This piece was originally published in the Boston Globe.
It is a familiar tableau: two white-coated (usually male) doctors standing at a podium delivering the solemn report. Looking professional, tight-lipped and slightly self-important, the doctors deliver a scripted summary of the VIP's condition: "The candidate is in perfect health," "The actor is recovering nicely."
Like most physicians, I pride myself on giving the same care to all patients, regardless of their financial, ethnic or social status. But the reality is that celebrity patients, such as Senator Edward M. Kennedy last year when he was diagnosed with a brain tumor, have entirely different experiences than "normal" people when they access health care.
It can be seductive for a physician to be chosen to care for a celebrity -- they could have chosen anyone, and they chose me! But caring for celebrity patients can be a mixed experience for a doctor, other physicians and patients.
When caring for one well-known family, I recall being so flattered and curious that I got drawn into their world. I found myself making special efforts, treating them at home, and taking their late-night calls, even on vacation. My husband asked me why I was extending such courtesies to the family and not my other patients. I realized I had been so entranced by the glamor and strangeness of the celebrity experience that I had crossed a boundary.
Doctors also tend to feel extra pressure to deliver exceptional care for well-known patients, so they may order extra tests for common complaints or initiate overly aggressive procedures.
One emergency room doctor recently told me about a VIP patient who came to the ER complaining of chest pain. The patient's visit triggered a cascade of events at the hospital administration level. The "VIP office" sent a delegate to smooth the way, and the patient came with his own personal physician, who was there to serve as a buffer and enabler for the patient. Not only was the "physician bodyguard" not in the right specialty for the complaint and age of the patient, but the physician gave orders: "Call the cardiologist and get an echocardiogram."
Both the resident and the responsible physician thought the patient's problem was gastro-intestinal; he had swallowed a huge antibiotic pill without enough water, and the esophagus was irritated enough to cause the chest pain. Instead of quickly looking at the patient's esophagus, hours were wasted getting cardiology and cardiac tests which were not needed. His VIP status delayed getting him proper care.
A VIP's office visit also can be disruptive to fellow patients. In one case, a celebrity visit upended a busy practice -- the decks were cleared, a long-planned computer change was scratched, and staff members were ordered to make multiple specialist referrals immediately. According to a doctor on the scene, the special attention angered staff and delayed care for other patients.
And you can be sure that these celebrities do not have to jump through the health care hoops that the average patient does. I recall giving an actor an insurance physical for a movie he was making in town. After the work was completed, I asked for payment options, and he looked at me as if I had two heads; clearly, money matters did not cloud his world view.
For the celebrity the trauma of being ill is coupled with the morbid curiosity of the public about all the private details of the illness. Fortunately, the strict HIPPA regulations as well as a health care system determined to respect patient privacy generally serve VIP patients well.
Senator Kennedy was a long-time champion of much-needed reforms to the health care system. But was a rare exception. Perhaps if more celebrities and politicians had to endure a typical health care experience, they would work harder to make the system better for all of us.
Dr. Victoria McEvoy, medical director at Mass General West Medical Group and an assistant professor of pediatrics at Harvard Medical School, can be reached at firstname.lastname@example.org.