Thursday, August 27, 2009


In today's Well blog in the NY Times, they discuss the curse of the VIP patient. VIP's can be anyone from celebrities to physicians to the mother of the hospital administrator. VIP Syndrome is well documented in the medical literature. Patients considered VIPs frequently wind up with worse outcomes than "regular" patients. It is a well known medical axiom that patients who are doctors and nurses frequently have unforeseen complications during the course of treatment. The Well blog discusses how the extremely wealthy father of a patient arranged to have five different physicians from five different hospitals take care of his son. None of them could agree on a course of treatment since nobody was actually in charge. As a consequence the son received worse care than he otherwise would have.

In the city where I practice, we have celebrities and other VIPs everywhere. You can see them jogging on the sidewalk or bump into them at the Whole Foods Market. Naturally we treat them all the time at our hospital. I've treated rock stars, billionaires, TV and movie celebrities. You can always tell when you are going to get a VIP patient. On the OR schedule there is an unusual pseudonym. When you log onto the hospital computer system to look at the patient's lab work, a warning comes up about how you are being monitored. While preop does not allow an entourage inside, there is usually the Patient Advocate standing at bedside to take care of any needs that might arise. Most of them are really nice, just regular folks, but there are a few that are notorious for being a pain in the ass. They get special cordoned off areas in preop and recovery. People walk on eggshells around them. I have to admit I still get butterflies when I treat a very prominent VIP. I wouldn't want to read in the newspaper the next day that so and so "died in the hospital during a routine procedure due to anesthesia complications." The horror.

Yes we try to treat everybody the same. But we are all human. We will treat VIP's differently despite our best efforts. We just hope we don't wind up being household names like Dr. Conrad Murray.

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