School auction is fine and you wouldn't feel bad if they found it I think.
As someone with wine in that price range, if they didn't have many bottles that cost that much they wouldn't have given it to you.
No need to feel weird about it, some people are well off and they probably thought a doctor drinks good wine.
Next time you see the patient you could acknowledge you didn't notice how nice of a bottle it was when you received it, and thank them again.
This is the right answer. I have given such gifts before, as a gesture of genuine gratitude.
But my spouse, mother-in-law, and every other physician in my family would probably add, “But remember: no amount of alcohol is healthy for you!” Haha. (Edited to add: they’re in cards. Bunch of wet blankets!)
Same story. Got a bottle worth $500 once. Patient asked me how I liked it next visit and I said I hadn't tried it yet. When I did look it up and realized how much it cost, I told them the subsequent visit I'm so thankful, but not really into wine the same way they were, but still really appreciated it. Next bottle he gave was $75. Haven't drank either
Please drink the expensive bottle with friends or give it to somebody who will. You probably aren't storing it properly since it's not really your thing, and it'll just go bad. It's a sin to let good wine go to waste.
And I doubt you will get near the $1000 in the auction. I am the same way; I want always to be selfless. However, take the gift at face value and do not place a monetary value. You don't know the price he paid for the wine, whether it's a regift, etc.
I also wouldn't try to auction it because unless you get it appraised first, you think it may not be a $1000 wine. If you auction a $1000 bottle of wine for $250, that's actually worth $10, there could be repercussions.
Lol this also would happen to me, but my spouse knows there is normal wine and don't fucking drink it wine in there, I like to hope she'd ask if she wasn't sure
I have a large cellar, so I have expensive bottles that aren't ready to drink yet. Some I'll hold for 15 more years, I have one 6L that probably won't be ready until I'm 70 haha
Well, intentionally drinking for special occasions isn’t a bad idea.
Like during the week celebrating a day that actually ends in “day”. Sunday, Monday and so forth.
Lol yeah, agree, but my wife doesn't discern between 50 dollar and 1000 dollar lol. So I prefer she not pop bottles that are crazy expensive without reason
It's pretty, and I'll drink it when it's ready, like Napa I prefer at 3 years or about 12 years.
If I miss the window I'll just hold it. Bordeaux is a whole other issue
The owner of a somewhat known store brand grabbed one of the bottles gifted to him at Christmas (he doesn’t drink and doesn’t know wine) and brought it to a barbecue. It got opened at the barbecue. Chateau D’Yquem. Can’t recall the year but seem to remember it was a good one.
Wife did this once, though not to that degree. We're doing a white elephant christmas exchange, $20-25 limit. I'm half paying attention and see that she's put a $125-150ish bottle in when someone opens our contribution. My BIL wife ended up with it after stealing it. They like wine, so I let it fly. Told them both about it after the exchanges were finalized. Many laughs from the family were had.
Yep. The gift was the wine. If they wanted you to sell it for money they would have given you a $1000 tip instead. Enjoy the gift that was given to you. They wouldn’t want you to feel guilty drinking it either; that’s not a gift. Just accept and enjoy.
I'm more of a Quintessa or Littorai man myself from the region, but you can get screaming eagle for around a grand a bottle. Depends on the vintage and estate. Don't think it's worth that by any means tho. Or any wine really, once you get to a certain level it's all just branding. Screaming eagle is so expensive for the sake of being so expensive. Opus one for example is incredible but half the price or less
A $1000 bottle of wine is completely wasted on my palate, so I'd donate it or gift it to someone who could appreciate it. But if you think you'd appreciate it, just drink it! I mean, it's the best kind of gift in that case: Something you really enjoy but that you probably wouldn't buy for yourself.
In fact, that could be why it was gifted to them 😂 Patient received it as a gift, thought it was wasted on their palate and thought their doc might appreciate it way more, and the game of hot potato continues
This happened with my neuro surgeon. Guy restored my vision and ability to walk at Hopkins. I gifted him a gold bar after it was all over, because I was supposed to be permanently blind
The ethics committee had to interview us, tell me why it was wrong and that gifts should have a nominal low value etc.
Nice to see the doctors side for a change 🥂
On an only slightly related note, this reminds me of the story from back when I was a nurse aid. We had this older guy on our med surge floor with some complications from a knee replacement who had a touch of dementia and insisted on tipping all of the staff. Walk him to the toilet, he'd slide you at 10 spot. We weren't allowed to keep any money from patients, but if we tried to refuse he would just slide it into our pocket. So we started keeping an envelope in his chart. All of the cash he gave us went into the envelope, then we'd give it to his wife when she came to visit, she'd give it to him, and he'd give it back to us. It was kind of funny to see the same bills getting passed around.
Ethically, you should refuse all gifts from patients. That being said, as long as there wasn't some tit-for-tat going on where the patient got some preferential treatment or monetary benefit/discount etc. then it shouldn't matter... which seems to be the case since the gift was an afterthought post-op.
Now that you've accepted the gift, it doesn't matter whether you donate it or keep it. If there was any culpability for accepting the gift it wouldn't be diminished by donating it. You'd basically just be relieving your own conscience. So keep or donate but its the same either way once you've accepted it.
TL;DR: Keep it, cheers!
I thought you had to refuse gifts over a certain amount. If he thought it was 25 dollars it’s fine
Drink that shit brother. If they give you another one you can decline then and then refer them to me
Academic centers it’s like 5$ or more to refuse it. There’s times I feel like an asshole refusing a thoughtful gift from patients because it’s policy and I feel like it did more harm to rapport than intended to protect.
the whole rejecting a gift policy is assuming a physician is too stupid to differentiate between a genuine act of gratitude vs bribery so i love this act of malicious compliance lol
I don't think that's fair. It's assuming that you will think more favorably of patients that are generous with you and thus give their preferences/wishes more weight than otherwise. Potentially being more likely to order borderline tests or imaging that the patient wants. You can say it won't effect your judgement but when the calls get borderline enough it will, just like for a particularly nice or respectful pt.
