I just took over a practice and I have been handed a gift by a patient. The issue here is that I need to maintain ethical guidelines. But, if I refuse the gift this will make the patient uncomfortable. Since I'm new to rural community, perhaps handing out gifts is a well-practice gesture to welcome new visitors, so I need to be respectful. Also, if I deny the gift it might roughen up the new patient-physician relationship. From my personal experience of giving gifts physician, I know that handing gifts is usually not a problem. If accepting gifts is not against the rules of the practice, then I would show appreciate to the patient. This gesture may help build trust in our relationship, rather than refusing to accept the gift.