'They dictate their care': VIP syndrome may be behind Trump's discharge from Walter Reed, expert says
President Trump has returned to the White House after spending three days at Walter Reed National Military Medical Center for symptoms of COVID-19, which one expert says may indicate he’s getting special treatment. In press briefings over the weekend, his physician Dr. Sean Conley sent mixed messages about his state — at first insisting that he was “doing very well” and later revealing that he experienced a high fever and two periods of low oxygen levels.
Trump himself sought assure supporters on Sunday, making an “unannounced exit” from Walter Reed to circle the hospital while masked in an armored car. While the president continues to assert that his hospital stay was a success, some experts say the situation bears resemblance to a well-known and dangerous phenomenon called “VIP syndrome.”
Jennifer Perrone McIntosh, an assistant professor of nursing at Farmingdale State College in New York, published a study on the phenomenon in 2019 after years of having to provide special treatment to high-profile patients — something she recognizes in Trump’s care. “The care that he’s receiving is totally in line with VIP syndrome,” McIntosh tells Yahoo Life. “When a VIP patient presents to a health care facility, the rules are bent; they’re being treated completely differently than the general patient population.” The fact that Trump has been released from the hospital, she says, is a clear sign that he’s receiving special treatment.
The term VIP syndrome itself dates back to a 1964 paper written by Dr. Walter Weintraub, a psychiatrist and professor at the University of Maryland, who expressed concern that the psychiatric hospital in which he was working had been “thrown into turmoil” by the demands of influential patients. “The treatment of an influential man can be extremely hazardous for both patient and doctor,” Weintraub wrote.
Today, the term is used by medical professionals to describe the danger in treating an individual with access, power or wealth at a health care facility. “The care of ‘Very Important Patients’ (VIPs) is often qualitatively different from other patients because they may receive greater access, attention, and resources from health care staff,” wrote Dr. David Alfandre in the 2016 paper Caring for ‘Very Important Patients’ – Ethical Dilemmas and Suggestions for Practical Management.
Alfandre noted that while “VIP” may imply these individuals receive better treatment, many times it’s the opposite. “In spite of these perceived benefits, the quality of their care may be inferior because health care staff may be more likely to deviate from standard practices when caring for them.”
Reports about Trump’s care, which have come mostly from press briefings, suggest an atypical experience. On top of being released after three days in the hospital, while still in the midst of treatment, he’s reportedly received multiple experimental treatments — including the antiviral remdesivir, an unapproved monoclonal antibody therapy and a corticosteroid known as dexamethasone. The three are rarely (if ever) given together and are typically reserved for serious illness.
McIntosh says all of this aligns with VIP syndrome, which can lead to both too much and too little care. “VIP syndrome means patients are either undertreated or overtreated. So they may be undertreated, meaning the health care team may feel uncomfortable asking them to go for certain tests, or they could be overtreated and get the opposite,” says McIntosh. “Based on what I’m hearing about what's happening currently with our president, it sounds as though he may be the recipient of both.”
She says that receiving multiple experimental drugs, including one that is not FDA approved, is a good example of being overtreated, and that “being discharged from the hospital already, that would be an example of undertreatment.” While this syndrome is potentially dangerous for patients themselves (some believe that celebrity deaths like that of Prince may be linked to VIP syndrome), it also negatively affects the health care staff involved — nurses in particular.
“We have an ethical code of conduct we have to follow whereby we’re told to respect patient autonomy, to treat everybody equal and not to differentiate care based on somebody’s race, gender or socioeconomic status,” says McIntosh. “So we’re being told really to practice unethically.” Currently teaching her students about the dangers of the syndrome, McIntosh hopes that things may change. But when it comes to individuals like Trump, she knows what it feels like.
“The health care team listens to them, they feel intimidated, and that’s part of the VIP syndrome — they use their power,” says McIntosh. “They use it to exert pressure on the team and say, ‘This is what I want and no, I don’t want this.’ If they don’t want this X-ray, they won’t get it. If they want to get this discharged early, then they’re getting discharged early. They dictate their care.”
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