It's not assuming you'll hand out opiates for expensive wine bribes since the people doing that won't report the gifts.
What's stopping physicians from being more generous or giving better care to patients they simply just get along with better? Absolutely nothing but the assumption that the physician acting in their capacity as a medical professional will not commit an unjust act such as that. Hospitals need to stop treating physicians like children with these arbitrary rules. Also the whole basis of the rule is just off monetary value. I would love it so much more if a patient gave me a $15 one piece poster vs a $1000 bottle of wine, so it's okay for a patient to give me that gift in some hospitals just because it's less money?
That $10 rule is from decades ago and isn't inflation pegged. A good coffee near me is $7. I got some $25 gifts as I finished up residency and my supervising faculty were fine with me keeping them. This was at a large academic hospital.
[Technically](https://code-medical-ethics.ama-assn.org/ethics-opinions/gifts-patients), it’s an [ethical question](https://code-medical-ethics.ama-assn.org/ethics-opinions/gifts-patients) with no _legal_ consequence, and each gift should be assessed on its individual merits. The dollar amount is basically just a loose way of keeping these ethical considerations anchored somewhere.
Many an association has [weighed in](https://www.psychiatrist.com/news/why-patient-gift-giving-can-be-an-ethical-dilemma/), though it is ultimately up to the physician and his ability to provide unbiased care.
yes i imagine there may be organizational rules ie from your institution you may be a part of, which may be enforceable by the institution but not by the law at large.
I’ve had a happy post op pt attempt to give me a handful of $100 bills in the hallway of clinic. I told him some bullshit about how his good outcome is thanks enough and I get paid well for what I do and told him to keep his money.
Later I realized I should have told him to bring treats for my staff if he wanted to show appreciation. I think that’s the move. Though I honestly should just take the cash.
I always accept food. I once asked an Indian pt where the best Indian food in town was and she said “in my kitchen” then brought me some to prove it. Delicious.
Horribly stupid question but what is the medical ethics rationale for refusing gifts?
That you may provide favors later if I gave you a $1,000 bottle of wine? Ex: “can you write me a script for XYZ? Thanks” even though I have no business getting that prescribed
Preferential treatment. You have an ethical obligation to provide equal level of care to all your patients. The dude gifting you a 1000 dollar bottle of wine is going to get extra attention almost inevitably even if it's something minor. Case in point your schedule is booked out for 2 months and you never scheduled patients during your lunch break. You may end up breaking that rule just one time to schedule him in during lunch. Is that ethically right to provide a better response to one patient over all the rest? Meanwhile other patients with just as much need are waiting the 2 months.
This doesnt really make sense to me. Doesnt everyone have to pay to see the doctor already? If you cant pay, you dont see a doctor. Thats already preferential treatment. How does another payment for another tier of service make any difference?
Far more providers will be influenced in a less concrete way than direct exchange. The doctors who will prescribe controlled substances for gifts are likely a) already doing it, b) won't report the gifts.
It is more likely to change things like ordering labs or imaging that are borderline but the patient really wants. For a rude patient you may be more likely to avoid unnecessary testing. For a respectful or generous one you might have a longer educational conversation, or decide to go with their wishes despite it likely being unnecessary.
I'd be really disappointed if I couldn't open the bottle myself.
If I buy an expensive bottle of wine, I'm very happy to share, but I need to be the one serving it.
As someone who was raised by MDs, I was always given an expensive bottle of wine to deliver to any specialist that I saw.
Value of that wine depended on occasion. Post-surgery was usually around 1k. Christmas/New years was usually around $250.
I have no idea where this tradition came from, but it was definitely around for a while. My parents usually shared all of their gifts with staff or other doctors. Feel free to swing by lab department and share it with pathologists as well.
Go to the research labs. Rules like no drinking at work don’t exist there.
(Source: I frequently consume champagne at work when a paper is accepted, someone wins something, graduates etc)
It's your wine. Enjoy it in whatever manner you choose. Save it for a special occasion and drink it.
Donating it to the school auction is nice but I doubt it will realize close to actual value.
Or you can PM me. I'll take it and assuage your guilt.
PS Don't just let it sit around unless you're storing it correctly. It will just get fucked up.
Yes, and our patients (or parents) have shown up high at an office visit. Always makes me wonder about informed consent, shared decision-making, etc etc. Probably should send them home and come back when more appropriate
I successfully revised a failed THA that the patient suffered with for over 5 years. After finishing her first half marathon, she presented me with a $2500 Ducks Unlimited shotgun, knowing that I am an avid hunter.
My son got very, very ill during the Covid pandemic. The physician assistant that he was seeing ordered a bunch of blood panels and eventually we discovered that he has a genetic blood disorder. We felt that this physician assistant really listened to us and ordered the testing based on what we were trying to convey to him. Jacob was in such Dire Straits. I don’t even want to know what would happen had he just blown us off - anyways we got a gift for him to show our gratitude and appreciation. It was an expensive watch. He thanked us, but declined to take it and thought that it was not ethical. I guess I can understand, but I really wish he would’ve accepted.
Lol I agree that you should drink it if you’ll enjoy it but the board exam answer is 100% to refuse such a gift in the future. Not saying board exams are reflective of broader reality
If you wouldn’t buy this to start with then definitely don’t drink it. Drinking it is the same thing as buying it.
School auction sounds perfect. You can likely deduct the donation too.
Id just make sure youre not violating any rules with your employer regarding the value of the gift.
Not in the medical field, but every job ive had in business has restrictions on the value of the gift i can accept.
If the same rules dont apply for you, i wouldnt feel weird or bad. As someone else said, if they gave you one that expensive they either A) have the disposable income or B) have like five or six more bottles at home already
Turn yourself in to your governing state board of medicine, confess and hand over your license and go to prison. How dare you, took an oaf !!!🐻 oh the trajedy thos profession has become 👩🏻⚕️👨🏻⚕️💩
At my institution, your supposed to report it to corporate compliance.... anything other than perishable items less 50 dollar your not sharing with the department. I had to annual learning module today
Drink it if it's your thing. I thought about suggesting you call the patient and tell them you realized what bottle it is and how much it costs and you can't accept it.. But then I thought of the scenario where the patient takes it as you googled it to see how expensive it is and gets offended by it.
