NYU gives preferential treatment to VIP’s at their ED.

[srirachamayonnaise]

Does that happen everywhere anyway?

‘Major Trustee, Please Prioritize’: How NYU’s E.R. Favors the Rich (Published 2022)

Dozens of doctors said the nonprofit hospital pressured them to give preferential treatment to donors, trustees and their families.

www.nytimes.com

---

Members don't see this ad.

 

[Wordead]

Yes.

 

[Billiam95]

Would you sit in an ER waiting room after donating $10M+ to a hospital?

 

[GoSpursGo]

Yes of course, particularly at private institutions. Of course it isn't "right" but let's not pretend this is a phenomenon that is unique to just one institution.

 

[Mr.Smile12]

Boutique medicine happens. Sorry.

 

[ACSurgeon]

The things that people get “morale outrage” about these days…

I think people on the inside should have some perks. Any hospital physician, nurse, janitor, transport personal etc should be treated special when they are treated at their hospital. Now be careful how you interpret special because in healthcare more isn’t always better.

Donors I feel less strongly about. But still makes sense if they’re providing the hospital with a large donation for them to be considered part of the hospital family.

 

[mrbreakfast]

This article is overly-dramatic, but yes, and to varying degrees depending on how "VIP" the person is, particularly for celebrities, who often haven't donated one penny to the hospital.

As noted above, "VIP care" does not always equal "better care." We had one VIP in the hospital awhile ago whose stay was significantly lengthened because everyone was terrified to do any interventions which involved any degree of risk.

Besides, if we as a society have decided that concierge outpatient medicine is fine, how big of a pragmatic leap is it to say that subscribers to that service also don't have to sit in the ER for 16 hours getting coughed on by the hoi polloi?

 

[voxveritatisetlucis]

Imagine Ken Langone waiting in the ER waiting room

 

[operaman]

It does but this sounds like NYU has made quite a habit of it it. They seem to have fired or run off multiple docs and other staff and their EM residency is now on probation because of this. Their spokesman seemed to suggest it was just some big coincidence egged on by sour grapes from former staff, but that sounds like a load of bull in light of the times and ACGME findings.

I think we all go beyond for friends and family. I definitely sewed up an attending of mine on a weekend as a junior resident and did the same for a couple of their kids as well over the years. We’ve always had some separate practices for celebrities but this is more about protecting their privacy and their safety. It’s usually more private rooms, staff escorts, and using service elevators to avoid public areas. The alternative would be this sick person sitting in a waiting room while everyone around was filming them or asking for selfies and posting their medical visit on social media. In those cases, jumping the line seems the lesser of two evils.

This NYU thing sounds like a much more formalized system of streamlining care for VIPs at the expense of others. Basically operating a pseudo concierge practice where membership dues are millions in donations, but running it out of a public ED. I think there’s nothing wrong with offering this kind of service, but it should be its own separate entity like a separately staffed area that caters to VIPs so they can deliver expedited care to their big donors but without distracting from the care to others. Plenty of hospitals and practices do this; sounds like NYU wanted the el cheapo version of this. Maybe time to get one of those VIPs to fund a dedicated NYU concierge practice with emergency coverage.

 

[ACSurgeon]

But I did still have to board in the ER overnight and be on clears way longer than I wanted to be lol.

Starvation is good for the soul.

 

[sloop]

It does but this sounds like NYU has made quite a habit of it it. They seem to have fired or run off multiple docs and other staff and their EM residency is now on probation because of this. Their spokesman seemed to suggest it was just some big coincidence egged on by sour grapes from former staff, but that sounds like a load of bull in light of the times and ACGME findings.

I think we all go beyond for friends and family. I definitely sewed up an attending of mine on a weekend as a junior resident and did the same for a couple of their kids as well over the years. We’ve always had some separate practices for celebrities but this is more about protecting their privacy and their safety. It’s usually more private rooms, staff escorts, and using service elevators to avoid public areas. The alternative would be this sick person sitting in a waiting room while everyone around was filming them or asking for selfies and posting their medical visit on social media. In those cases, jumping the line seems the lesser of two evils.

This NYU thing sounds like a much more formalized system of streamlining care for VIPs at the expense of others. Basically operating a pseudo concierge practice where membership dues are millions in donations, but running it out of a public ED. I think there’s nothing wrong with offering this kind of service, but it should be its own separate entity like a separately staffed area that caters to VIPs so they can deliver expedited care to their big donors but without distracting from the care to others. Plenty of hospitals and practices do this; sounds like NYU wanted the el cheapo version of this. Maybe time to get one of those VIPs to fund a dedicated NYU concierge practice with emergency coverage.

