Novel JHM Research Explores Challenges of VIP Patient Care

First-of-its-Kind Study Finds Clinicians Often Feel Pressured by Patients, Families to Perform Unnecessary Testing and Treatment

The Journal of Hospital Medicine, the official peer-reviewed journal of the Society of Hospital Medicine (SHM), recently published a study titled “Perceived Safety and Value of Inpatient ‘Very Important Person’ Services,” which is the first study of its kind. In the study, a majority of physicians who reported the presence of very important person (VIP) services at their hospital felt pressured by VIP patients or their family members to perform unnecessary testing or treatment.

“The provision of unnecessary care can pose a potential harm to patients,” notes Joshua Allen-Dicker, MD, MPH, FHM, hospitalist at Beth Israel Deaconess Medical Center and instructor at Harvard Medical School, one of three principal investigators for the study. “We examined the care provided to VIP patients – a frequent topic of conversation but rare focus of academic research – and asked whether or not VIPs received different care than the average patient.”

The study reads, “Providing care to VIP patients can pose unique moral and value-based challenges for providers. No studies have examined VIP services in the inpatient setting. Through a multi-institutional survey of hospitalists, we assessed physician viewpoints and behavior surrounding the care of VIP patients.”

Eight study sites participated in the survey through the Hospital Medicine Reengineering Network (HOMERuN), an organization that brings numerous hospital medicine professionals and institutions together to improve patient outcomes. Sites included the University of California, San Francisco, Baystate Medical Center, Beth Israel Deaconess Medical Center, Brigham and Women’s Hospital, Christiana Care Health System, Northwestern Memorial Hospital, San Francisco General Hospital and Vanderbilt University.

Andrew Auerbach, MD, MPH, SFHM, Professor of Medicine in Residence at the University of California San Francisco and Editor in Chief for the Journal of Hospital Medicine, and Shoshana Herzig, MD, MPH, Director of Hospital Medicine Research within the Division of General Medicine and Primary Care at Beth Israel Deaconess Medical Center, Senior Deputy Editor for the Journal of Hospital Medicine served as co-investigators.

“Studying VIPs is significant because these patients are ‘important’ in ways that may not differentiate them from other patients for clinical reasons,” states Dr. Auerbach. “Dr. Allen-Dicker’s work points out how physicians react when faced with that disconnect.”

On study outcomes, Dr. Allen-Dicker notes, “We hope that by raising awareness about VIP care, we can promote discussions with physicians, hospitals and patients about how to ensure that all patients receive safe and appropriate care.”

To access the study, visit www.journalofhospitalmedicine.com. For more information, please contact Joshua Allen-Dicker, MD, MPH, FHM at DrJoshuaAD@gmail.com.

About the Journal of Hospital Medicine:
The Journal of Hospital Medicine is the premier, ISI-indexed publication for the specialty of hospital medicine and official journal of the Society of Hospital Medicine. The journal advances excellence in hospital medicine as a defined specialty through the dissemination of research, evidence-based clinical care, and advocacy of safe, effective care for hospitalized patients. For more information, please visit www.journalofhospitalmedicine.com.

About the Hospital Medicine Reengineering Network:
The Hospital Medicine Reengineering Network (HOMERuN) was established in 2011 to advance the field of Hospital Medicine by facilitating and conducting collaborative, rigorous, inter-professional, multi-site, research studies which improve outcomes of patients with acute illnesses. HOMERuN research focuses on developing, evaluating and disseminating innovations in healthcare delivery that encompass the entirety of patients’ acute illness. To learn more, please visit www.hospitalinnovate.org.