151:, nurses and physicians there in 2014 complied when he asked that they not wear protective gowns because he felt the gowns implied that he was "dirty", which he found offensive. Doctors and staff may unconsciously act to please the VIP patient by avoiding unpleasant historical or social details germane to their history. VIPs may be prescribed narcotics or other controlled substances when an ordinary patient would be denied them, or they may be over-medicated with larger amounts of such drugs than appropriate. In sum, deviating from the standard of care to accommodate VIP care may result in worse outcomes.
26:—the phenomenon of a perceived "VIP" (very important person) using his or her status to influence a given professional or institution to make unorthodox decisions under the pressure or presence of said VIP—that relates to the accessibility and quality of health care. It is essentially health care in which a physician or hospital accommodates a wealthy, important or famous patient who can afford to pay the full medical bill outright, usually with luxury amenities, and seclusion from the ordinary run of patient, as added benefits. As a result, such a patient may receive something other than the normal
187:
76:
prying eyes of journalists as well as those of the curious onlookers among the hospital staff who may not be directly involved in their care. Their desire for privacy is an understandable aspect of their need for extra security. Often the pressure on medical staff for special accommodations comes from a VIP's entourage rather than from the patient.
130:
A VIP may insist on the senior-most specialist at an academic institution or teaching hospital—the chair of the department of medicine, or of surgery, for instance. But the senior-most, or most eminent, caregiver is not necessarily the most skilled at performing a given procedure. Such an individual
62:
is thought to have been coined in 1964 when
Maryland psychiatrist Walter Weintraub reported that his hospital had been thrown into turmoil as staff there struggled to respond to the relentless demands of influential patients and their relatives. In addition to the turmoil, Weintraub was particularly
139:
was discharged from the hospital with the diagnosis of an inner-ear infection when, in fact, he had suffered a stroke.) Many VIP wings are physically removed some distance from the rest of the hospital; in the case of a "code", such as a cardiac arrest in the VIP area, staff may be dangerously far
122:
as screening tests as part of the "chairman's physical", a measure considered entirely unjustified as routine care. Over-medication may result. Imaging tests may actually increase the risk of cancer from radiation exposure and have never really been shown to improve anyone's health. And if there is
79:
Medical personnel are also not immune to becoming fascinated by the presence of a celebrity or powerful figure. Physicians and hospitals may relish the extra revenue accruing from the treatment of VIP patients, sometimes in the form of lavish donations, and so may accommodate them accordingly. Some
75:
Prominent or famous people who fall ill have obvious reasons for desiring instant and ample medical care. Additionally, they have a desire to avoid public scrutiny in matters of private medical care, as all patients do, and may demand special accommodations on this basis. They may want to avoid the
49:
High-profile individuals typically receiving VIP medical treatment include prominent and powerful politicians, royals and aristocrats, the super-rich (including corporate executives), entertainment and sports celebrities, and eminent or famous medical people themselves. The families or relatives of
37:
providers. A "VIP suite", or "wing", is one venue where VIP medicine may be practiced in the hospital setting—indeed, whole floors of a hospital building, at major medical centers, may be dedicated to it. A particular type of formalized and regularized VIP medical practice is known as
88:
Often characterized by walnut-paneled rooms and high-thread-count bed sheets, VIP accommodations at large hospitals have traditionally inspired special, sometimes sarcastic, nicknames such as "the Gold Coast" and "Millionaires' Row". Examples include the labor and delivery ward at
170:, warning staff against bending the rules, accepting lavish gifts, and automatically bringing in department chairs to care for a patient rather than a lower-ranking physician who might actually be more expert in treating a particular ailment. At the
146:
Medical personnel may acquiesce to a VIP's unorthodox requests, even when doing so represents a breach of standards or is frankly dangerous to other patients. Although a Middle
Eastern royal at Boston's Brigham and Women's Hospital had a
113:
Hospitals and doctors aiming to give some patients more medical care, more time, and more resources contradicts fundamental medical ethics. It may not be consistent with the idea of justice within medicine: a fair distribution of scarce
80:
wealthy patients are not above gifting individual providers lavishly in hopes of easier accommodation of their needs, a situation that creates a conflict of interest when specific requests may be counter to a patient's welfare.
497:
117:
VIP medicine can be extravagant and wasteful. Excessive drug prescriptions may be written and imaging studies ordered. Some health care programs for corporate executives, for example, involve periodic full-body
134:
In their haste to attend to a VIP without stint, star-struck administrators, doctors and nurses may, in their distraction and flustration, provide substandard care. (A case in point was when former
President
140:
away. Even proper routine staffing with the appropriate specialist nursing care (cardiac nurses, orthopedic nurses, etc.) may not get all the way out to an exceptional, isolated patient.
