How Should Hospitals Ask Patients for Donations?

Hospital fundraising provides critical resources, but a new study looks to ensure it’s done effectively and ethically.

11:00 AM

Author | Nicole Fawcett


As many hospitals and health centers face dramatic drops in revenue from ramping down services during the coronavirus pandemic, donations from grateful patients and philanthropists become more important than ever.

A new study looks for the first time at patients' views of hospital fundraising, including legally allowable practices that encourage physicians to work with their hospital's fundraising professionals.

"Fundraising is essential. We cannot abandon philanthropy for hospitals and health systems, especially in the current environment. But we need to learn how best to do this both effectively and ethically," says Reshma Jagsi, M.D., D.Phil., director of the Center for Bioethics and Social Sciences in Medicine at the University of Michigan and lead author of a new paper published in JAMA.

LISTEN UP: Add the new Michigan Medicine News Break to your Alexa-enabled device, or subscribe to our daily updates on iTunes, Google Play and Stitcher

The paper is the first to ask groups of patients about their attitudes toward hospital fundraising.

Researchers surveyed 513 members of a U.S. national survey panel, reflective of the general population. Participants were asked how they felt about common strategies hospitals use to identify, solicit and thank donors. These practices are all legally allowed.

Just under half of the responses endorsed doctors giving patient names to hospital fundraising staff after asking a patient's permission, and 9% said it was OK without asking permission. While 80% said doctors could talk to patients about donating if the patient brought it up, 14% said it was acceptable if the patient had not brought it up.

Wealth screening, in which fundraising staff use publicly available data to identify patients who might be capable of large donations, was endorsed by 10% of respondents.

"These policies were made with the best intent to facilitate fundraising for hospitals and health care institutions. We don't want to hamstring this as the money is used to the benefit of society as a whole," Jagsi says. "But I think it's also important to understand public perspectives toward these practices. We found that certain specific practices cause a lot of people concerns, and maybe those should be avoided."

The survey also assessed how hospitals could show thanks to those who make large donations. Half said it was acceptable to provide nicer hospital rooms, a quarter endorsed expedited appointments and 20% said it was OK to provide doctors' cell phone numbers.

"As a practicing physician asked to engage my patients around philanthropy, it's occurred to me that this could be a potential conflict of interest," Jagsi says. "I want guidance to navigate this, to understand what I should do to encourage philanthropy, but also to protect my patients and maintain their trust."

The authors suggest additional research is needed to further understand the attitudes and preferences of patients and the general public. Jagsi says she hopes this work helps inform future conversations about policy so that hospital fundraising efforts can continue in ways that are both effective and ethical.

"Especially in the midst of a pandemic, we've discovered how vulnerable health systems are. Now perhaps more than ever it's incredibly important for development and philanthropy to thrive. We want to help development professionals continue doing their important work in ways that the public views as ethically appropriate," Jagsi says.

Additional authors on the paper are Kent A. Griffith, Joseph A. Carrese, Megan Collins, Audiey C. Kao, Sara Konrath, Stacey A. Tovino, Jane L. Wheeler, Scott M. Wright.

Funding for this work is from the Greenwall Foundation.

Paper cited: "Public Attitudes Regarding Hospitals and Physicians Encouraging Donations from Grateful Patients," JAMA. DOI: 10.1001/jama.2020.9442

MORE FROM THE LAB: Subscribe to our weekly newsletter

More Articles About: Industry DX Hospitals & Centers Community Health
Health Lab word mark overlaying blue cells
Health Lab

Explore a variety of health care news & stories by visiting the Health Lab home page for more articles.

Media Contact Public Relations

Department of Communication at Michigan Medicine

[email protected]


Stay Informed

Want top health & research news weekly? Sign up for Health Lab’s newsletters today!

Featured News & Stories colorful pills falling into blue hand
Health Lab
Repurposing generic drugs can reduce time and cost to develop new treatments
But low profitability remains a barrier.
health care worker leaning over to talk to pregnant women in mask sitting
Health Lab
Maternity health care workers expressed anguish, questioned roles early in pandemic
An analysis found nurses, physicians and midwives alike held complex emotions about how COVID-19 has impacted their work. 
100 dollar bill currency mask
Health Lab
Patients hospitalized for COVID-19 this year could pay thousands of dollars, study suggests
As insurance companies start charging members for hospital-related costs again, analysis of 2020 data shows what they might owe.
Number 5 with year underneath next to a block M
Health Lab
Michigan Health Lab Turns 5
A thank you to the readers, and look back at the most read story of each year since our launch five years ago.
Health Lab
The Non-Veteran Experience at VA hospitals
Non-Veterans admitted to VA hospitals in Southeast Michigan during the pandemic's surge had were overwhelming positive experiences, one study found.
hospital beds in different colors
Health Lab
What Can Hospitals Do to Prepare for COVID-19 Cases?
Hospital preparedness for COVID-19 cases caused by coronavirus has to happen now, including preparation for bed capacity increases and use of scarce resources.