The practice of providing preferential treatment to influential individuals can result in compromised patient safety and access to equitable patient care, AIIMS doctors have warned.
In an article published in Oncology Reviews, Dr. M D Ray, Professor of Surgical Oncology at AIIMS, Delhi and his MCh student Dr. Hema Siri Kottu examined the ethical and clinical challenges that the doctors face while dealing with “VIP syndrome”, where high-profile patients receive preferential treatment that deviates from standard medical protocols.
The authors have explained in the article the challenges that arise in practice, particularly with patients seeking VIP treatment. According to them, these challenges often stem from interference from management or external pressures and it is not limited to patients of high socioeconomic or professional status only, as it extends to relatives of healthcare providers as well.
The article mentions how such interferences “influence patient care” and pose challenges for the doctors. “Even within the medical community, when treating fellow doctors, there can be a tendency towards overcaution, leading to undue anxiety over minor conditions. Addressing these challenges requires maintaining the principles of the Hippocratic oath while navigating pressures that may compromise equitable patient care,” it said.
“While special accommodations for high-profile individuals may be acceptable if they do not compromise access or the quality of care for others, healthcare providers must be vigilant,” the authors have concluded.
In the article, the authors have discussed the challenges faced by oncosurgeons with VIP patients, the patients, and hospital staff. It also lays down the do’s and don’ts for doctors while caring for VIP patients.
Referring to their clinical experiences in surgical oncology, the authors described how pressure from patients, their relatives or hospital administrators results in unnecessary investigations, surgery without adequate preoperative preparation, and prolonged intensive care unit (ICU) stays. This ultimately can expose patients to unnecessary delays in treatment, confusion, and avoidable complications.
“The resources and attention devoted to VIP patients can indirectly affect non-VIP patients. When physicians and staff are preoccupied with high-profile cases, the care and attention given to regular patients may diminish, leading to delays or substandard treatment,” explained the authors.
In the article, the authors recount the case of a 58-year-old woman with advanced ovarian cancer. Following pressure from hospital management, the patient underwent surgery without adequate preoperative preparation.
These pressures extended beyond admission, influencing decisions such as prolonged ICU stays postoperatively, which were not necessary. Consequently, her recovery was complicated by delayed ambulation, leading to postoperative basal atelectasis and subsequent pulmonary complications. Her hospital stay extended to 12 days, whereas patients typically undergoing similar surgeries are discharged within 5 days, the authors said.
