Decision Science

Philanthropy is at the heart of our healthcare institutions and academic medical centers. Many of our nation’s great healthcare organizations trace their origins back to a group of individuals who had the wisdom and foresight to build a strong healthcare system to anchor their community. Today, the need for philanthropic investment in our healthcare and academic medicine institutions is greater than ever as they strive to provide exceptional care and advance scientific knowledge to improve health. Donors remain an essential partner in this mission and make a real difference in the quality of life in our communities.

Unintentionally, the recent JAMA study may have done a disservice to the healthcare community in undermining the critical and sensitive relationship between physician and patient, suggesting that physicians are asking patients for donations when patients don’t want to be asked. The study also undercuts the field of healthcare philanthropy by implying it is not conducted ethically or responsibly. BWF could not disagree more vehemently with either implication.

The survey’s statement that “… a substantial proportion did not endorse legally allowable approaches for identifying, engaging, and thanking patient-donors” is flawed. The survey did not study the most common “legally allowable approaches” to fundraising in healthcare institutions, but, in fact, one of the least common.

Patients and the general public have, in fact, endorsed current fundraising practices by responding favorably to them, donating more than $41.46 billion to healthcare in the United States in 2019[1]. This generosity has improved the lives of countless patients and benefitted many others through philanthropically supported disease research.

From BWF’s own 2019 study of those who make charitable contributions, “importance and value to the community” has consistently been a lead motivator in giving to hospitals[2]. More than half of the respondents (54%) reported that they gave a gift to a hospital without being asked following a personal or family hospital experience. Spouses or partners ranked as the strongest influences in determining gifts (63%), far above any employee of the hospital, including physicians.

The JAMA study’s focus creates the faulty impression that fundraising depends on physicians. Those knowledgeable of healthcare fundraising understand the many approaches non-medical staff employ to build relationships with prospects and donors in order to align donors’ philanthropic priorities with the needs of their healthcare institution. Those who are knowledgeable also understand that the physician’s role, if there is one, is that of referrer, not of solicitor. And they further understand that physician referrals are a relatively small source of prospects. Even then, as the JAMA study reports—but does not promote—almost 80% (79.5%) “reported it acceptable for physicians to talk to patients about donating if patients have brought it up.”

What guides patient giving more than wealth is gratitude. When patients are grateful, their care provider can direct them how to demonstrate that gratitude in any number of ways, only one of which is financial. The grateful patient fundraising programs implemented at some of the country’s leading healthcare institutions, like all fundraising, are implemented under the ethical standards promoted by the Association of Fundraising Professionals, standards that have been in place for nearly 60 years, and by the Donor Bill of Rights.

And when they give, donors are usually not expecting to be treated differently. From BWF’s survey, only 28% of respondents who give to hospitals expect to be recognized or receive special consideration as a patient. Regardless, medical ethics are designed to ensure that philanthropy does not impact someone’s quality of care.

Philanthropy and the voluntary support of healthcare and other charitable causes dates back to the founding of the country. Those who are engaged in the noble pursuit of raising funds to support our healthcare institutions deserve better than the potentially misleading implications of this survey’s results, most especially as a global pandemic threatens these organizations’ ability to fulfill their mission.

BWF is committed to helping healthcare organizations build strong community engagement programs by ensuring that grateful patient programs are designed and implemented ethically, appropriately, and respectfully of all members of the community. Programs like these provide donors an important way to demonstrate their gratitude and support the mission of a healthcare provider that has had an impact on them personally.

[1] Giving USA 2020: The Annual Report on Philanthropy for the Year 2019. IUPUI Lilly Family School of Philanthropy.
[2] What the Affluent Think About Giving to Healthcare. BWF’s 2019 Healthcare Survey.