From its title, the article published July 21, 2020, by Gina Kolata in the New York Times, “Patient, Can You Spare a Dime?,” suggests a focus on charitable donations to healthcare as a handout, a transactional flipping of a coin into a tin cup. A similar phrase—“Brother, can you spare a dime?”—comes from the Great Depression, the quiet desperation and appeal of a down-on-his-luck man on the street to a passerby.

Meaningful philanthropy is all about putting away the tin cup and shifting the culture of philanthropy from transactional “asking” to transformational engaging.

We agree that it is never advisable, ethical or acceptable for a healthcare clinician to ask a patient or family member for a donation, especially in a clinical setting. We educate clinicians, rather, to be present with patients and family members, to hear and accept words of gratitude, to reciprocate these genuine human connections with empathy, to view “thank you” as part of the healing process and, when appropriate, to make referrals to a philanthropy professional.

We encourage healthcare administration and clinical leaders to engage patients, family members, and the community by sharing their vision, passion, work, and outcomes to help people understand more about healthcare, rather than to ask for money.

When a patient or family member expresses the desire to do something to help, we support that process with a trained philanthropy professional who engages and guides, connecting individuals who want to make a difference through philanthropy with the people and projects that can help them achieve that goal.

Philanthropy may be considered the healthcare industry’s best-kept secret. While many elements of delivering care make headlines, philanthropy works quietly in the background to provide what other avenues of funding cannot consistently deliver. Because of philanthropy, healthcare organizations can:

• Provide care to those who cannot pay their medical bills.
• Develop better, more effective treatments.
• Purchase and maintain state-of-the-art equipment and facilities.
• Improve medical outcomes.
• Increase capacity for patient care.
• Train providers in the most up-to-date methods.
• Mitigate the effects of reduced government funding.
• Stave off stagnation and continue to embrace progress in treatment and research.

Recent reports have inquired into the ethical ramifications of grateful patient philanthropy. The fact that philanthropy’s role in healthcare is surprising to many is evidence of its unobtrusiveness. Foundations and fundraising offices are often sensitive and subtle in their approach, enabling those patients, families, and community members who wish to give the opportunity to do so without compromising the ethical standards of treatment or access they receive.

We are seeing this desire to give especially this year. In these months of COVID-19, philanthropists have reached out to medical centers asking how they can help and literally, voluntarily, given billions of dollars. Rather than denigrate fundraising as something untoward we do to people, we should celebrate philanthropy as an important walk we take with patients, family members, and community members.

Of course, not all patients wish to contribute philanthropically. By educating clinicians and other patient-facing staff members to recognize signs of gratitude and refer interested parties to the appropriate fundraising professionals, healthcare organizations can optimally reach those for whom philanthropy would be meaningful and desired. Clinician referrals are widely accepted as the most reliable and effective point of contact with potential donors, but screening for the ability to give can also assist fundraisers in helping advance their organization’s important missions.

When educated to best practices, clinicians know that their ethical role in philanthropy never involves directly asking a patient or family member for money. Further, their standards of care are never compromised by helping connect interested parties to their philanthropy colleagues. Instead, they give patients and families the gift of engagement—whether through philanthropy, a volunteer role, or simply the opportunity to share their story. Contributions made to healthcare organizations tend to be highly meaningful for donors—often, driven by significant life experiences and a deep desire to pave a smoother road for future patients. Philanthropy has the ability to assist in the healing process, empower in the midst of tragedy, and incorporate donors meaningfully into a body of respected people doing important work.

Referral-based medical philanthropy—a term for “grateful patient” fundraising that focuses on the patient or family member, that individual’s passions and values, and the referral by a health professional as a key moment of connection—is ethical, democratic, and important to both the patient and the healthcare provider. Increased awareness of these programs should be leveraged as opportunities to dispel myths and provide accurate information about the role of philanthropy in healthcare: that through these important programs, patients are empowered, care is improved, communities are strengthened, and healthcare is enriched.