If you are a doctor, you help people because you want to. If you accept this gift, you might start to subconsciously expect other patients to offer you gifts as well for your services. It a personal choice you, but with gifts people always feel indebted and it can change the relationship between patient and doctor or co-workers, etc. One suggestion might be to find a charity you can have the gift donated to - this way the patient can feel happy and that they repaid you and you can feel good about helping those in need without creating a sense of always expecting gifts for your services. In the long run I think you will like you job more for the good work that you do and not distract yourself with thoughts of gifts from patients.