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There are concerns about the ethics of “grateful patient fundraising.” These may not be entirely unfounded, but we should understand the practice accurately first.

Philanthropy seems to be receiving more attention in American public life, from Senator Whitehouse’s crazed rant about “dark money”—which he appears to think is a tactic exclusive to the Right—to Vox’s Future Perfect blog, a pop-culture outlet looking into and reporting on “the best ways to do good.”

A recent study from the Journal of the American Medical Association joined this trend and investigated “public attitudes” toward practices used by hospitals and medical centers to raise support from patients. Known as “Grateful Patient” fundraising, hospital fundraisers will reach out to patients to solicit their support of the hospital.

This is an interesting question, and in the wake of the Epstein controversy—which caused a lot of interest about the ethics of fundraising and the importance of gift acceptance policies—it’s worth gauging public opinion about certain fundraising practices before the enlightened mob is turned against you.

That said, it’s important to ensure that those surveyed actually know what they are being asked about. Few outside of professional hospital fundraising will know what “grateful patient fundraising” means.

The study’s researchers summarize their findings at The Conversation. While they list the fundraising practices they asked interviewees about and indicate the “disapproval rates,” they neglect to provide a positive description of what grateful patient fundraising actually is.


Rhetoric is everything here, and when the tone of the question is “do you approve of exploiting patients when vulnerable and promising preferential treatment in the future?” well, respondents are likely to disapprove. But for the sake of an honest investigation, it’s worth giving grateful patient fundraising a fair hearing when polling “the public.”

I was unfamiliar with healthcare philanthropy until my colleague at American Philanthropic, Owen Thomas, introduced me to it. While there are various approaches to grateful patient fundraising—and unethical people will always be unethical—the goal is not to obfuscate the doctor-patient relationship or to promise gilded rooms to the wealthiest among us. Much to the contrary (and as the name indicates), the goal is to provide grateful patients an opportunity to express their gratitude: a way to give back and help more and future patients receive the life-saving care that they received.

It’s a truism in fundraising that donors don’t give unless they are asked. That’s not because all donors are cheap or stingy, it’s because giving your money away—and giving it to “this” place rather than “that” place—happens because “this” place asked you and gave you a good reason to support them.

That is what happens in grateful patient fundraising. Few patients leave a hospital struck by the thought, “I’m going to make a major donation to express my gratitude!” That’s not because they are ungrateful or self-interested; it’s because they haven’t been given the idea or presented with the opportunity. It’s true, of course, that the work of a fundraiser is encouraging a potential donor to express her gratitude through financial generosity. But the operative term here is encouraging: not manipulating or coercing, but encouraging by sharing how valuable her support can be and how she can help future patients in need of the care she received.


What’s more, in the final episode of Givers, Doers, & Thinkers, Jeremy Beer reminds us that, historically, “charity” (as distinct from “philanthropy”) was meant to change the giver as well as the receiver. Less concerned with “root causes” and “systemic change,” charity is born out of love for those in need in an effort to ease the latter’s suffering—and part of the value of charity is in the giver’s sacrifice and his act of love towards his neighbor.

It is this richer and human act of charity that is at play in grateful patient fundraising. It is an act of love, born out of gratitude, to help those in need by supporting the hospital or medical center that will care for future patients. The grateful patient is given the opportunity to participate in an act of love by making a charitable gift. Presented in this way, this is not something (I suspect) that “public attitudes” would oppose.

Needless to say, there are ways to raise money—and surely some do this—which exploit patients or promise preferential treatment, and “the public” is not unwise to object to these practices. But before we criticize grateful patient fundraising, we should give ourselves a full picture of the practice, the goal, and the persons involved.

I think all patients would disapprove of losing the opportunity to express their gratitude or to benefit from the generosity of other patients.

If you would like to learn more about Grateful Patient Fundraising, join us at 1:00pm EST on Thursday, November 19th for a free webinar with healthcare consultant Owen Thomas! You can learn more and register for the webinar here.

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