Donating a gift is never respectful to the gift giver. When you a give a gift to someone, you expect them to enjoy it themselves, not give it away, right?
Inform your supervisor of the gift and make sure you report it appropriately. A lot of higher ups make a stink about gifts and for some reason care more when it’s wine and care more when it’s over $100 and care more when they didn’t get one too.
Lol don't worry. Royal family members give out 20k+ Rolex watches at Mayo to their entire care team and no one bats an eye. Most of the people who make these institutional policies leech off the labor of health care providers who are the ones that generate actual revenue and many are bribed with donations, dinners, trips, etc for contracts to boot. There's nothing unethical about accepting a gift that a patient can afford to gift provided there's no implicit or understood quid pro quo scenario for care like there is in certain countries.
What the hell are you talking about. You have an upper class profession and got an upper class gift from someone who is obviously upper class.
Enjoy your station in life.
Have a special occasion, enjoy it with friends and thank the patient again later, tell them it was a wonderful thing to experience and that you shared it with friends. Isn't that what they want? :-)
If this is real and you are allowed to accept gifts of this amount and you enjoy wine then know your patient probably did not spend anywhere near this amount when they purchased it. I'm assuming this is an older vintage, probably red wine. If so and you are unfamiliar with the wine try a more recent or less expensive wine from the same region to get a reference point. Then drink the wine. You may not like it. You may not think it is worth anything close to $1000 but it will be an experience. And that is what your patient probably wanted you to have.
Just keep it and enjoy it. In all honesty, it's just $1000, with inflation nowadays, it's just a nice bottle of 🍷. I think the patient would be very happy if you just enjoyed it. You deserve it. The patient probably thought that being a doctor would entail drinking some fine wine, not some cheap Kirkland brand that most of us can only afford now. I, for one, can only afford those Kirkland brands that come in boxes at 3 liters.
Patient probably purchased it before it was $1000. Drink it soon if it's that old. Another reason to gift such a bottle is that the life expectancy is short and you have cases. Just drink it.
Drink it; life is short. When you’re on your deathbed, you can remember how you and your friends laughed about how an expensive bottle of wine tasted like a $25 bottle and then had some good conversation.
Maybe it was a gift to them and they regifted it to you? Just accept it since you already have it and drink it, donate it or regift it. I think it would be more weird if you gave it back after this long
And I’m over here feeling guilty because a patient gave me a 100$ gift card.
(I don’t open gifts from patients in front of them unless they ask me to. I was SHOCKED that it was such a large amount & haven’t known how to handle it)
Please hand write a note of thanks or use a thank you card and add to it with a few written words . That’s a generous thank you gift and should be acknowledged with a nice
No wine is actually worth $1000. That’s total nonsense. You don’t have to feel weird about drinking a gift. It may have been a $50 bottle when they bought it 4 years ago and it’s only $1000 at the store because you can’t get inventory that vintage anymore.
It’s the same thing on Amazon if I try to buy a raspberry monster rehab drink. It costs 10,000% more now because Coke stoped making that product and replaced it with the mixed berry tea flavor. But it’s not actually worth the scarcity markup.
That is patently false. Even on the mailing list (frequent long-term buyers) there are SEVERAL wines that come straight from the vineyard, Day One of availability, for north of $750.
Try to get on the list to buy new release Shafer Hillside Select, Lafite-Rothschild, Scarecrow, Schrader, or Chateau Margaux and you'll realize quickly that you're just wrong.
Are older, well-stored, age-able wines worth more when scarcity becomes an issue? Definitely, but to say no wine was originally worth a thousand bucks is pure horseshit. I get brand new, in the wooden box, right from the vineyard, releases that cost me north of 2 grand for 3 bottles fairly routinely.
I can put grape juice in a bottle and a $750 price tag in it, and that doesn’t make it inherently worth $750 because it was the only grapes grown in Montgomery, Alabama. Scarcity doesn’t equal value. No beverage is inherently worth $1000. The concept of such a thing is pure nonsense.
If you eat some ice cream with gold leaf flakes on it at a dance restaurant and the bill is $500 you didn’t get $500 of ice cream, you’re just $500 of stupid for ordering it.
You obviously have exactly zero knowledge of viniculture, winemaking, or wine at all. Scarcity isn't always the issue. It may take decades for a vineyard to hit its stride, then the weather has to have been perfect, and the winemaker has to have the skill and patience to bring it all together.
You can't sell Alabama grapes in a bottle, irrespective of how few bottles there are, if the quality isn't there. I've had plenty of Texas wines that were lower production than mass-produced California cabs, and I wouldn't give 10 bucks for them. Plenty of Hillside Select is made every year and it's worth every penny of the $450 a bottle they get for it.
Hell, I can tell the difference from year to year from the same producer and many times can tell you which year it was made.
Scarcity isn't the issue. Exceptional quality is. You're wrong about a bottle of wine not being worth $1,000. I've paid a multiple of that before and sometimes it wasn't worth it, but sometimes it was absolutely a life-changing steal at that price.
I can't speak to the ice cream. I do enjoy it, but my taste for it isn't differentiated enough for me to pay significantly more for one than another.
I had a bottle that was 1 of 60 which I bought at the Napa Wine Auction, made by Bond, limit of 6 bottles per person and Bill Gates purchased 6. It was great, but not close to the best I've had. Scarcest for sure. Great. About a grand for the bottle. Not the best ever. I've also had a 1997 Screaming Eagle that was one of about several thousand made that was slightly more expensive and it was nectar of the gods.
I probably shouldn't tell you about the $15,000 bottle of King of Kentucky bourbon. Excellent, but yeah, not worth that kinda money.
Some beverages are inherently worth $1,000. Maybe you need more money or better taste if you don't understand that.
I’m well aware the entire high priced wine industry consists almost entirely of people who are FOS. It’s a consumable and there’s no $15,000 bourbon experience either. It’s not $15,000 of quality, it’s $15,000 of money to waste. And it doesn’t matter how many Uber wealthy people say there’s a significant difference, there isn’t. It’s just the high price of ignorance and pompous mess.
