‘‘The Medical Self’’ 71
purposefully handpicked their physicians-of-record from among friends
and colleagues in order to ensure certain types of care. Questions arose
about how to proceed.
Entitlement and VIP Treatment
Awareness of the pitfalls of VIP treatment arose, but was rare. ‘‘VIP
syndrome’’ has been described (4), in which hospitalized VIPs receive
substandard care due to the reluctance of medical staff to treat the VIP as
a ‘‘mere’’ patient. Ill doctors faced similar issues, though important dif-
ferences arose, since physicians were not only VIPs, but doctors posses-
sing medical knowledge. Moreover, the VIP syndrome has never been
examined from the point of view of the VIPs themselves—only from that
of the treating medical staff.
A few of the doctors here expressed caution about receiving ‘‘special
treatment.’’ Albert, who had an MI on the highway, felt that being
treated by a generic doctor on call at his local hospital was appropriate:
the system then operated as it was supposed to.
When President Reagan was shot in Washington, the doctor was a
vascular surgeon on call. Several other doctors could have been
mobilized. But sometimes the system functioning according to the
way it’s designed is a bigger plus than the increment in quality of
care you might get from somebody with a better reputation.
Hence, Albert had asked the head nurse whom she would recommend.
Nevertheless, the majority of these doctor-patients sought or received
VIP treatment, often because, as suggested earlier, they were patients at
institutions where they were well-known as doctors. Ill physicians who
knew their provider as a colleague might trust him or her more, but de-
crease how much authority they ceded.
Indeed, many physicians felt they were members of a ‘‘fraternity,’’ and
hence deserved good care from each other. Jim, the drug company re-
searcher with leukemia, felt he had taken care of others, and as a result
he now expected special treatment in return: ‘‘I am part of this group,
this profession, and have contributed to it. I’ve done my share of taking
care of people—that may be selfish, but that’s reality.’’
Many simply anticipated VIP or ‘‘special’’ treatment in some way. For
example, Jacob didn’t ask for favors, but just expected them. He became