“Very important people” (VIPs) are frequently encountered in healthcare. These “well-known” patients (celebrities, benefactors, CEOs, administrators) or “well-connected” patients (family members, colleagues, healthcare providers) are often referred to as “influential” or even “intimidating” because of their status.[1] [2] [3] [4] [5] [6] [7] The “VIP” designation may be context and clinician-dependent and can extend further to include anyone for whom we have special interest. As such, VIPs are those who have been deemed important by the healthcare institution in which they are seeking care, and whose status may influence their providers.[1] [8] When this influence causes undue deviation in clinicians' trained judgment and in standards of care, the outcome is not always superior for the VIP or for the system; this is termed the “VIP syndrome.”[5] [9] [10]

There are some potential positive effects of VIP care. The current medical system can be rather byzantine and difficult to navigate, and VIPs may be able to circumvent unnecessary roadblocks. Enhanced privacy protections afforded to VIP patients help prevent undue harm to high-profile patients such as celebrities and political figures.[1] [11] Moreover, providing special services to people with substantial economic or social capital may benefit a practice or institution collectively in the future if the VIP is inspired to reciprocate.[1] [5] [6] [11] Despite this, VIP patient care poses many practical and ethical challenges, such as complicating the allocation of finite resources and threatening the quality of care both for VIPs and non-VIPs.[1] [3] [10] Ultimately, VIP care is not necessarily wrong to engage in, but there is potential for it to be if doing so compromises patient care. Although this is a complex medical issue that interventional radiologists (IRs) are likely to encounter, most existing discussions are not specific to IR, and there is a lack of specialty-focused guidance for approaching these cases. This article explores some of the ethical issues that IRs are likely to encounter in VIP patient care and provides a framework for navigating them.

Article published online:
17 November 2022

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