DEAR MISS MANNERS: To treat my chronic pain, my doctor has prescribed massage therapy once a week. The doctor’s office contains all the treatment rooms necessary, including a massage room.

On the bookshelf in this room is a small sign reading, “Tips accepted gratefully, but not required.”

Am I missing something here? When I was raised, back in the Pleistocene era, one did not tip medical personnel. Has this changed?

GENTLE READERS: What has changed is that solvent people now feel no shame about begging.

Miss Manners abhors the tipping system for many reasons, but acknowledges that it is necessary to supplement workers who do not otherwise earn the wages they deserve. Doctors are not normally perceived as suffering financially without extra largesse from their patients. Self-respecting practitioners do not solicit handouts.

DEAR MISS MANNERS: I would like to know if it is appropriate to record how much money each of your guests give you at your wedding, like a financial ledger.

Personally, I find this extremely tacky. Too much focus is placed on the monetary value, as opposed to the personal value behind the giver’s sacrifice.

This turned into a major blowout with my in-laws, when I said that it shouldn’t matter: $50 might seem like 50 cents to some, and vice versa; therefore, the actual dollar figure should be inconsequential.

Their answer was twofold: First, you need to record the amount each guest gave you so that YOU know how much to give when invited to THEIR kids’ weddings. And second, that Aunt So-and-So “deserves to have you know and remember” that she gave so many thousands, even if Aunt Somebody Else gave considerably less.

Please let me know if my heart is right in thinking that this puts terrible emphasis on the shallowest feature of gift-giving.

GENTLE READERS: Are you really wondering if it is vulgar of your relatives to keep track of your guests’ donor levels so that you can dole out thanks proportionately and plan to retaliate against those with moderate contributions?

Miss Manners begs you to resist this mean and greedy way of treating people to whom you are supposedly close. But no doubt, explaining this to your in-laws would be a waste of time.

DEAR MISS MANNERS: We want to visit some old friends, but we don’t want to inconvenience them at all. They are quite elderly, and she, in particular, is very formal. Although we have stayed at their home before, it was several years ago.

How do we invite ourselves to visit them? How far ahead of time should we call or write?

GENTLE READER: Long enough to give them time to plan, but not so long as to make it implausible if they say it is an inconvenient time.

But Miss Manners does not like that part about inviting yourselves. What you should do is to say that you hope to travel to see them, and let them add the part about staying. Or not.

(Please send your questions to Miss Manners at her website, www.missmanners.com; to her email, dearmissmanners@gmail.com; or through postal mail to Miss Manners, Andrews McMeel Syndication, 1130 Walnut St., Kansas City, MO 64106.)

DEAR MISS MANNERS: I pride myself on being a blunt, yet kind, person. I choose my battles wisely, speak from my heart, and always let someone know when they have upset me or my family.

I have some family members (in-laws) who are not used to my approach, which often leads them to ignore me, shame me on social media or call me names.

Should I just keep my mouth shut around them, or continue to be me?

GENTLE READER: The “you” of whom you are so proud is, by your own account, someone who habitually antagonizes others and inspires them to retaliatory rudeness. Miss Manners would not care to attend your family gatherings.

Whatever you mean by “blunt, yet kind,” it is not working. Perhaps you mean the supposed kindness of pointing out everyone’s faults. As it serves no purpose but to inspire the targets to upset you even more, Miss Manners would think that the closed-mouth solution would be a good choice.

DEAR MISS MANNERS: I have what I believe is a benign lipoma on the outside of my calf. It is not painful, but it has grown over the years, and now looks rather like half of a baseball has lodged itself in my leg. Because of its size, I rarely wear shorts in public, but occasionally it is noticed by someone, and questions often follow.

Notably, on the rare occasion when I treat myself to a professional pedicure, the technician refuses to concentrate solely on my toes and insists on giving me the “full treatment,” which includes a lower-leg massage. Invariably, they express surprise at seeing my unwelcome “guest.” Upon explaining what it is and assuring them that, other than cosmetically, it doesn’t really bother me, they ask about or suggest various treatment/removal options.