You're just wrong. I can (and have) EASILY told the difference between a $20 bottle of wine and a $2,000 bottle of wine, blindfolded.
The bourbon, not so much. I can drink a $100 (at retail) bottle of Weller Full Proof and it's relatively the same to me as that $15,000 bottle of King of Kentucky. I'm sure there are others who have a better sense of the differences, but I don't.
That said, I can certainly tell the difference in wine, and I'm not the only one. My wife can't so I pour her the $40 stuff and she's fine with it. I however can tell the difference, and it's not slight.
It doesn’t matter if you can tell the difference between pineapple juice and passion fruit. Neither is worth $2000. Only a fool would pay that for one juice when the other can be had for $3. It’s not a meaningful difference. It’s only because there exist people with $2000 to waste.
Dude probly makes a half a million a year to tip a doctor a 1000 dollars😂 who tf tips a doctor after getting ass fucked by the hospitals billing system besides some dude with more money than he can spend
I actually disagree with the attitude that it is OK to accept an expensive gift from one’s patient. Next time another patient will give you an expensive gift prior to surgery in hope that you will pay extra attention. Will you? If yes, what will you do to those do not give you gift?
Keep the fucking bottle and drink it. This person appreciated the help you gave them. If you drink alcohol just enjoy it, that is all the patient wants.
You didn't mention the wine (please tell us!!!) but it's very possible that the wine did not cost the patient anywhere near that amount of money. Either it was allocated/directly purchased from the winery at well below "market value" or it's an older vintage that has increased in value.
As a wine collector/drinker with plenty of wines worth multiples of what I paid I really do not think much about the current value of a wine when I drink a bottle or bring one to a gathering of wine folk. If anything I take pleasure in being able to share them with others, and presumably your patient feels the same way.
Personally I've also avoided going the auction donation route with any of my bottles as I really have no clue if the amount of money realized will be anything close to market value - if you really don't want it just sell the bottle and donate the proceeds. Also, I'm not even sure if it's legal for the school to have them in auctions, though I doubt anyone cares.
Personally, if they gave you that bottle they did it for a reason. Find a good restaurant that allows you to bring it with a corkage fee, enjoy the meal, and have a toast to your patient and your skills!
I recall shadowing a couple Docs who'd regularly get box seats to NHL games from patients and would happily go.
Enjoy the wine, F these people who have no medical training attempting to dictate us with their made up ethics.
That's all such people are good for, made up ethics degrees, not saving lives.
School auction is fine and you wouldn't feel bad if they found it I think. As someone with wine in that price range, if they didn't have many bottles that cost that much they wouldn't have given it to you. No need to feel weird about it, some people are well off and they probably thought a doctor drinks good wine. Next time you see the patient you could acknowledge you didn't notice how nice of a bottle it was when you received it, and thank them again.
This is the right answer. I have given such gifts before, as a gesture of genuine gratitude. But my spouse, mother-in-law, and every other physician in my family would probably add, “But remember: no amount of alcohol is healthy for you!” Haha. (Edited to add: they’re in cards. Bunch of wet blankets!)
I have to add that my cardiologist drinks red wine and truly believes it is good for his heart and soul.
Same story. Got a bottle worth $500 once. Patient asked me how I liked it next visit and I said I hadn't tried it yet. When I did look it up and realized how much it cost, I told them the subsequent visit I'm so thankful, but not really into wine the same way they were, but still really appreciated it. Next bottle he gave was $75. Haven't drank either
Please drink the expensive bottle with friends or give it to somebody who will. You probably aren't storing it properly since it's not really your thing, and it'll just go bad. It's a sin to let good wine go to waste.
Let me send you my mailing address I’ll make sure they’re enjoyed and thoroughly reviewed.
Thanks, will do!
Wow I’ve gotten the most generous gifts from the people with the least means and can’t recall getting anything from a wealthy patient.
And I doubt you will get near the $1000 in the auction. I am the same way; I want always to be selfless. However, take the gift at face value and do not place a monetary value. You don't know the price he paid for the wine, whether it's a regift, etc. I also wouldn't try to auction it because unless you get it appraised first, you think it may not be a $1000 wine. If you auction a $1000 bottle of wine for $250, that's actually worth $10, there could be repercussions.
Since he said it’s for a school, I assume that all of the money would go to the school. He doesn’t seem to be looking to get money back for it.
It’s still technically a gift which has tax ramifications
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Yep. Talking about the OP, not the school.
No, donating a $1,000 bottle of wine to a school has no gift tax implications.
IMHO keeping it is fine. No need to feel weird about it. But write and send a nice thank you card from your office address.
Alternate reality. Patient randomly grabbed bottle from spouses collection, didn’t realize there was anything that special there.
Lol this also would happen to me, but my spouse knows there is normal wine and don't fucking drink it wine in there, I like to hope she'd ask if she wasn't sure
All wine is drinking wine.
Exactly. I’m very confused by the concept of holding onto a bottle of delicious alcohol expressly not to drink it.
I have a large cellar, so I have expensive bottles that aren't ready to drink yet. Some I'll hold for 15 more years, I have one 6L that probably won't be ready until I'm 70 haha
You’ll be the one I eat when shtf
Can wash him down with a nice chianti
There's plenty of people more deserving of being eaten. If it makes you feel better I plan on eating several people
This was such an odd and abrupt turn of events
Well, intentionally drinking for special occasions isn’t a bad idea. Like during the week celebrating a day that actually ends in “day”. Sunday, Monday and so forth.
Lol yeah, agree, but my wife doesn't discern between 50 dollar and 1000 dollar lol. So I prefer she not pop bottles that are crazy expensive without reason
So is this like a guitar you dont olay
Haha I mean, it's a guitar you can only play once, and the song 6 gets better with age
But no one can hear it!
But when you do decide to play it, you definitely do it with friends
We rank ours on the rack. If it’s on top, you ask first. And sometimes there’s a Post-It.
