Monday, October 26, 2015

one patient labeled important renders other patients less important by default


NYTimes |  WHEN I saw my first red blanket as a young medical student, I thought little of it.
One morning, as I rushed around a hospital in California on my daily rounds, I spotted an old man who lay in bed beneath a scarlet cover, a sharp contrast to the white linens wrapped around the other patients. He looked unremarkable, and I assumed he brought the blanket from home. So I moved on. He wasn’t my patient, anyway.

That afternoon, I overheard a discussion about the patient between two physicians. Instead of identifying him in the usual manner — age, gender, medical problems — one of the doctors said, “This is a red blanket patient.”

The significance became clear after I took care of my own red blanket patients: It was a marker of status. At that hospital, patient relations gave them to some C.E.O.s, celebrities and trustees’ friends. Although we weren’t instructed on how to treat the V.I.P. patients, the blanket spoke for itself: “This patient is important.”

Today, I work at a hospital in Massachusetts that gives the same white blankets to everyone. Yet I continue to see red blanket patients. Here, they are called “pavilion patients” because they pay extra to stay in private hotel-like rooms on the top floor, which come with gourmet food, plush bath robes and small business centers.

Whether red blankets or luxury suites, elite services exist in various forms at hospitals around the country, and are nearly universal at the most prestigious medical centers. Of the nation’s top 15 hospitals, ranked by U.S. News and World Report, at least 10 offer luxury treatment options.

Some physicians suggest that V.I.P. services are a harmless way to raise money. Wealthy patients can afford to pay over $1,000 a night for deluxe rooms. More important, if V.I.P.s have good experiences, they might make big donations. At some cancer centers, doctors are even trained to solicit donations themselves. It makes sense. With more money, the hospital can improve its overall service. It’s trickle down health care.

But are red blankets really harmless?