Please explain why it's not right to show your appreciation to someone providing you a service by gifting them a nice dinner.

 

It's not "someone". It's a doctor. A highly educated, highly compensated professional. Not some kid or a flunky or a gladhander or in a profession society has decided to under compensate in expectation customers will support (restaurants).
Let's be honest. When you get down to it a tip is either charity or a quid pro quo. The doc doesn't need your charity ( and if he does...) and a scratch my back relationship is flat out unethical.
You want to show your appreciation? Pay your bill in full and on time. Or do whatever you want. No skin off my back.

 

How magnanimous of you.

 

I worked for a large group of physicians in an associate practice for years. Tipping was not at all uncommon. Gift cards, fruit baskets, homemade baked goods. Almost a daily occurrence. You would not believe what the pharmaceutical representatives brought us EVERY single day of the week! I didn't have to buy lunch for 5 years. They would order all of us whatever we wanted and bring it in just for the doctor to give them 5 minutes and take samples of the drugs to give to patients. They also gave tickets to games, races, and concerts. You'd be surprised how much tipping goes on in professional practices, even if not monetary.

 

Not sure what you are referring to but ok

 

This is totally different from a patient tipping the doc. What you are describing used to happen exactly as you write and that was only the tip of the iceberg. Imagine what the doc got behind closed doors that he didn't tell you abt. Its also highly illegal now

 

I see your points, but I don't think we always tip for charity or quid pro quo. Sometimes we tip to be thoughtful? Or maybe even for karma? But tips in the case of my doctor, they are simply forms of appreciation. Zoo & aquarium tickets he can hand out to underprivileged patients, restaurant gift certificates, and silver art (my thing). He makes special accommodations for me, above and beyond, and I am inspired to do something that says "I recognize I receive more attention than I deserved, thank you". There is a chance he is wealthy, and simply gives them to his staff or his patients, who are definitely not wealthy. There is also a chance that he is still paying off student loans, and not making a ton as a general practitioner, and would enjoy a night at the city's best restaurant on me.

I would suspect that he enjoys the hand written notes more than anything.

 

Some hosts make 1m a year. More than most people here I'm sure...they still expect to be tipped...

 

Yeah, I think tipping your doctor is a bit weird and unnecessary, but the logic of not tipping them because they're highly educated and paid well is a head scratcher. If you want to tip someone, what difference does it make if they are paid $25k, $100k, or $500k or if they have a GED, Bachelors, or PhD? Do you tip more to the guy making less money or vice versa? I'm just not understanding the correlation or logic....

Also there is no ethical violation, unless they're giving you some sort of prescription that's unwarranted (like pain meds or something) or giving you some sort of free treatment at the expense of his/her employer (if it's their private practice then still no problem). In Silvered's case, maybe his doctor is squeezing him in to his schedule before he normally comes in or staying late to see him, or even skipping lunch? I think most people are ignorant of the mechanics of a physicians schedule, and don't understand that if you're coming in on short notice, it likely means they're changing their schedule to accommodate you. While tipping or giving gifts isn't necessary, I can tell you that an appreciative patient is much more likely to have the doctor shuffle around their schedule to accommodate them than the ones who call up demanding to be seen immediately, think that they're the only patient that the doctor has, and expect concierge level medicine without paying for it. Again I'm not sure tips or gifts are necessary, but if one feels inclined to do so, there isn't any sort of ethical issue and to state so is bizarre...

 

You answer your first question in your second paragraph.