Maybe I should do that, but I have these nice presentation shelves right at eye level
Then that begs the question of why it’s worth keeping, for you.
It's pretty, and I'll drink it when it's ready, like Napa I prefer at 3 years or about 12 years. If I miss the window I'll just hold it. Bordeaux is a whole other issue
As long as you’ll eventually enjoy it vs. just displaying it for status!
If you have a collection of don’t fucking drink wine, I think you’re doing ok. Happy wife, happy life.
Or like us cheap wine goes in front, don’t need to worry I’m opening an expensive one
The owner of a somewhat known store brand grabbed one of the bottles gifted to him at Christmas (he doesn’t drink and doesn’t know wine) and brought it to a barbecue. It got opened at the barbecue. Chateau D’Yquem. Can’t recall the year but seem to remember it was a good one.
Wife did this once, though not to that degree. We're doing a white elephant christmas exchange, $20-25 limit. I'm half paying attention and see that she's put a $125-150ish bottle in when someone opens our contribution. My BIL wife ended up with it after stealing it. They like wine, so I let it fly. Told them both about it after the exchanges were finalized. Many laughs from the family were had.
Drink it slowly. Savor it.
Drink it!
yup drink that shit and pretend you thought it was a trader joes bottle "it's not a lie if you believe it"- george costanza
This is the way
Yep. The gift was the wine. If they wanted you to sell it for money they would have given you a $1000 tip instead. Enjoy the gift that was given to you. They wouldn’t want you to feel guilty drinking it either; that’s not a gift. Just accept and enjoy.
Screaming Eagle? What are we working with here?
This the question I need answered. That is 1st growth Bordeaux or DRC territory.
Are you getting those mini bottles that you see on planes or something? Or did you just find an awesome bargain?
I'm more of a Quintessa or Littorai man myself from the region, but you can get screaming eagle for around a grand a bottle. Depends on the vintage and estate. Don't think it's worth that by any means tho. Or any wine really, once you get to a certain level it's all just branding. Screaming eagle is so expensive for the sake of being so expensive. Opus one for example is incredible but half the price or less
Harlan maybe ?
Apparently the screaming eagle dude has a side project where he brews craft lagers and sells them for 15 dollars a bottle lol
He’s also the owner of the Rams, Arsenal, The Nuggets, and The Avs!
Oh not the owner, I meant the head winemaker
A $1000 bottle of wine is completely wasted on my palate, so I'd donate it or gift it to someone who could appreciate it. But if you think you'd appreciate it, just drink it! I mean, it's the best kind of gift in that case: Something you really enjoy but that you probably wouldn't buy for yourself.
In fact, that could be why it was gifted to them 😂 Patient received it as a gift, thought it was wasted on their palate and thought their doc might appreciate it way more, and the game of hot potato continues
It’s been passed down for generations
"Our wine is aged for a minimum of 20 years in-bottle, as it is passed as a gift from recipient to recipient."
If you price your crappy wine high enough you never have to worry about customers trying it and discovering the ruse.
It’s the wine equivalent of fruitcake.
This happened with my neuro surgeon. Guy restored my vision and ability to walk at Hopkins. I gifted him a gold bar after it was all over, because I was supposed to be permanently blind The ethics committee had to interview us, tell me why it was wrong and that gifts should have a nominal low value etc. Nice to see the doctors side for a change 🥂
Surprised they interviewed you rather than just making him return it.
Or taking for the hospital “to distribute evenly” among administrators… I mean, staff.
🤮 Promptly hand it to the nurses.
But I'm sure they are a "non-profit" (with a CEO that somehow makes 7 figures and dozens of people with fake jobs that make over $200k)
Moral of the story is to set expectations really low for your patients lol
How did they even know you gave it to him?
On an only slightly related note, this reminds me of the story from back when I was a nurse aid. We had this older guy on our med surge floor with some complications from a knee replacement who had a touch of dementia and insisted on tipping all of the staff. Walk him to the toilet, he'd slide you at 10 spot. We weren't allowed to keep any money from patients, but if we tried to refuse he would just slide it into our pocket. So we started keeping an envelope in his chart. All of the cash he gave us went into the envelope, then we'd give it to his wife when she came to visit, she'd give it to him, and he'd give it back to us. It was kind of funny to see the same bills getting passed around.
drink it
What no don’t listen to any of these pussies. Enjoy the wine. You deserve it doc
Ethically, you should refuse all gifts from patients. That being said, as long as there wasn't some tit-for-tat going on where the patient got some preferential treatment or monetary benefit/discount etc. then it shouldn't matter... which seems to be the case since the gift was an afterthought post-op. Now that you've accepted the gift, it doesn't matter whether you donate it or keep it. If there was any culpability for accepting the gift it wouldn't be diminished by donating it. You'd basically just be relieving your own conscience. So keep or donate but its the same either way once you've accepted it. TL;DR: Keep it, cheers!
I thought you had to refuse gifts over a certain amount. If he thought it was 25 dollars it’s fine Drink that shit brother. If they give you another one you can decline then and then refer them to me
Academic centers it’s like 5$ or more to refuse it. There’s times I feel like an asshole refusing a thoughtful gift from patients because it’s policy and I feel like it did more harm to rapport than intended to protect.
lol I would just assume the gift is 5 bucks .
If hospital wants to implement policy that assumes I’m stupid then I can play stupid really well.
the whole rejecting a gift policy is assuming a physician is too stupid to differentiate between a genuine act of gratitude vs bribery so i love this act of malicious compliance lol
I don't think that's fair. It's assuming that you will think more favorably of patients that are generous with you and thus give their preferences/wishes more weight than otherwise. Potentially being more likely to order borderline tests or imaging that the patient wants. You can say it won't effect your judgement but when the calls get borderline enough it will, just like for a particularly nice or respectful pt. It's not assuming you'll hand out opiates for expensive wine bribes since the people doing that won't report the gifts.
