I do give gifts but to the "office" as a whole so it isn't just to the T or meds provider. Usually it is some kind of gourmet food--chocolate or something that I find & like--that can be shared in the staff break room. I do write letters to my T & meds provider periodically expressing my appreciation when they have helped me through an especially difficult time. And I also give them books that I have found that I think would be good additions to their libraries. They have always said how much they appreciate those letters & books.--Suzy