297:
143:
VIPs also have particular issues with privacy because everyone is interested in their health and may compromise confidentiality when managing medical records and studies.
236:, New York City "A waterfall, a grand piano and the image of a giant orchid grace the soaring ninth floor atrium of McKeen...(where) afternoon tea is served daily"
174:
in
Minnesota, new policy states that personal gifts to staff in excess of $ 25 value cannot be accepted and must be forwarded to the development office.
561:
63:
concerned by the large number of "therapeutic failures" (10 of 12) among the patients in his series. A high rate of signing-out of the hospital
105:
A number of criticisms have been leveled at the practice of VIP medicine. These can be broadly categorized as focusing on issues of fairness (
33:
VIP medicine may be initially reflected in expedited care in an emergency room or more immediate and direct access to specialists, bypassing
240:
448:
583:
315:
160:
Some medical institutions have drafted new policy directed at correcting some of the excesses of VIP medicine. In 2011, the
166:
194:
498:
Rappleye, Emily, "Brigham and Women's under scrutiny for succumbing to VIP syndrome in care for Middle
Eastern prince",
382:
233:
219:
131:
may be out of practice, or no longer up-to-date, and the "no name" subordinate may actually be much more skilled.
226:
562:
https://www.nytimes.com/2012/01/22/nyregion/chefs-butlers-and-marble-baths-not-your-average-hospital-room.html
27:
578:
534:, January 9, 2017, pg 73—characterizes the Phillips House as "a wing of Mass General where wealthy
383:"'Beyonce' rooms for affluent new moms at Lenox Hill Hospital are putting newborns at risk: nurses"
347:
Weintraub, Walter (February 1964). "'The VIP syndrome': a clinical study in hospital psychiatry".
64:
588:
473:"CNN Transcript - Breaking News: Former President Ford Suffers Small Stroke - August 2, 2000"
271:
472:
542:, who was an in-patient there in 1977, wrote a poem about it ("Phillips House Revisited").
8:
387:
127:, as there often is, more tests might be ordered, which may lead to unnecessary biopsies.
90:
30:; the deviation may be in the direction of either greater or lesser safety and quality.
556:
430:
124:
39:
198:
422:
364:
360:
434:
414:
356:
161:
525:
148:
43:
551:
535:
530:
259:
298:"Was patient with apparent ties to royalty worth breaking hospital protocols?"
572:
539:
426:
265:
402:
316:"VIP Syndrome: Why the rich and powerful might get substandard medical care"
538:
patients were typically housed". In the same article he mentions that poet
368:
253:
34:
23:
171:
136:
50:
these types of people are also apt to receive special medical treatment.
449:"Principles of Bioethics | UW Department of Bioethics & Humanities"
418:
94:
320:
164:'s Jorge Guzman published nine principles of caring for VIPs in the
554:- "Chefs, Butlers, Marble Baths: Hospitals Vie for the Affluent",
256:, physician to 1950s and '60s celebrities; known as "Dr Feelgood"
119:
106:
177:
247:
109:), economy (wastefulness), and safety (lax standards).
239:The Medical Executive Treatment Unit (METU) at the
570:
155:
512:Gershengoren L. Our Duty to the "VIP Patient".
291:
289:
287:
516:. 2016;8(5):784. doi:10.4300/JGME-D-16-00468.1
403:"Do you know who I am? Treating a VIP patient"
178:Notable medical VIP suites, wards, and floors
284:
241:Walter Reed National Military Medical Center
349:The Journal of Nervous and Mental Disease
346:
295:
16:Effect of celebrity status on healthcare
571:
400:
268:, Michael Jackson's personal physician
248:Notable practitioners of VIP medicine
274:, Elvis Presley's personal physician
181:
167:Cleveland Clinic Journal of Medicine
262:, Adolf Hitler's personal physician
13:
14:
600:
314:Meisel, Zachary and Jesse Pines,
67:was a notable attendant problem.
361:10.1097/00005053-196402000-00012
185:
93:in New York City, known as the "
584:Healthcare in the United States
545:
528:—in "The Voices in Our Heads",
519:
506:
296:Kowalczyk, Liz (2 April 2016).
491:
465:
441:
394:
375:
340:
327:
308:
227:Massachusetts General Hospital
1:
401:Davies, Marika (2016-06-08).
278:
234:NewYork–Presbyterian Hospital
156:Solutions to related problems
100:
70:
335:When Doctors Become Patients
243:(WRNMMC), Bethesda, Maryland
220:Brigham and Women's Hospital
83:
53:
7:
46:overlap with VIP medicine.
