To tip or not to tip?
Answers in Practice
October 1, 2023
The New York Times recently posted a Q&A column titled, “Why Did My Dermatologist Ask Me for a Tip?” where a reader questions whether being presented with a tip screen while paying for a cosmetic procedure performed in a medical office is normal.
DermWorld asked members if soliciting a tip for cosmetic procedures performed by a physician is appropriate. Here is what they said:
Roman Bronfenbrener, MD, FAAD: Dermatologists are physicians who have taken the Hippocratic Oath. I find it inappropriate for any physician to receive a tip for services rendered, even if cosmetic. This can create an ethical dilemma of differential care.
Stephanie Fabbro, MD, FAAD: COVID-19 changed American tipping culture in a profound way. Many non-traditional merchants began utilizing tipping to support struggling local businesses. While many Americans were happy to oblige, now there is a lot of confusion about when and where to tip. In my opinion, including tipping in a physician’s office, even if it is for something cosmetic and not medically necessary, disrupts the patient-physician relationship and makes it feel transactional. A patient who is asked to tip may have different expectations at their physician’s office and it may affect the way they treat physicians and staff. Similarly, it may subconsciously affect the way staff treats the patient.
Ellen Gendler, MD, FAAD: This is the most absurd question I have seen posed here. Tipping for our cosmetic procedures? Then complaining that we are frequently viewed as no more than glorified aestheticians? A resounding NO. It’s disgraceful, in my opinion.
Reena Jogi, MD, FAAD: As a board-certified dermatologist who has been in practice for 15 years, I can say with certainty that asking for tips for medical services provided is not a mainstream practice. In discussing this with my colleagues and close friends who are also dermatologists, the overwhelming consensus was that this was not a practice we would condone.
Anthony Nuara, MD, PhD, FAAD: Gratuity should not be given gratuitously. While every physician has received small tokens of appreciation, they are never expected or solicited and should not risk altering the physician-patient relationship.
Scott Paviol, MD, FAAD: For physicians, no. Honestly, in medical practices, no. Aesthetician-only practices, yes. Physicians want to be viewed and recognized as physicians, but then do what non-physicians do.
Curtis Raskin, MD, PhD, FAAD: If the physician owns or is a partner in a private practice, then asking for a tip in this scenario is beyond distasteful. If the physician is merely an employee and has no control over pricing, asking for a tip is still wrong and should be actively discouraged, but could be an important warning sign that in this era of increasing corporatization of medicine, physicians are becoming commoditized.
Editor’s note: Responses have been edited for clarity and space.
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