The unexpected death of American comedienne Joan Rivers may have been an example of the baneful effects of the “VIP syndrome”.

The unexpected death of American comedienne Joan Rivers after a routine procedure in a Manhattan endoscopy clinic may have been an example of the baneful effects of the “VIP syndrome”, according to the New York Times. The phrase was coined in 1964 by a psychiatrist, Dr Walter Weintraub. “The treatment of an influential man can be extremely hazardous for both patient and doctor,” he wrote.

For physicians, “The VIP, cursed with the touch of Midas, arouses only resentment and fear.” They regard these patients as demanding and manipulative and to resent them for it, which can diminish the quality of their care. But for hospital administrators, “The VIP is more than just a patient. He is also an object to be bartered for future favors.”

The most famous victim of the VIP syndrome may have been entertainer Michael Jackson, who died after his personal physician gave him a surgical anaesthetic to help him sleep. The doctor was convicted of involuntary manslaughter and was sentenced to four years in prison.

Doctors can also become overly deferential, which may affect their clinical judgement. They may settle for a conventional treatment so that they cannot be accused of reckless treatment if something goes wrong. “Often with VIP patients, doctors won’t say, ‘Joe Famous Person, look, you have to take your medicine or you have to come in for surgery immediately,’” bioethicist Robert Klitzman, of Columbia University, told the Times.

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VIP syndrome

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Michael Cook

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