I'm sure someone has. Then again, I'm sure at least one person on this forum has offered sexual favors in exchange for an LOR. I have never shadowed, nor do I plan to, so I am probably not the best person to answer your question. However, I don't see an implicit problem with a small thank you note or an inexpensive gift.
A thank you card or a small token gift would be a nice gesture, especially if you have shadowed the doctor for a while. You could also follow up with a thank you card when you get accepted to a med school, thanking the doctor for all the advice/guidance/insert-what-you-want-to-thank-the-doctor-for-here, and letting him/her know about the good news that you got into a med school and will be a doctor.
I would do a small token gift...what are they obsessed with? What is their guilty pleasure? Do they have to get a Starbuck's in the morning ($10 gift card or so)? Do they always chew a certain kind of gum (pick up a couple packs and tie them with ribbon)? Just do something thoughtful that is small if you want to give them a token of your appreciation.
After I was done shadowing a neurosurgeon for a month (full-time) I baked a cake for the practice doctors and staff. I think they really appreciated that
I cleaned an organized supply closets and helped the front office staff. It was a way of thanking by offering some of my time as a thank you for time given to me. Several months later I took in a big batch of goodies for the staff, and personal gift baskets for the docs. It was a chance to say hello & to let them know that I still appreciated what they had done for me.
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