Treat Everyone the Same

Two decades ago I read a terrific autobiography of a man who had specialized in Infectious disease, and had treated kings, monarchs, the rich and powerful, and just regular people.  Over and over in his book he’d point out that the Rich and Famous (R&F) get worse medical care than the general public because the system got changed to accommodate the demands of the R&F.

In fact he realized it, and when consulted to help with the case of a European Monarch (?50’s?) with pneumonia, his deal was that the monarch would check into a public hospital under an assumed name, stay on a regular floor, and get the same care everyone else got.  He recovered.

Everyone in medicine has seen it, and it stinks: they’re rich/powerful/connected, and so the normal patterns and flow don’t apply, usually to the detriment of the one who thinks they’re getting special treatment.  Yes, it’s special, all right.

Dr. Tim (from Left Brain) had his original post picked up at BlogCritics, and it’s a told-to-be-true tale of exactly the same behavior, gone nuts:

VIP Syndrome

If he gets worse, we will take him immediately to the operating room.  JVIP agrees to this plan, but soon becomes agitated in the ER. “When am I going to get my room,” he complains to the ER nurse, followed by, “It smells in here. Did someone crap their pants?” followed by “There are drunks in here, get me out of here right now!” The ER nurse, then the ER physician, as well as the residents, explain that the hospital is very full, but they are working as fast as they can to obtain an available bed as soon as possible. JVIP tells them to hurry, and make sure it’s a private room. But after one more hour of being in the ER, JVIP decides he can’t stand it any more, and checks out Against Medical Advice.

Being a (Junior) VIP, he is incensed by his “shabby” treatment, and uses his connections to contact the local newspaper outlet, the local television news outlet, the mayor’s office, and several prominent friends who are tight with the hospital board members….

Read it, as it’s a modern immorality tale, and a cautionary one as well.


  1. This is absolutely true. Generals and high-ranking officers in the military were notorious for pulling this stuff.

    The poorer care VIPs receive is also the reason why the AF finally did away with its “executive medicine” program, though it took an Air Force General dying like a dog from his missed prostate cancer to kill it. As I recall the story, the very busy General was having difficulty urinating, and so was whisked straight up to see the head of urology. The 0-6 careerist Urologist, eager to please the powerful general, did a very perfunctory HX and physical (no rectal exam, because he didn’t want to discomfit the busy and reluctant general), diagnosed prostatitis, and sent the general on his way with antibiotics. Unfortunately, the general had a prostate mass… not simple BPH or prostatitis. Due to his schedule, the general was lost to follow-up, but he continued to have problems, and his enormous prostate mass was finally diagnosed some time later by a GMO flight surgeon. By then, he had metastatic disease.

    People fail to understand that all the pedestrian procedures and processes that we use are ultimately in place to benefit them. Ego can be a deadly handicap.

  2. While in the ER, I overheard a nurse telling the doctor about a VIP patient demanding to be brought up to his room.

    Doc: “What’s his position?”
    Nurse: “City Councilman”
    Doc: “City Councilman? I have more respect for the city garbageman.”

  3. The main trick to dealing with VIPs is that you make them feel like you are treating them like a VIP, otherwise, they get the same care as everyone else, because you’re already trying to give everyone the best care you can. No such thing as best of the best of the best. Usually all it really requires is a few more pitstops, saying, “Just checking in to make sure you’re doing OK…”

    I’ve had hospital admins come up, saying in low tones, “I just wanted you to know who that is…” at which time you realize that if you really concentrate you CAN keep from rolling your eyes.

  4. What the….?

    Man… that’s some wacky sh*t right there.

  5. Just prior to TheNewGuy’s comment was a (since deleted) 30 screen screed, having nothing whatever to do with the topic.

    It was pretty manic, though.

  6. Hi, GruntDoc,
    Do you remember the title or author of the book that you read? It sounds interesting, and I’d like to read it.

  7. No, Laura, I don’t. I have looked for it in the house, and now wonder if it wasn’t a library book. It was a pretty good read.

  8. I found the book I referenced in the post. It’s

    M.D.: One Doctor’s Adventures Among the Famous and ** (Mass Market Paperback)
    by B.H. Md Kean (Author)

    and is available on Amazon, here:

    I just ordered a copy.