacy, consent, and the ethical use of the physician-patient relationship. His study aimed to clarify the ethical challenges of identifying, soliciting and even acknowledging patient donors.

Your friend would find the dissertation fascinating. The study found that physicians have widely differing views about GPFR, shaped by their personal ethics, workplace experiences and level of trust in their own institutions. Some physicians were comfortable participating in GPFR, while others felt it blurred ethical boundaries.

Several physicians expressed discomfort with fundraising practices that appeared to exploit the physician-patient relationship or give preferential treatment to wealthy donors, Smith found. Some also felt reluctant to support fundraising because they believed their institutions did not adequately support physicians.

Smith argued that GPFR should aim to balance the need to raise money and the institution's mission to save lives against the rights and interests of patients, physicians, and other stakeholders. Some physicians expressed concerns about the need to protect patient trust, avoid coercion and prevent preferential treatment for wealthy donors.

Bottom line: Even if a hospital employs a physician and holds photographs of employees for administrative purposes, that does not automatically mean that those employees have given consent for those images to be used in fundraising campaigns or on "walls of honor" like you might see in a department store or fast-food restaurant.

If this is how a hospital treats staff, you might wonder how it treats its patients.

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Check out the Moneyist private Facebook group, where members help answer life's thorniest money issues. Post your questions, or weigh in on the latest Moneyist columns.

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By emailing your questions to the Moneyist or posting your dilemmas on the Moneyist Facebook group, you agree to have them published anonymously on MarketWatch.

-Quentin Fottrell

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07-02-26 1901ET