10:
605:
333:Klitzman, Robert (2008),
149:drug-resistant infection
225:The Phillips House at
65:against medical advice
272:George C. Nichopoulos
453:depts.washington.edu
199:adding missing items
22:is a variety of the
579:Medical terminology
388:New York Daily News
232:McKeen Pavilion at
91:Lenox Hill Hospital
557:The New York Times
391:(18 October 2012).
197:; you can help by
125:incidental finding
42:. Many aspects of
40:concierge medicine
419:10.1136/bmj.i2857
215:
214:
596:
564:
560:, Jan. 21, 2012
549:
543:
523:
517:
510:
504:
500:The Boston Globe
495:
489:
488:
486:
484:
469:
463:
462:
460:
459:
445:
439:
438:
398:
392:
381:Smith, Greg B.,
379:
373:
372:
344:
338:
331:
325:
312:
306:
305:
302:The Boston Globe
293:
218:The Pavilion at
210:
207:
189:
188:
182:
162:Cleveland Clinic
28:standard of care
604:
603:
599:
598:
597:
595:
594:
593:
569:
568:
567:
550:
546:
526:Jerome Groopman
524:
520:
514:J Grad Med Educ
511:
507:
502:(4 April 2016).
496:
492:
482:
480:
479:. 2 August 2000
471:
470:
466:
457:
455:
447:
446:
442:
399:
395:
380:
376:
345:
341:
332:
328:
313:
309:
294:
285:
281:
250:
211:
205:
202:
186:
180:
158:
103:
86:
73:
56:
44:medical tourism
17:
12:
11:
5:
602:
592:
591:
586:
581:
566:
565:
552:Nina Bernstein
544:
536:Boston Brahmin
531:The New Yorker
518:
505:
490:
464:
440:
393:
374:
355:(2): 181–193.
339:
326:
307:
282:
280:
277:
276:
275:
269:
263:
260:Theodor Morell
257:
249:
246:
245:
244:
237:
230:
223:
213:
212:
192:
190:
179:
176:
157:
154:
153:
152:
144:
141:
132:
128:
115:
102:
99:
85:
82:
72:
69:
55:
52:
15:
9:
6:
4:
3:
2:
601:
590:
587:
585:
582:
580:
577:
576:
574:
563:
559:
558:
553:
548:
541:
540:Robert Lowell
537:
533:
532:
527:
522:
515:
509:
503:
501:
494:
478:
474:
468:
454:
450:
444:
436:
432:
428:
424:
420:
416:
412:
408:
404:
397:
390:
389:
384:
378:
370:
366:
362:
358:
354:
350:
343:
336:
330:
324:(8 Oct 2008).
323:
322:
317:
311:
303:
299:
292:
290:
288:
283:
273:
270:
267:
266:Conrad Murray
264:
261:
258:
255:
252:
251:
242:
238:
235:
231:
228:
224:
221:
217:
216:
209:
200:
196:
193:This list is
191:
184:
183:
175:
173:
169:
168:
163:
150:
145:
142:
138:
133:
129:
126:
121:
116:
112:
111:
110:
108:
98:
96:
92:
81:
77:
68:
66:
61:
51:
47:
45:
41:
36:
31:
29:
25:
21:
589:Primary care
555:
547:
529:
521:
513:
508:
499:
493:
481:. Retrieved
476:
467:
456:. Retrieved
452:
443:
410:
406:
396:
386:
377:
352:
348:
342:
334:
329:
319:
310:
301:
254:Max Jacobson
206:January 2017
203:
165:
159:
104:
87:
78:
74:
60:VIP syndrome
59:
57:
48:
35:primary care
32:
24:VIP syndrome
20:VIP medicine
19:
18:
483:30 December
172:Mayo Clinic
137:Gerald Ford
573:Categories
458:2022-06-08
279:References
195:incomplete
114:resources.
101:Criticisms
71:Motivation
427:0959-8138
413:: i2857.
321:Slate.com
229:, Boston.
222:, Boston.
84:VIP wards
58:The term
54:Etymology
435:80259475
369:14119515
120:CT scans
97:Rooms".
477:CNN.com
107:elitism
95:Beyoncé
433:
425:
367:
431:S2CID
485:2016
423:ISSN
365:PMID
415:doi
411:353
407:BMJ
357:doi
353:138
201:.
123:an
575::
475:.
451:.
429:.
421:.
409:.
405:.
385:,
363:.
351:.
318:,
300:.
286:^
487:.
461:.
437:.
417::
371:.
359::
337:.
304:.
208:)
204:(
Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.