Robert M. Centor, MD: 'Special' Care May Be Inferior CareOver the years I have cared for several VIPs (Very Important Persons). Of course, we might have different definitions of who qualifies as a VIP. But I have had patients who I considered to be 'very important.'
What makes someone a VIP? Do these people define themselves as VIPs? What standards do we use to categorize a patient as a VIP?
Some of my VIP patients have been poor and unknown. I considered them VIPs even though no one else would. They were VIPs because they became very important to me.
Fortunately, I do not care for many patients who consider themselves VIPs. While I am able to take care of such narcissists, I find it draining and unpleasant. I would rather care for ordinary patients and try to deliver extraordinary care. Those who declare themselves VIPs are the most challenging, for they expect a different level of attention.
I have also cared for some patients who would be considered VIPs by almost anyone: legislators, college deans, and even the best known radio announcer in town. Most VIPs ask for nothing special. They have selected you as their physician and are able to act appropriately, without making any extra demands.
However, other VIPs are a pain in the (pick your anatomic location). These people (who generally consider themselves VIPs, even if I do not) add a narcissistic edge to the doctor-patient relationship.
What adjustments do I make for VIPs? I believe the most notable difference is the access I provide to them. For someone who is truly a VIP (but not those who just consider themselves as such), I will always adjust my schedule to fit their schedule. I give them my cell phone number and my email address. In essence, I give them the concierge treatment.
In terms of the medical care I provide, I can recall no differences at all. I do my best to provide the highest quality care and attention to all patients.
In fact, VIP patients actually run the risk of providers making adjustments to their care that are not particularly beneficial. This is similar to when physicians care for other physicians. Often, when caring for such 'special patients,' we may treat them differently in a way that deviates from optimal care. Unfortunately, 'different' rarely means 'better.'
We must remember that good care should remain an ideal that all patients deserve. Treating patients differently often leads to worse care. In an effort to 'protect' special patients (especially colleagues) from uncomfortable but necessary care, we might actually be providing inferior care.
Medscape Med Students © 2007 Medscape
Cite this: How Do You Treat VIP Patients? - Medscape - Jul 18, 2007.