Bioethics Discussion Blog: Physician As Patient (2)

REMINDER: I AM POSTING A NEW TOPIC ABOUT ONCE A WEEK OR PERHAPS TWICE A WEEK. HOWEVER, IF YOU DON'T FIND A NEW TOPIC POSTED, THERE ARE AS OF MARCH 2013 OVER 900 TOPIC THREADS TO WHICH YOU CAN READ AND WRITE COMMENTS. I WILL BE AWARE OF EACH COMMENTARY AND MAY COME BACK WITH A REPLY.

TO FIND A TOPIC OF INTEREST TO YOU ON THIS BLOG, SIMPLY TYPE IN THE NAME OR WORDS RELATED TO THE TOPIC IN THE FIELD IN THE LEFT HAND SIDE AT TOP OF THE PAGE AND THEN CLICK ON “SEARCH BLOG”. WITH WELL OVER 900 TOPICS, MOST ABOUT GENERAL OR SPECIFIC ETHICAL ISSUES BUT NOT NECESSARILY RELATED TO ANY SPECIFIC DATE OR EVENT, YOU SHOULD BE ABLE TO FIND WHAT YOU WANT. IF YOU DON’T PLEASE WRITE TO ME ON THE FEEDBACK THREAD OR BY E-MAIL DoktorMo@aol.com

IMPORTANT REQUEST TO ALL WHO COMMENT ON THIS BLOG: ALL COMMENTERS WHO WISH TO SIGN ON AS ANONYMOUS NEVERTHELESS PLEASE SIGN OFF AT THE END OF YOUR COMMENTS WITH A CONSISTENT PSEUDONYM NAME OR SOME INITIALS TO HELP MAINTAIN CONTINUITY AND NOT REQUIRE RESPONDERS TO LOOK UP THE DATE AND TIME OF THE POSTING TO DEFINE WHICH ANONYMOUS SAID WHAT. Thanks. ..Maurice

FEEDBACK,FEEDBACK,FEEDBACK! WRITE YOUR FEEDBACK ABOUT THIS BLOG, WHAT IS GOOD, POOR AND CONSTRUCTIVE SUGGESTIONS FOR IMPROVEMENT TO THIS FEEDBACK THREAD

Sunday, October 03, 2004

Physician As Patient (2)

What is the VIP syndrome? The Very Important Person (VIP) syndrome is a pattern of behavior by both the ill physician and his/her healthcare providers that may be deleterious to the established standards of medical care. From the ill physician’s point of view, his or her illness as a physician requires special attention by the caregivers not given to the other patients. The physician is to be treated as a professional and is to be kept fully informed about all the clinical details and is to be consulted as a colleague by the treating physician. The ill physician may request that appointments or lab tests take priority over others for personal convenience. When hospitalized, the physician may be demanding about which nurses are assigned and how they respond to requests. Also, the family of the sick doctor may be similarly demanding.

I suspect that the VIP behavior by the ill physician is not as common as the potential for altered behavior by the treating physician. Unless the treating physician has had lengthy experience caring for medical colleagues, the experience of being a doctor’s doctor can be emotionally traumatic with anxiety, uncertainty, anger and guilt. From the outset, history taking of the doctor may be more incomplete than the average patient since there may be a tendency to avoid asking important but personally embarrassing questions such as involving mental illness, family problems, sex or drug and alcohol use. Physical exams of the ill physician may be more casual and pelvic, breast or rectal exams may be omitted. Testing may be inadequate especially if the appropriate test is uncomfortable. Telling the ill physician the diagnosis and treatment options may be difficult if the treating physician is personally uncomfortable with the conclusion and identifies with a patient with whom he or she has professionally interacted. All of these VIP elements do nothing but worsen or delay proper diagnosis and treatment

Proper communication with the ill physician is essential and probably the most important thing that a treating physician can do is at the outset to make it clear that the sick doctor is going to be treated as a patient and not as a doctor.

For more reading on this topic: "’Doctoring’ Doctors and Their Families” by Stuart A. Schneck, MD
JAMA. 1998; vol.280, pages 2039-2042.

3 Comments:

At Thursday, June 09, 2005 7:47:00 PM, Blogger Kathy said...

Very interesting. As a nurse, I tend to resent the different treatment I am expected to give to VIPs...& all MDs/families are considered so whether they "have the syndrome" or not. It is expected by the hospital where I work & by their attending.

I have found that the attending physician takes much more interest in a colleague & expects the care/orders to be carried out with the utmost urgency, regardless of staff load or priorities of more critically ill clients assigned to the nurse. I had not factored in that the attending physician may feel a certain amount of pressure in taking care of "this" patient; although I do know that nurses are typically uncomfortable taking care of other nurses...the usual view is fear of comparison/judgment in duties, etc.

If the client is a physican that the nursing staff also has a working relationship with, they also tend to alter their interview/assessment techniques as well.

Lastly, I note the VIP/pt does not truly have the same HIPPA protection as general public. It never ceases to amaze me at the number of doctors that request an update of me...& depending on the situation I don't always know who really has been consulted in on the case. Nor is it unusal for the physicians to just come & get the chart. Once when I brough HIPPA up the offending doctor responded by saying he needed to know what was going on before entering the room to say hi in case he was asked his opinions & that as a nurse I had no right challenging him. He went to my supervisor to "report" my behavior & was extremely hostile whenever we interacted on his admits to the floor for a long time (I work in a critical care unit)..which affected the way his patients were taken care of.

 
At Monday, July 25, 2005 8:13:00 PM, Anonymous Anonymous said...

I am a CNA and I have come to HATE taking care of physicians and their families!

They (MDs/family) seem to think that because they are ill they deserve special attention. I believe they should be treated just like the other patients!

Patients are coded according to level of severity of illness (at the hospital I work at). Most individuals rate a 3:1 ratio (3 patients per nurse) but MDs think they rate a 1:1 no matter what!

I will continue to treat MDs and their families as I would any other patient, regardless of their "God" complex.

 
At Friday, November 12, 2010 4:57:00 PM, Anonymous joshtoma said...

If my patient is a former/current MD or Nurse I would give special attention to make sure they are comfortable. I am a nurse and I feel that you need to take care of your own. That doesn't mean that I'm gonna neglect my other patient but I would certainly treat my MD/RN patient with a higher degree of respect. I would expect the same as a nurse ill in the hospital.

 

Post a Comment

<< Home