Your patient wrote you into their will... Now what?

Doctors often receive baked goods or small tokens of appreciation from grateful patients, but when a patient leaves a significant amount of money to their doctor in their will, it can quickly become both a legal and an ethical issue.

“Sometimes, just the appearance of impropriety is enough to ruin a physician’s reputation or make people question their judgment,” says Mitch Mitchell, Product Counsel at Trust & Will, an online estate planning service. “Gifts from longtime patients who are friends outside the clinical setting are likely to be seen as above board, but anything else might be viewed as questionable.”

So, how do you handle patient gifts made as part of a will or trust? A lawyer and an AMA representative weigh in.

Start with a conversation

An article published in Family Practice Management noted that since there are no clear-cut guidelines about receiving gifts from patients, physicians are often uncertain how to handle the issue.^[]

Mitchell says if a physician learns a patient intends to name them as a beneficiary in their will or trust, the first step should be having a discussion with the patient. 

“It’s important for a physician to learn why the patient wants to name them in their will, to ensure the patient is of sound mind, and to determine whether it will cause family discord,” Mitchell says. 

Since many hospitals forbid their doctors and other staff from accepting gifts that have a large monetary value, Mitchell recommends physicians suggest viable alternatives. For example, if a patient is pleased with the care they received while hospitalized, doctors can encourage them to leave a legacy gift to the hospital’s medical foundation. A patient could also leave a monetary gift designated to benefit a physician’s ongoing research.

Why patients give gifts and leave bequests

While it may seem odd for a patient to gift their physician, an article in The Western Journal of Medicine noted that most are given out of beneficence or appreciation.^[]

In the case of the Australian doctor who inherited $24 million from a patient, questions arose about impropriety since this was the second time a patient had named the doctor as a beneficiary. In the first case, a patient in 2005 had left the doctor their entire $80,000 estate. More recently, the doctor was named the beneficiary of the $24 million after the patient changed his will six months before his death.

While the AMA Code of Ethics doesn’t assign a monetary cap to patient gifts when they fall within the realm of goodwill or cultural traditions, the AMA advises that more extravagant gifts should be declined since they may be an attempt to garner preferential treatment or influence the physician.^[] Seeking advice to avoid legal repercussions

If a patient is adamant about making a substantial donation to a physician, Mitchell encourages both the doctor and the patient to consult with separate probate lawyers.  

“Anytime the patient’s family encounters an unexpected disinheritance, even a partial one where a substantial sum goes to another person, there’s the potential for conflict,” Mitchell says. “The typical recourse for the aggrieved family members is to claim the will was procured by coercion or was the product of undue influence.”

While Mitchell says there is very little a physician can do proactively to prevent these claims, evidence the patient consulted independently with a lawyer of their choosing will weigh heavily against claims of coercion and undue influence. 

When a bequest comes as a surprise

In some cases, a physician might only learn they were named in a will after their patient’s death. 

If a physician doesn’t want to inherit property, Mitchell says they have two options. They can disclaim it, and it will either go to another person named in the will, or the decedent’s heirs, or they can accept the bequest and give it to another entity, such as their hospital foundation.

“Whether or not a physician accepts an inheritance from a patient is their personal choice,” Mitchell says. “No one named in a will is forced to take the bequest.”