Miss Manners, I am not an idiot. I know that it might be surgically removed, but right now I have no medical insurance and I am still a half-year away from Medicare. And even if I had insurance, my research tells me that removal of this growth is unlikely to be a covered procedure (if I am correct about its nature).

The same line of conversation also tends to occur when friends or family notice it. As much as possible, I prefer to ignore its existence, and I really do not appreciate it being made the topic of extended conversation, even if those prying have the best of intentions.

Short of being rude, how can I shut this down? I’d ideally like some kind of all-purpose response.

GENTLE READER: “It’s not catching. And I’m fine, thank you. How are you?”

DEAR MISS MANNERS: Waitstaff in restaurants virtually always place the bill by the male in any party. I take offense at this old-school, sexist presumption. I would prefer waitstaff either place the bill in the middle of the table, equally accessible to all genders, or just ask who wants the bill. I’m eating in a restaurant; I know I’m going to pay for my meal. It’s not a surprise! How can I politely correct this outdated, sexist practice when it happens?

GENTLE READER: With an outstretched hand and an “I’ll take that, please.”

(Please send your questions to Miss Manners at her website, www.missmanners.com; to her email, dearmissmanners@gmail.com; or through postal mail to Miss Manners, Andrews McMeel Syndication, 1130 Walnut St., Kansas City, MO 64106.)

DEAR MISS MANNERS: During our weeklong visit, our dear hosts subjected us to one of their quirks I can’t abide by. They issued each of us a cloth napkin to be used for the week. Granted, we were not eating ribs, but it still just seemed unsanitary.

GENTLE READER: Why? What else were they being used for?

Miss Manners is sorry to tell you, but saving a cloth napkin for up to a week is not only acceptable, it comes with accessories. That is the purpose of those round silver things that are too small to be bracelets. They are napkin rings. For frequent guests, Miss Manners even gets them monogrammed -- an honor, she assures you.

However, if you feel that yours is being overused to the point of being ineffective, graciously blame it on yourself. “I am afraid I over-enjoyed my dinner last night and sorely abused my napkin. I wonder if I might have a fresh one tonight. And I will try to take better care of it.”

DEAR MISS MANNERS: I received a bachelor’s degree in art history and am currently finishing up a master’s in another art-related field. For many years, I have often had to put up with people’s rude comments regarding my career choice.

When I tell people what degree I am pursuing, I have received responses such as (literally) “So, you want to live in a box for the rest of your life?”, “So, you want to be poor?”, “So, you want to starve?” Unfortunately, they are often not saying this in jest, and will continue to demean my profession for several minutes.

I try to make a joke out of it and direct the conversation elsewhere, but I am losing patience. Any suggestions for how to avoid this ugly situation or deal with it appropriately are appreciated.

GENTLE READER: “Yes, I suppose that’s a possibility, but at least I will live poor and starving in a beautifully decorated box.”

DEAR MISS MANNERS: I have a toddler and an almost-1-year old. The toddler does pretty well nowadays when we eat out at restaurants, but the infant tends to spill a lot of food on the floor.

I don’t want people to think I am fine with letting my kids make a big mess for other people to clean up, so usually at the end of our meal, I get down on the floor and clean up the baby’s crumbs. I have had times in which the restaurant owners seemed appalled that we are cleaning up after ourselves and I sort of understand that (it’s probably not a good look to the other customers). What is the most polite approach for handling kid messes in public?

GENTLE READER: Small messes should be picked up as they happen. For larger ones, a reasonable effort should be made.

But much like the wallet reach when one is fairly certain that one’s restaurant companion is paying, the intent is generally more appreciated than the result. Similarly, Miss Manners suggests that the attempt to clean up should be genuine, but graciously retractable if the other party objects strongly enough.

(Please send your questions to Miss Manners at her website, www.missmanners.com; to her email, dearmissmanners@gmail.com; or through postal mail to Miss Manners, Andrews McMeel Syndication, 1130 Walnut St., Kansas City, MO 64106.)