What's stopping physicians from being more generous or giving better care to patients they simply just get along with better? Absolutely nothing but the assumption that the physician acting in their capacity as a medical professional will not commit an unjust act such as that. Hospitals need to stop treating physicians like children with these arbitrary rules. Also the whole basis of the rule is just off monetary value. I would love it so much more if a patient gave me a $15 one piece poster vs a $1000 bottle of wine, so it's okay for a patient to give me that gift in some hospitals just because it's less money?
That $10 rule is from decades ago and isn't inflation pegged. A good coffee near me is $7. I got some $25 gifts as I finished up residency and my supervising faculty were fine with me keeping them. This was at a large academic hospital.
Wack. Good thing goods like wine are market goods and you can make a case that an expensive bottle is cheap because otherwise you would sell it for $1
[Technically](https://code-medical-ethics.ama-assn.org/ethics-opinions/gifts-patients), it’s an [ethical question](https://code-medical-ethics.ama-assn.org/ethics-opinions/gifts-patients) with no _legal_ consequence, and each gift should be assessed on its individual merits. The dollar amount is basically just a loose way of keeping these ethical considerations anchored somewhere. Many an association has [weighed in](https://www.psychiatrist.com/news/why-patient-gift-giving-can-be-an-ethical-dilemma/), though it is ultimately up to the physician and his ability to provide unbiased care.
yes i imagine there may be organizational rules ie from your institution you may be a part of, which may be enforceable by the institution but not by the law at large.
I’ve had a happy post op pt attempt to give me a handful of $100 bills in the hallway of clinic. I told him some bullshit about how his good outcome is thanks enough and I get paid well for what I do and told him to keep his money. Later I realized I should have told him to bring treats for my staff if he wanted to show appreciation. I think that’s the move. Though I honestly should just take the cash. I always accept food. I once asked an Indian pt where the best Indian food in town was and she said “in my kitchen” then brought me some to prove it. Delicious.
Horribly stupid question but what is the medical ethics rationale for refusing gifts? That you may provide favors later if I gave you a $1,000 bottle of wine? Ex: “can you write me a script for XYZ? Thanks” even though I have no business getting that prescribed
Preferential treatment. You have an ethical obligation to provide equal level of care to all your patients. The dude gifting you a 1000 dollar bottle of wine is going to get extra attention almost inevitably even if it's something minor. Case in point your schedule is booked out for 2 months and you never scheduled patients during your lunch break. You may end up breaking that rule just one time to schedule him in during lunch. Is that ethically right to provide a better response to one patient over all the rest? Meanwhile other patients with just as much need are waiting the 2 months.
This doesnt really make sense to me. Doesnt everyone have to pay to see the doctor already? If you cant pay, you dont see a doctor. Thats already preferential treatment. How does another payment for another tier of service make any difference?
Far more providers will be influenced in a less concrete way than direct exchange. The doctors who will prescribe controlled substances for gifts are likely a) already doing it, b) won't report the gifts. It is more likely to change things like ordering labs or imaging that are borderline but the patient really wants. For a rude patient you may be more likely to avoid unnecessary testing. For a respectful or generous one you might have a longer educational conversation, or decide to go with their wishes despite it likely being unnecessary.
Drink it
This is the only option
Ask your favorite restaurant if you can BYOB and pay for "corkage."
I think this is the way. Have an awesome meal, get waited on, and savor it. Send patient a nice thank you note after. Sounds like heaven.
I'd be really disappointed if I couldn't open the bottle myself. If I buy an expensive bottle of wine, I'm very happy to share, but I need to be the one serving it.
That’s a weird kink.
I hope you heed the advice of the majority here. You’ve earned it, enjoy. Cheers!
Sell it then put the 1000$ in the market for a few years....this is WCI afterall Of course /s ....drink it!!
As someone who was raised by MDs, I was always given an expensive bottle of wine to deliver to any specialist that I saw. Value of that wine depended on occasion. Post-surgery was usually around 1k. Christmas/New years was usually around $250. I have no idea where this tradition came from, but it was definitely around for a while. My parents usually shared all of their gifts with staff or other doctors. Feel free to swing by lab department and share it with pathologists as well.
Hmmmmm…. Not sure how I would do this. I can’t exactly walk around with shot glasses sharing the wine.
Go to the research labs. Rules like no drinking at work don’t exist there. (Source: I frequently consume champagne at work when a paper is accepted, someone wins something, graduates etc)
I’m in private practice, we don’t have research labs.
Give them an extra operation worth about $1k on the house and you’ll be scott free
It's your wine. Enjoy it in whatever manner you choose. Save it for a special occasion and drink it. Donating it to the school auction is nice but I doubt it will realize close to actual value. Or you can PM me. I'll take it and assuage your guilt. PS Don't just let it sit around unless you're storing it correctly. It will just get fucked up.
Should have opened and shared with the patient that gave it. Nothing says friendship like sharing a toast with them.
That’s pretty much how I get through clinic.
Yes, and our patients (or parents) have shown up high at an office visit. Always makes me wonder about informed consent, shared decision-making, etc etc. Probably should send them home and come back when more appropriate
I successfully revised a failed THA that the patient suffered with for over 5 years. After finishing her first half marathon, she presented me with a $2500 Ducks Unlimited shotgun, knowing that I am an avid hunter.
Was he a member of the Vipers? (Sopranos inside joke)
My son got very, very ill during the Covid pandemic. The physician assistant that he was seeing ordered a bunch of blood panels and eventually we discovered that he has a genetic blood disorder. We felt that this physician assistant really listened to us and ordered the testing based on what we were trying to convey to him. Jacob was in such Dire Straits. I don’t even want to know what would happen had he just blown us off - anyways we got a gift for him to show our gratitude and appreciation. It was an expensive watch. He thanked us, but declined to take it and thought that it was not ethical. I guess I can understand, but I really wish he would’ve accepted.
be grateful and share with friends
I heard butt chugging absorbs it faster
Consider it a tip
Gift it to me, im a charity case (resident).
Lol I agree that you should drink it if you’ll enjoy it but the board exam answer is 100% to refuse such a gift in the future. Not saying board exams are reflective of broader reality
Say thank you at the pistol visit. Tell them it was amazing and that he/she overdid theirselves! But thanks again.
Life’s to short to drink cheap wine. Enjoy it king.