To add to this, such a policy can amount to an EMTALA violation depending on how it is implemented. Some of the accusations I have seen about what NYU was doing, if accurate, might amount to systematic violation of EMTALA.

For example, there are accusations that the hospital was utilizing a suite for VIPs that was supposed to be used to prioritize care for severely ill patients. Conversely, there are also accusations that ambulance workers were pressured to bring homeless patients to Bellevue instead. The major accusation is that they got expedited treatment and access to resources (scanners, etc.) due to their VIP status.

 

[srirachamayonnaise]

It does but this sounds like NYU has made quite a habit of it it. They seem to have fired or run off multiple docs and other staff and their EM residency is now on probation because of this. Their spokesman seemed to suggest it was just some big coincidence egged on by sour grapes from former staff, but that sounds like a load of bull in light of the times and ACGME findings.

I think we all go beyond for friends and family. I definitely sewed up an attending of mine on a weekend as a junior resident and did the same for a couple of their kids as well over the years. We’ve always had some separate practices for celebrities but this is more about protecting their privacy and their safety. It’s usually more private rooms, staff escorts, and using service elevators to avoid public areas. The alternative would be this sick person sitting in a waiting room while everyone around was filming them or asking for selfies and posting their medical visit on social media. In those cases, jumping the line seems the lesser of two evils.

This NYU thing sounds like a much more formalized system of streamlining care for VIPs at the expense of others. Basically operating a pseudo concierge practice where membership dues are millions in donations, but running it out of a public ED. I think there’s nothing wrong with offering this kind of service, but it should be its own separate entity like a separately staffed area that caters to VIPs so they can deliver expedited care to their big donors but without distracting from the care to others. Plenty of hospitals and practices do this; sounds like NYU wanted the el cheapo version of this. Maybe time to get one of those VIPs to fund a dedicated NYU concierge practice with emergency coverage.

Agree. If they want they should have a separate clinic.

 

[ChordaEpiphany]

I recently spent a few days at a big name cancer center (e.g., MSK, MDA, DF, Fred Hutch, etc...). Plenty of VIPs come through. I think the overall care for everyone was excellent, but it was interesting to see the exact dichotomy between treatment a fortune 500 CEO coming in with a family member vs. the average joe. Average Joe gets 20 minutes with the doctor while CEO's relative gets 30 minutes and maybe there are two doctors in the room. I don't think the outcomes changed very much between the two, and the CEO's got more of a dog and pony show. Maybe the executive packages at Cleveland Clinic are wildly different experiences, but it seems like an appointment is an appointment.

Overall, I actually think it's a testament to how good healthcare is compared to other essential systems (e.g., education, legal services, nutrition/food, housing, etc...). For as much as everyone hates on American healthcare, objectively it's one of the most equitable systems in place in the US. We just place a greater cultural emphasis on equity in medicine and other countries have gone further than we have, which makes it more obvious, leading to massive criticism of the system. Sure, the logistics of insurance are an absolute mess, but a homeless man could book an appointment right after a multi-millionaire and he'll still be seen and overall be given similar treatment (literally saw this scenario). The millionaire will have an easier time scheduling, receive more attention, and more easily get a second opinion (e.g., Monday book at DF and Tuesday take a private jet into MDA), but ultimately they'll get one doctor, one surgeon, and an identical treatment regimen for an identical presentation.

Having come from another industry prior to med school, medicine doesn't even touch the sort of inequality seen in those other essential services. If you're born poor you get shuttled into a public school with no supplies and teachers who don't get paid enough to care. Piles of research shows that this leads to massively poor economic and health disparities. The rich essentially have a completely separate legal system from the poor. Top lawyers won't even breathe in your direction if you don't have $10M+, and many legal services the rich use extensively (e.g., trusts and estates) literally don't even exist for the 99%. Over 30M Americans live with food insecurity and tens of millions more can't afford healthy food. We have a massive obesity crisis because the poor live in food deserts and heavily utilize fast food because McDonald's is closer and cheaper than fresh produce. Housing conditions have a greater effect on health than healthcare ever could, yet we've allowed municipalities across the country to restrict housing supply so corporations and wealthy individuals can turn housing into an investment and bleed the middle class dry.

