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CEO Corner: Thoughts on JAMA’s Public Attitudes Regarding Hospitals and Physicians Encouraging Donations From Grateful Patients

Alice Ayres
Published:  07/23/2020
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In the last few months, the general public has seen in vivid color the critical importance of private philanthropy in securing hospitals’ ability to achieve our missions to deliver the best quality care. With predictions of $320B+ in budget shortfall for hospitals in the United States through the end of the year and now the prediction of half of our hospitals likely to be in the red by the end of 2020, there has never been a more critical moment in the financial health of our institutions.

The Journal of the American Medical Association (JAMA) recently published a piece called Public Attitudes Regarding Hospitals and Physicians Encouraging Donations From Grateful Patients (access the abstract). Many of the researchers involved in this study were also participants in AHP’s ethics summit, led by Steven Rum at Johns Hopkins, which produced the 2019 report titled Ethical Issues and Recommendations in Grateful Patient Fundraising and Philanthropy. 

We find many of the data points from the study to be informative and instructive: 

Point 1: As healthcare fundraisers, we know that expressing gratitude through giving is part of the emotional healing process for many donors and their families. 

The study supports this, stating that 85.2% of those responding reported feeling good after donating. We know the importance of our work in the health of our communities, both physically and emotionally.

Point 2: There is a broad agreement that clinicians should not be involved in making the ask. 

In the study, 90.7% felt that patients would feel pressured to donate if their physician made the ask. As outlined in our Ethical Issues and Recommendations in Grateful Patient Fundraising and Philanthropy report, the recommended best practice is that the professional fundraiser––not the physician––makes the ask of a donor only after there have been numerous conversations. The purpose is to understand the donor’s interests and to identify areas where those interests align with hospital needs before making a formal ask. AHP’s report also concludes that discussions with patients about acts of philanthropy should be distinct from those related to the patient’s health, treatment, or other clinical concerns, ideally occurring after the course of treatment.

Point 3: 91% of respondents agree that donor intent should be honored at all times.

This, too, is best practice, which is why AHP, in conjunction with the Association of Fundraising Professionals (AFP), CASE Foundation, and The Giving Institute, published the Donor Bill of Rights which underscores the paramount importance to clearly define and honor donor intent in the use of restricted funds.

Point 4: 59% of respondents feel it is important to gather input on how to apply funding from people who receive care from the hospital but do not have the ability to make large donations. 

These patient groups, along with many other groups within a hospital’s community, are frequently included in mandatory community benefit needs assessments completed every three years by all not-for-profit healthcare organizations.

Point 5: The study showed some level of respondent discomfort with the hypothetical donor benefits included in the survey.

While 50% of respondents were comfortable with room upgrades, fewer showed support for donors to receive expedited visits (25%) or increased access to physicians (20%). While concierge benefits vary by organization, the commitment to delivering the same quality of care for all patients does not. And, because of the spotlight on the public’s discomfort with some donor benefits, we realized that AHP can and should gather more member input on concierge programs, with the goal of publishing best practices around concierge programs in the near future.

There has never been a more urgent need for communities to come together to support the mission of delivering the very best quality care than now. As a profession, we are committed to holding ourselves to the highest possible standards as we work with our donors, many of whom are patients. They choose to support healthcare organizations’ missions because of their experiences with our clinicians, our staff and our care, and we are grateful for their commitment to the important work of delivering the best possible care to all our patients.

For more resources on ethical fundraising, visit our new Ethics in Fundraising page containing a growing library of relevant studies, guidelines, and best practices.

NEWS  /01/28/19
Official guidelines regarding the ethics of grateful patient fundraising
NEWS  /12/05/18
In this season of reflection, I have been thinking a lot about the question of ethics and morals in health care philanthropy as well as about the science of gratitude.

Meet The Author

Alice Ayres
Alice Ayres
President and CEO

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