This chapter, written for undergraduate medical students and post-graduate doctors in training, presents information on how to manage gifts — a case which they are likely to encounter in the future in a general practice setting. It presents the case of a 56-year-old business executive attends his general practitioner (GP) for a review appointment for his lower back pain. The GP had taken a history and examined the patient and diagnosed simple lower back pain. On the other hand, the GP might be afraid that rejecting the generous gift might upset his patient endangering the development of a good patient–doctor relationship. The chapter provides details of the patients' medical history and the key findings of clinical examination, together with initial investigation results data for evaluation, and helps them develop their skills of clinical reasoning. Key questions then prompt the student to evaluate the patient, and reach a decision regarding their condition and the possible treatment plan.