Sunday, April 17, 2016

Sunday Globe Special: The V.I.P. Room at Brigham

Enjoy your stay:

"Was patient with apparent ties to royalty worth breaking hospital protocols?" by Liz Kowalczyk Globe Staff  April 03, 2016

The new patient had apparent ties to Middle Eastern royalty, and brought along a personal chef and an entourage of seven attendants. This, by itself, is not unheard of in the cost-is-no-object world of VIP medicine, in which elite hospitals in Boston and other cities accommodate wealthy patients, some from distant lands, who can afford the full tab for care — and for premium amenities like deluxe rooms that cost up to $800 a day more than regular ones.

Commonly addressed as a prince, the patient also seemed to arrive in 2014 with some definite ideas about how he wanted to be treated, and Brigham staff tried hard to please him even when that ran afoul of hospital policies. It’s a phenomenon common enough that it has a name — VIP syndrome — and hospitals across the country, even as they relish the extra revenue from treating such patients, have had to work hard to avoid its side effects.

In the case of the Brigham and the prince, there were many.

The embarrassing episode is a vivid example of what can happen when administrators, doctors, and nurses veer from their usual clinical judgment and behavior because of a patient’s special status and demands. The term VIP syndrome is believed to have been coined in 1964 by Dr. Walter Weintraub, who wrote that his Maryland psychiatric hospital was thrown into turmoil when staff struggled to respond to the relentless requests of influential patients and their relatives.

Leaders at the Cleveland Clinic said the problem may be more pronounced today because of the rise in medical tourism, with celebrities, royalty, and political leaders willing to travel far and pay whatever it costs to obtain the best care. It requires constant vigilance by staff and administrators, they said, to resist pressures to change usual clinical wisdom and practices — though high-profile patients are not the only ones who can be demanding.

Not all international patients are wealthy, and hospital trustees, prominent physicians, and community leaders also can be VIP patients. Former Boston mayor Thomas Menino was treated for cancer at the Brigham Pavilion.

The prince was originally admitted to the hospital in 2012. He returned in 2014 for surgery, accompanied by a chef, a personal physician, six attendants, some of whom identified themselves as nurses, and a “helper/cleaner,’’ the health department report said.

He had two rooms in the Pavilion, which offers concierge services, in-room offices, and gourmet food. The surcharge is $300 to $800 per night in addition to the normal cost of a hospital room and medical care.

The prince slept during the day and stayed awake at nights, sometimes sending out for buffets of food, other times leaving to stay at a nice hotel. He was dispensed large amounts of prescribed narcotics, which some nurses were uncomfortable with, said the two people familiar with the situation.

Dr. Robert Klitzman, a psychiatrist at Columbia University Medical Center, said VIP syndrome emerged as a theme when he interviewed physicians for his 2008 book “When Doctors Become Patients.” Many were treated as high-profile patients in their own hospitals, leading to benefits such as expedited care in the emergency room and direct access to specialists. But their status also hurt care at times, such as when caregivers skipped prostate exams because they were embarrassed. It was also hard for prominent doctors to keep their medical condition private.

Klitzman said when a celebrity or member of royalty is admitted to the hospital, the typical relationship between doctor and patient can be turned on its head. “Normally a doctor has authority and professional expertise. Celebrities are viewed as gods. If you have a celebrity, you are a mere doctor.’’

At least you know the pecking order.


I don't see the problem. The global elite and wealth can buy what we can't. Been that way forever, and who would want to change it?


"As one of Massachusetts’ most prestigious hospitals becomes increasingly popular with wealthier patients from around the country and the globe...."


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