I have to agree with a lot of prior commenters—
(1) The EMS/EMTALA/DUMPING part of this is utter BS and should be squashed.
(2) VIP care, to some level, is part of every single ED in every country in the world. We each must learn to navigate it.
Thing is, in most reasonable hospitals, you can handle 90% of VIP needs by simply telling the nurse / resource that Mr. XYZ is a VIP b/c of ABC ,and just being nice when you meet them and acknowledge that you heard they are former chair of the board / whatever, and you and the team are going to take great care of them. You don’t actually have to change your standard care, you don’t need to completely break triage, just be nice and give them a blanket. Often they already have some specialist / PCP eagerly waiting to see them / receive a call about their results which makes your job 10x easier. Just grease the wheels a bit. Karma will smile upon you.
Now a system that insists that a VIP come back before an actual sick ESI 2? Screw it. Thankfully, I’ve never had to work somewhere so morally bankrupt.
In my experience, its often the smaller “VIPs” that are actually problem. Former Big Hospital Board member showed up in our ED a couple years ago, registered like a normal patient, happily sat in the WR for a hour, didn’t tell anyone, I recognized his name on the board (I’ve met him socially) and went to see him. Nurse had no idea he was, at least locally speaking, a huge deal. Super nice guy. Praised everyone for taking such care during a pandemic. Wrote a thank you letter afterward to the CEO naming each tech/nurse. I’m lucky to have some souls like this in leadership positions.
Where as sometimes you get the ex-wife of the ex-chief of surgery in the waiting room and its DEFCON-2 if she isn’t in a private room in 5 minutes for a hangnail…