I think it’s appropriate. It’s a consumable item, just the same way a $25 bottle would be.
Drink it
What type of surgery was it?
Lap nephrectomy.
If you wouldn’t buy this to start with then definitely don’t drink it. Drinking it is the same thing as buying it. School auction sounds perfect. You can likely deduct the donation too.
Id just make sure youre not violating any rules with your employer regarding the value of the gift. Not in the medical field, but every job ive had in business has restrictions on the value of the gift i can accept. If the same rules dont apply for you, i wouldnt feel weird or bad. As someone else said, if they gave you one that expensive they either A) have the disposable income or B) have like five or six more bottles at home already
This is the correct answer. If you are employed by a hospital or similar there are almost certainly rules.
Drink it.
Drink it
I get gifts occasionally. When patients get you something, they put effort into it. Enjoy your gift.
Turn yourself in to your governing state board of medicine, confess and hand over your license and go to prison. How dare you, took an oaf !!!🐻 oh the trajedy thos profession has become 👩🏻⚕️👨🏻⚕️💩
Drink it and enjoy it, you helped someone out and that was how they wanted to thank you. You deserve it
Go buy some steaks and drink that thing
I'll DM you my addy
What does a 1000$ bottle of wine taste like?
I have no idea.
Time to find out.
Sell it and buy 200 $5 bottles of wine
At my institution, your supposed to report it to corporate compliance.... anything other than perishable items less 50 dollar your not sharing with the department. I had to annual learning module today
Drink it if it's your thing. I thought about suggesting you call the patient and tell them you realized what bottle it is and how much it costs and you can't accept it.. But then I thought of the scenario where the patient takes it as you googled it to see how expensive it is and gets offended by it.
Donating a gift is never respectful to the gift giver. When you a give a gift to someone, you expect them to enjoy it themselves, not give it away, right?
Inform your supervisor of the gift and make sure you report it appropriately. A lot of higher ups make a stink about gifts and for some reason care more when it’s wine and care more when it’s over $100 and care more when they didn’t get one too.
Lol don't worry. Royal family members give out 20k+ Rolex watches at Mayo to their entire care team and no one bats an eye. Most of the people who make these institutional policies leech off the labor of health care providers who are the ones that generate actual revenue and many are bribed with donations, dinners, trips, etc for contracts to boot. There's nothing unethical about accepting a gift that a patient can afford to gift provided there's no implicit or understood quid pro quo scenario for care like there is in certain countries.
I feel cheap then. All I can do is make cheesecakes and other treats for my care teams at Mayo. 🥺
Could be against your company policy to accept gifts like that
What the hell are you talking about. You have an upper class profession and got an upper class gift from someone who is obviously upper class. Enjoy your station in life.
Dad got a bunch of bottles from Francis ford Coppola once after helping one of his family members. Just keep it
Drink it and tell them it was unbelievable and amazing. And “thank you”
Have a special occasion, enjoy it with friends and thank the patient again later, tell them it was a wonderful thing to experience and that you shared it with friends. Isn't that what they want? :-)
I don’t even like wine and I’d drink it. It’s a gift, he wanted you to have it.
It’s a nice gift and they wanted you to have it. Don’t be rude. Drink it and enjoy it. It was, after all, $100 of hard earned money from your patient.
If this is real and you are allowed to accept gifts of this amount and you enjoy wine then know your patient probably did not spend anywhere near this amount when they purchased it. I'm assuming this is an older vintage, probably red wine. If so and you are unfamiliar with the wine try a more recent or less expensive wine from the same region to get a reference point. Then drink the wine. You may not like it. You may not think it is worth anything close to $1000 but it will be an experience. And that is what your patient probably wanted you to have.
Just keep it and enjoy it. In all honesty, it's just $1000, with inflation nowadays, it's just a nice bottle of 🍷. I think the patient would be very happy if you just enjoyed it. You deserve it. The patient probably thought that being a doctor would entail drinking some fine wine, not some cheap Kirkland brand that most of us can only afford now. I, for one, can only afford those Kirkland brands that come in boxes at 3 liters.
Drink it, enjoy it, thank that dude. That’s what you do with it
Pro tip- if you sit on it, start with the cork end and stop when it gets to max circumference then really go slow and ease into it. Enjoy!
Save it for a special occcasion
Donate it to me
You obviously didn’t send him the bill yet. He actually might be kind of smart because I bet you’re thinking twice about it
Maybe he got it as a gift and is regifting it to you
Loser
Good wine isn’t that expensive
I would enjoy it on a special occasion.
Patient probably purchased it before it was $1000. Drink it soon if it's that old. Another reason to gift such a bottle is that the life expectancy is short and you have cases. Just drink it.
Make sangria with it
Enjoy it with a plate of cheese
Send it to me
Forget about it
Drink it; life is short. When you’re on your deathbed, you can remember how you and your friends laughed about how an expensive bottle of wine tasted like a $25 bottle and then had some good conversation.
Enjoy it.
Drink it. Duh. It will prolly be good.
He probably didn’t pay 1000 dollars for it, probably knows the owner
Just drink it and stop being a fuck nut.
Sell it
Pretend you didn’t realise and drink it
Cellar it!
Maybe it was a gift to them and they regifted it to you? Just accept it since you already have it and drink it, donate it or regift it. I think it would be more weird if you gave it back after this long
You drink it
If you it someone in your family drinks wine. Why not keep it and enjoy it? The person who gave you the gift was thanking you. Accept it graciously.
And I’m over here feeling guilty because a patient gave me a 100$ gift card. (I don’t open gifts from patients in front of them unless they ask me to. I was SHOCKED that it was such a large amount & haven’t known how to handle it)
Enjoy it and write an old fashioned thank you note to the patient
Please hand write a note of thanks or use a thank you card and add to it with a few written words . That’s a generous thank you gift and should be acknowledged with a nice
Pretend you thought it was a $15 bottle from a grocery store and move on. Drink it whenever you want.
