Thoughts on VIP Medicine

The concept of VIP medicine came up in a discussion today and someone liked how I phrased my thoughts, so I figured it was time to kick off the Schutzblog once again!

I like to think of VIP medicine as how a clinician would deviate from his or her usual style of care for a given patient who is of some special status-- wealthy, famous, connected, in some supervisory position over the patient, etc.  The general teaching is that VIP medicine is generally disastrous for the patient, and can even be lethal; but why?  Why would thinking of a patient more frequently, wishing to spare them discomfort, unpleasant examinations, embarrassing diagnoses, waiting, or the performance of clinical tasks by anyone but the physician be dangerous?

Fundamentally, our job as physicians is to balance risk and benefits for our patients.  All of our tests and therapies are potentially harmful, or at least uncomfortable and expensive and carry the risk of false or true positives and negatives of uncertain sign…