I think there's a lot of criticism in healthcare over things that are actually quite small compared to other essential services. It's like we're so used to the gargantuan inequality that we don't even think to question it. To be clear, I'm not criticizing medicine for being self-critical. It's why I still have a little bit of faith in this profession. Just pointing out that it's a bit of a small victory that we get mad over things like this while our peers in education, law, and real estate turn a blind eye to much more glaring problems.

 

[BigPikachu]

The big wigs in executive can request priority and special treatment all they want, but I try and treat all my patients with the same respect and due diligence and proper care that they all deserve.

 

[qwerty89]

I recently spent a few days at a big name cancer center (e.g., MSK, MDA, DF, Fred Hutch, etc...). Plenty of VIPs come through. I think the overall care for everyone was excellent, but it was interesting to see the exact dichotomy between treatment a fortune 500 CEO coming in with a family member vs. the average joe. Average Joe gets 20 minutes with the doctor while CEO's relative gets 30 minutes and maybe there are two doctors in the room. I don't think the outcomes changed very much between the two, and the CEO's got more of a dog and pony show. Maybe the executive packages at Cleveland Clinic are wildly different experiences, but it seems like an appointment is an appointment.

Overall, I actually think it's a testament to how good healthcare is compared to other essential systems (e.g., education, legal services, nutrition/food, housing, etc...). For as much as everyone hates on American healthcare, objectively it's one of the most equitable systems in place in the US. We just place a greater cultural emphasis on equity in medicine and other countries have gone further than we have, which makes it more obvious, leading to massive criticism of the system. Sure, the logistics of insurance are an absolute mess, but a homeless man could book an appointment right after a multi-millionaire and he'll still be seen and overall be given similar treatment (literally saw this scenario). The millionaire will have an easier time scheduling, receive more attention, and more easily get a second opinion (e.g., Monday book at DF and Tuesday take a private jet into MDA), but ultimately they'll get one doctor, one surgeon, and an identical treatment regimen for an identical presentation.

Having come from another industry prior to med school, medicine doesn't even touch the sort of inequality seen in those other essential services. If you're born poor you get shuttled into a public school with no supplies and teachers who don't get paid enough to care. Piles of research shows that this leads to massively poor economic and health disparities. The rich essentially have a completely separate legal system from the poor. Top lawyers won't even breathe in your direction if you don't have $10M+, and many legal services the rich use extensively (e.g., trusts and estates) literally don't even exist for the 99%. Over 30M Americans live with food insecurity and tens of millions more can't afford healthy food. We have a massive obesity crisis because the poor live in food deserts and heavily utilize fast food because McDonald's is closer and cheaper than fresh produce. Housing conditions have a greater effect on health than healthcare ever could, yet we've allowed municipalities across the country to restrict housing supply so corporations and wealthy individuals can turn housing into an investment and bleed the middle class dry.

I think there's a lot of criticism in healthcare over things that are actually quite small compared to other essential services. It's like we're so used to the gargantuan inequality that we don't even think to question it. To be clear, I'm not criticizing medicine for being self-critical. It's why I still have a little bit of faith in this profession. Just pointing out that it's a bit of a small victory that we get mad over things like this while our peers in education, law, and real estate turn a blind eye to much more glaring problems.

Is that really the main reason? Obesity is exploding around the world. Particularly in the Middle East and India. Over there its mainly the middle class and wealthy who can afford to eat American style fast food frequently. Do they have new massive food deserts?

Middle East.

 

[ChordaEpiphany]

Is that really the main reason? Obesity is exploding around the world. Particularly in the Middle East and India. Over there its mainly the middle class and wealthy who can afford to eat American style fast food frequently. Do they have new massive food deserts?

Middle East.

In the US, there is a negative correlation between income and obesity and diabetes. It's a pretty well-studied phenomenon that the availability and affordability of fast food and processed foods and difficulty obtaining/affording healthy food leads to obesity. I've personally experienced this. Med student living in a food desert across the street from a Burger King, Dunkin, and KFC. When you're a med student with no time (or a single mother working two jobs, or any poor parent, or just a poor person with no money to automate/outsource daily chores), it's really hard to walk 20 minutes to and from the grocery store (or try to take the bus) and then make a healthy meal from lentils on a consistent basis. Sure it's possible, but in practice it just doesn't happen. On a global scale it's the opposite if people are so poor they can't afford food, obviously, but in developed nations the most obese people are almost always the poorest.

The point stands that these industries literally do zilch to prevent these disparities. It's 100% focused on profit with zero consideration of social mission despite these things (legal representation, education, nutrition) being even more critical to health than even access to healthcare.