At its best, the doctor-patient relationship is an intimate one. Often, our patients appear before us in the most vulnerable moments of their lives. We treat their diseases, but we also tend to their emotional and spiritual well-being. That kind of intimacy can be meaningful and rewarding, but it can also breed awkward and even potentially compromising interactions. That is particularly true when money gets involved.
Despite widespread dissatisfaction with the health care system as a whole, medical workers (physicians, nurses, and physician assistants) are still generally perceived positively. Many of our patients perceive us as well-educated, high-achieving, and well-connected. We are also perceived as high-income earners. Over the course of my career, this perception has led more than one patient to approach me seeking a financial donation to a cause or even a business investment.
My first experience with this dilemma occurred more than 30 years ago. A patient of mine (a single mother with a one-year-old child) had recently broken her leg. Crutches were impractical for her situation. She needed her hands free to care for her toddler, and the slow, awkward movement of traditional mobility aids made daily life nearly impossible. Out of necessity, she improvised. She took one of her older children’s scooters, modified it, and discovered she could move around more efficiently while keeping her child safe.
Her father helped her turn that improvised solution into a prototype. When she brought it to me, she was proud, hopeful, and determined. She asked if I would help fund the patenting process. She believed in her idea, and she wanted someone (anyone) to believe in it with her.
I vividly remember my reaction. While I admired her creativity, I found the concept to be unrealistic. I imagined my older patients trying to balance on a scooter and dismissed the idea as impractical. Additionally, I was concerned about potential conflicts of interest between the patient and the physician, as well as the possible legal and ethical implications. I politely declined, convinced that the device had no future in mainstream medicine.
Three decades later, that same concept (now known as the knee scooter) has become a staple medical device worldwide. My patient was never able to secure the funding needed to develop her invention. Today, knee scooters are used in clinics, hospitals, and homes worldwide. They have generated millions of dollars in revenue for a multinational company. I still feel guilty about turning her down.
Years later, when another patient approached me with a prototype for a piece of luggage with retractable wheels, I listened more carefully. He had multiple patents, had done his due diligence, and presented himself as someone who understood the process with a bona fide business. He was articulate, confident, and persuasive. I thought about the young mother I had turned down, and I took a different approach.
I sought legal advice regarding the ethical and legal boundaries of becoming involved in a patient’s business. It turns out the rules are fairly straightforward: You can’t. So, I told the patient we had to end our physician-patient relationship if he wanted my investment, and we did. Understanding these guidelines helps physicians navigate investments ethically and avoid legal pitfalls.
The investment failed. Completely.
Throughout the years, other patients have approached me for money. Usually, it has been relatively innocuous requests for donations to charitable or nonprofit campaigns. But each of these experiences raises an important ethical question: When is it permissible for physicians to invest financially in their patients’ dreams, interests, and hobbies?
The answer is not simple.
We want to support the people we care for with encouragement, which can foster trust and a sense of shared purpose. But there are risks: ethical, legal, financial, and emotional.
When a patient asks for money, the physician-patient relationship shifts, raising ethical questions about conflicts of interest and professionalism. This awareness can help physicians feel responsible for preserving boundaries. Financial interests can cloud clinical judgment. Even an early altruistic investment can lead to conflict when money is involved.
Medical training does not prepare us to evaluate patents, prototypes, or business plans. We may understand physiology, but that doesn’t translate into understanding markets, manufacturing, or intellectual property law. We are experts in healing, not in forecasting consumer behavior or navigating the complexities of product development.
When you invest in a patient’s idea, you are not just investing money; you are investing hope. Recognizing the emotional toll of potential failures can help physicians feel empathetic and resilient in facing setbacks.
So, is it worth it?
After years of reflection, my answer is this: Support your patients’ ideas with encouragement, but approach each opportunity with careful judgment to foster confidence and responsibility.
Seek independent advice, understand the laws, and be honest with yourself about your motivations to maintain integrity and clarity in your decisions. Most importantly, strongly consider ending the physician-patient relationship to avoid conflicts of interest and potential legal repercussions.
While patients may bring us brilliant ideas, it doesn’t mean we are the right people to fund them. Sometimes the best support we can offer is guidance or encouragement, not capital. Sometimes the best investment is simply staying in our lane.
And sometimes, the most valuable lesson comes not from the opportunities we seize, but from the ones we let go, and the ones we should have.
Francisco M. Torres is an interventional physiatrist specializing in diagnosing and treating patients with spine-related pain syndromes. He is certified by the American Board of Physical Medicine and Rehabilitation and the American Board of Pain Medicine and can be reached at Florida Spine Institute and Wellness.
Dr. Torres was born in Spain and grew up in Puerto Rico. He graduated from the University of Puerto Rico School of Medicine. Dr. Torres performed his physical medicine and rehabilitation residency at the Veterans Administration Hospital in San Juan before completing a musculoskeletal fellowship at Louisiana State University Medical Center in New Orleans. He served three years as a clinical instructor of medicine and assistant professor at LSU before joining Florida Spine Institute in Clearwater, Florida, where he is the medical director of the Wellness Program.
Dr. Torres is an interventional physiatrist specializing in diagnosing and treating patients with spine-related pain syndromes. He is certified by the American Board of Physical Medicine and Rehabilitation and the American Board of Pain Medicine. He is a prolific writer and primarily interested in preventative medicine. He works with all of his patients to promote overall wellness.
