Physicians often feel pressure from patients' family members and hospital leaders to provide extra, unnecessary care to high-profile patients, according to a recent study.
The study, published in the Journal of Hospital Medicine, surveyed hospitalists across eight hospitals about services provided to patients who are considered "VIPs." In some hospitals, "VIP services" are provided to patients with close relationships to the hospital and may include extra space, enhanced facilities and extraneous comforts and supports. Of the respondents who reported that the presence of VIP services at their hospital, a majority said they felt pressure from VIP patients or their family members to perform additional treatments or tests and roughly one-third felt this pressure from hospital staff, according to the report.
For example, researchers polled hospitalists on the following scenario: a hospital board member who was admitted with community-acquired pneumonia is now stable for discharge, but concerned about leaving. Respondents who reported VIP services at their hospital were more than twice as likely as their peers who worked at hospitals without reported VIP services to keep the patient in the hospital (55.7 percent vs. 24.4 percent). Researchers then asked the respondents who said they would not discharge the patient to select all reasons that applied for why they chose this course of action. Most (79 percent) said their decision related to patient concerns, 61 percent said it related to the patient's connection to the board and 15 percent said their decision was based on medical concerns.
"While this study was not designed to quantify the burden of unnecessary care for VIP patients, our results have implications for individual patients and public health, including potential effects on resource availability, the identification of clinically irrelevant incidental findings, and short- and long-term medical complications of procedures, testing and radiation exposure," the authors wrote.
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