Accepting Gifts in the Healthcare Workplace

Q. My supervisor's daughter recently received a new video iPod from the company that has the service contract for our hematology lab equipment. The supervisor defends accepting it, saying that she has worked closely with this particular representative for many years; that they are close personal friends,

and that the video iPod was in the corporate gift budget for the vendor. Another company, which provides reagents and supplies, has offered to provide a luncheon during Medical Laboratory Professionals Week. Is this appropriate? What are the limits on accepting gifts in the course of business?

A. For years, critics of healthcare have complained that undue influence at the level of individuals (from physicians, institutions, pharmaceutical companies, and other business partners) has made American medicine less efficient and more costly than it should be. As a result, healthcare workers, including laboratory staff, have been subject to more restrictions on their business relations with vendors and clients than some of their colleagues in other industries. Despite this, the details of corporate gift policies remain obscure for many hospital employees. Such unfamiliarity, coupled with a sense that "everybody does it," can lead to real trouble.

Most companies--hospital and other healthcare institutions included--now have strict policies about what gifts employees can and cannot accept in the course of business. Almost all corporations prohibit employees from accepting gifts that have more than token value, which is generally set in the range of $20 to $50. For these reasons, corporate gifts have become predictable: calendars, mugs, pens, inexpensive organizers, and low-value gift certificates. This value restriction applies to gifts given as well as those accepted. The days of hospitals giving expensive leather briefcases or Waterford decanters to their physician staff, for example, are long gone.

The usual policy on accepting gifts requires that gifts be infrequent, related to business purposes, and of a type that is generally acceptable in the course of business practices. Larger gifts can sometimes be acceptable, as long as there is permission from the proper corporate executive, and when circumstances permit. For example, a vendor might give a retirement gift that is more generous than might otherwise be allowed--and possibly perfectly acceptable--to a laboratory employee with whom they have had a long relationship, in part because the chances that a gift in those circumstances will result in undue favoritism toward the vendor is low. After all, the retiring recipient is leaving any position of potential authority over business decisions.