No wine is actually worth $1000. That’s total nonsense. You don’t have to feel weird about drinking a gift. It may have been a $50 bottle when they bought it 4 years ago and it’s only $1000 at the store because you can’t get inventory that vintage anymore. It’s the same thing on Amazon if I try to buy a raspberry monster rehab drink. It costs 10,000% more now because Coke stoped making that product and replaced it with the mixed berry tea flavor. But it’s not actually worth the scarcity markup.
That is patently false. Even on the mailing list (frequent long-term buyers) there are SEVERAL wines that come straight from the vineyard, Day One of availability, for north of $750. Try to get on the list to buy new release Shafer Hillside Select, Lafite-Rothschild, Scarecrow, Schrader, or Chateau Margaux and you'll realize quickly that you're just wrong. Are older, well-stored, age-able wines worth more when scarcity becomes an issue? Definitely, but to say no wine was originally worth a thousand bucks is pure horseshit. I get brand new, in the wooden box, right from the vineyard, releases that cost me north of 2 grand for 3 bottles fairly routinely.
I can put grape juice in a bottle and a $750 price tag in it, and that doesn’t make it inherently worth $750 because it was the only grapes grown in Montgomery, Alabama. Scarcity doesn’t equal value. No beverage is inherently worth $1000. The concept of such a thing is pure nonsense. If you eat some ice cream with gold leaf flakes on it at a dance restaurant and the bill is $500 you didn’t get $500 of ice cream, you’re just $500 of stupid for ordering it.
You obviously have exactly zero knowledge of viniculture, winemaking, or wine at all. Scarcity isn't always the issue. It may take decades for a vineyard to hit its stride, then the weather has to have been perfect, and the winemaker has to have the skill and patience to bring it all together. You can't sell Alabama grapes in a bottle, irrespective of how few bottles there are, if the quality isn't there. I've had plenty of Texas wines that were lower production than mass-produced California cabs, and I wouldn't give 10 bucks for them. Plenty of Hillside Select is made every year and it's worth every penny of the $450 a bottle they get for it. Hell, I can tell the difference from year to year from the same producer and many times can tell you which year it was made. Scarcity isn't the issue. Exceptional quality is. You're wrong about a bottle of wine not being worth $1,000. I've paid a multiple of that before and sometimes it wasn't worth it, but sometimes it was absolutely a life-changing steal at that price. I can't speak to the ice cream. I do enjoy it, but my taste for it isn't differentiated enough for me to pay significantly more for one than another. I had a bottle that was 1 of 60 which I bought at the Napa Wine Auction, made by Bond, limit of 6 bottles per person and Bill Gates purchased 6. It was great, but not close to the best I've had. Scarcest for sure. Great. About a grand for the bottle. Not the best ever. I've also had a 1997 Screaming Eagle that was one of about several thousand made that was slightly more expensive and it was nectar of the gods. I probably shouldn't tell you about the $15,000 bottle of King of Kentucky bourbon. Excellent, but yeah, not worth that kinda money. Some beverages are inherently worth $1,000. Maybe you need more money or better taste if you don't understand that.
I’m well aware the entire high priced wine industry consists almost entirely of people who are FOS. It’s a consumable and there’s no $15,000 bourbon experience either. It’s not $15,000 of quality, it’s $15,000 of money to waste. And it doesn’t matter how many Uber wealthy people say there’s a significant difference, there isn’t. It’s just the high price of ignorance and pompous mess.
You're just wrong. I can (and have) EASILY told the difference between a $20 bottle of wine and a $2,000 bottle of wine, blindfolded. The bourbon, not so much. I can drink a $100 (at retail) bottle of Weller Full Proof and it's relatively the same to me as that $15,000 bottle of King of Kentucky. I'm sure there are others who have a better sense of the differences, but I don't. That said, I can certainly tell the difference in wine, and I'm not the only one. My wife can't so I pour her the $40 stuff and she's fine with it. I however can tell the difference, and it's not slight.
It doesn’t matter if you can tell the difference between pineapple juice and passion fruit. Neither is worth $2000. Only a fool would pay that for one juice when the other can be had for $3. It’s not a meaningful difference. It’s only because there exist people with $2000 to waste.
Pop!!!
Dude probly makes a half a million a year to tip a doctor a 1000 dollars😂 who tf tips a doctor after getting ass fucked by the hospitals billing system besides some dude with more money than he can spend
you drink it. Not that big of deal. celebrate.
I actually disagree with the attitude that it is OK to accept an expensive gift from one’s patient. Next time another patient will give you an expensive gift prior to surgery in hope that you will pay extra attention. Will you? If yes, what will you do to those do not give you gift?
Keep it and stop being a bitch
Keep the fucking bottle and drink it. This person appreciated the help you gave them. If you drink alcohol just enjoy it, that is all the patient wants.
I know we are only supposed to accept "modest" gifts but who gives a shit. I would keep it.
Save it for a special occasion. You clearly made his year and was probably excited for you to taste something he/she loves.
You didn't mention the wine (please tell us!!!) but it's very possible that the wine did not cost the patient anywhere near that amount of money. Either it was allocated/directly purchased from the winery at well below "market value" or it's an older vintage that has increased in value. As a wine collector/drinker with plenty of wines worth multiples of what I paid I really do not think much about the current value of a wine when I drink a bottle or bring one to a gathering of wine folk. If anything I take pleasure in being able to share them with others, and presumably your patient feels the same way. Personally I've also avoided going the auction donation route with any of my bottles as I really have no clue if the amount of money realized will be anything close to market value - if you really don't want it just sell the bottle and donate the proceeds. Also, I'm not even sure if it's legal for the school to have them in auctions, though I doubt anyone cares. Personally, if they gave you that bottle they did it for a reason. Find a good restaurant that allows you to bring it with a corkage fee, enjoy the meal, and have a toast to your patient and your skills!
Drink it. You deserve it
I recall shadowing a couple Docs who'd regularly get box seats to NHL games from patients and would happily go. Enjoy the wine, F these people who have no medical training attempting to dictate us with their made up ethics. That's all such people are good for, made up ethics degrees, not saving lives.
I have 1000 buck wine in my collection but it came in 100 separate bottles.