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Oncologists are often called upon to speak with patients to deliver big news: sometimes the good news that treatment is working; other times, that treatment hasn’t checked the cancer.

But, increasingly, oncologists—and presumably other medical specialists—are being called upon to speak with patients not to deliver big news but to make the big ask: to ask grateful patients to make a donation to the hospital or medical center where they had their treatment.

A just-published study of oncologists at 40 top cancer centers finds that oncologists are being asked more frequently to play a role in fundraising for their hospitals, and many are heeding these requests.

For many, playing a role in fundraising doesn’t mean participating only on the sidelines of the fundraising process by, say, putting in an appearance at an event where there might be potential donors. No, oncologists are being asked to be the ones to make the fundraising pitch to their patients: fully 32% of oncologists reported that they had been asked to solicit a donation from a patient.

For physicians to become fundraisers—and to solicit their own patients!—is surely ethically fraught. According to this new study, physicians are concerned (as they should be!) that asking for a donation will undermine the relationship between themselves and their patients: 73% of oncologists in the study responded that they worry that soliciting a donation from a patient may interfere with the relationship with that patient. Half of the oncologists who reported that they had been asked to solicit a donation from a patient had refused to make the ask.

And, physicians are concerned about equity between patients who have made donations, or might do so, and other patients. Are donors given preferential treatment, such as expedited visits, physicians’ personal email addresses, or simply nicer rooms? Oncologists at 37 of the 40 cancer centers included in the study reported that donors received at least some sort of preferential treatment.

Some oncologists seemed to think that the ethical concerns could be managed. Some patients agree: a New York Times article on this study included an interview with a cancer patient who had not only become a donor but had made a video to coach physicians about how to make fundraising requests of patients.

The pressures on physicians to become fundraisers as well as healers is bound to increase, as hospitals and medical centers are pressed to provide ever-more-expensive care. Indeed, 37% of respondents in the study said that they were being asked to participate in fundraising efforts more than had been so in the past.

Of course, many development officers are only too eager to press physicians into service as fundraisers: browsing the fundraising literature in this area turns up such telling titles as, “The Reluctant Fundraisers: Getting Physicians into the Act,” “Physicians and Fund Development: Overcoming the Objections,” and “Engaging Physicians in Transformational Philanthropy.” Not surprisingly, oncologists in the study were nearly twice as likely to say that the fundraising office at their institution had taught them how to identify potential donors among their patients than to say that the fundraising office had offered ethical guidance about soliciting their patients.

There are many grateful patients who might well become donors—and there may well be appropriate ways for a hospital to identify and cultivate those potential donors. But hospitals should proceed carefully as they seek to “get physicians into the act” as fundraisers if they aren’t to undermine their central mission of care for sick.


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