Let's talk about 'VIP syndrome'
When a team of medical professionals are caring for a celebrity or person of power or influence, they may find themselves under pressure to roll out the red carpet.
However, not only does giving “very important people” special treatment contribute to inequity in health care, it can create challenges for doctors and patients that result in bad health outcomes.
What is ‘VIP syndrome’?
Coined in 1964 by Dr. Walter Weintraub, “VIP syndrome” is the tendency of some physicians to provide special privileges to a patient because of their status or wealth.
Special treatment may include better or faster care, greater access to treatments that are not readily available to the public, enhanced facilities or more attention from physicians. That means VIP syndrome risks giving some patients priority ahead of others with needs just as important.
According to the American Board of Internal Medicine, doctors that fall victim to VIP syndrome neglect two of the Physician Charter principles:
- Principle of Social justice: Providing some patients with special care based on their status or wealth creates an unfair promotion of resources and increasing room for discrimination.
- Principle of Primacy of Patient Welfare: By bending the rules for a patient, physicians may be putting them at risk.
“VIPs may receive bad care because they are not treated according to the usual standards,” says Dr. Neil Wenger, professor at the David Geffen School of Medicine in the Division of General Internal Medicine and chair of the Ronald Reagan UCLA Medical Center Ethics Committee. “Sometimes doctors do not ask the uncomfortable but necessary probing questions. Sometimes they allow patients leeway outside of good care because the doctor is respectful, afraid or awestruck. Some doctors may not be as firm with the patient as needed to get the best outcome.”
Dangers of VIP syndrome
Physicians experiencing VIP syndrome may find it difficult to deny the demands of prominent patients. They “run the risk of cutting corners or paying disproportionate attention to matters that could paradoxically lead to worsened outcomes,” says Dr. Benjamin Ansell, professor at the David Geffen School of Medicine in the Divisions of General Internal Medicine and Cardiology.
This phenomenon can also result in worse outcomes for all patients, not just the VIPs. Unnecessary tests and treatment lead to wasted resources, and more attention for “people with means or fame ahead of people with greater needs,” says Dr. Wenger.
Fundamentals of excellent care
“The fundamentals of patient care need to be the same, regardless of wealth, influence or celebrity,” says Dr. Ansell, adding that it’s important for health providers to be sensitive to all types of patient needs and expectations.
“When we can meet preferences, we certainly try our best – so long as they do not compete with medical interests,” he says. “But as the current pandemic illustrates, it is critically important for individuals, public health, as well as provider safety, to standardize many practices of care.”
Deviations from care that aren’t available for all patients risk poor outcomes not just for the patient, but also the physician: They may be violating hospital and/or legal policies and regulations.
When it comes to physicians with VIP syndrome, “if it's a zero-sum game, the non-VIP patient loses,” says Dr. Wenger. “Simply put, physicians should be treating patients equally.”
UCLA Health patient care principles & mission
UCLA Health works hard to provide all patients with equitable access to health services, diagnostics and treatments in a welcoming, healing, safe and professional environment.
“While we definitely take steps to ensure that publicly recognizable figures have their rights to privacy protected while seeking health care, they get their care with the same providers, same equipment and same examination and hospital rooms as any other patient in our system,” says Dr. Ansell.
He adds that it is important that health quality goes hand in hand with health equity, and that all patients have access to the “many world-class specialists, teams and facilities at UCLA Health.”