In this commentary article, I will identify and examine a variety of themes that arise in narratives written by 12 physician authors that detail their experiences with grateful patient fundraising. Grateful patient fundraising serves an important role in health care philanthropy. Donations by grateful patients offer practical benefits to society and altruistic giving can personally benefit donors and family members; however, solicitation of donations by physicians raises a number of legal and ethical issues including, concerns about equity and health information confidentiality. To prevent eroding or distorting the physician-patient relationship, physicians involved in grateful patient fundraising must adhere to ethical guidelines and recommendations.