Doctors at the All India Institute of Medical Sciences (AIIMS), Delhi, have warned that VIP culture in hospitals can compromise patient safety, undermine evidence-based treatment and create unequal access to healthcare. In an opinion paper published in Oncology Reviews, surgical oncologists Prof. M. D. Ray and Dr. Hema Siri Kottu explain how pressure from influential patients, their families and hospital management can lead to medical decisions that deviate from standard clinical protocols.
VIP Pressure Can Lead to Unnecessary Medical Procedures
According to the authors, VIP syndrome occurs when a patient’s social status, influence or connections affect clinical decisions. Consequently, doctors may face pressure to order unnecessary investigations, perform surgery before adequate preparation or extend intensive care and hospital stays without sufficient medical justification. “Every cancer patient deserves the same standard of evidence-based care,” Prof. Ray, Professor of Surgical Oncology, told The Times of India. The authors emphasise that medical decisions should depend on clinical evidence and patient needs rather than social standing or personal connections.
Case Studies Highlight Risks to Patient Safety
The opinion paper describes two cases that illustrate how VIP pressure can affect cancer treatment. In the first case, a 60-year-old woman with early-stage breast cancer underwent a positron emission tomography–computed tomography (PET-CT) scan after her relatives insisted on further investigation. The scan showed increased uptake in lymph nodes in her chest, prompting doctors to perform a biopsy to investigate possible cancer spread. However, the biopsy revealed reactive changes rather than metastatic disease.
In the second case, a 58-year-old woman with advanced ovarian cancer underwent surgery without adequate pre-operative preparation following pressure from hospital management. Subsequently, delayed mobilisation contributed to pulmonary complications, extending her hospital stay to 12 days, compared with the usual five days for similar surgeries, according to the authors. Prof. Ray warned that pressure to accelerate surgery, order unnecessary tests or prolong intensive care admissions can expose patients to avoidable harm while limiting access to care for others.
VIP Culture Affects Doctors and Hospital Staff
The consequences extend beyond patients. The authors describe an incident in which a department head was asked to explain why a first-year surgical resident had removed a patient’s drain according to established protocol after a relative objected to the resident performing the procedure. Such incidents can place junior doctors and other healthcare professionals under unnecessary scrutiny, even when they follow standard clinical practices. As a result, VIP pressure can increase workplace stress, undermine professional confidence and weaken adherence to evidence-based protocols.
Unequal Treatment Can Strain Hospital Resources
VIP culture can also affect hospital efficiency and the equitable distribution of limited medical resources. Drawing on their clinical experience at an oncology centre, the authors observed that three breast surgery patients could potentially have undergone surgery during the time occupied by one patient whose private-ward stay had been extended. They clarified that this observation reflects their clinical experience and does not represent a hospital-wide estimate. Nevertheless, it highlights how prolonged hospital stays and demands for additional attention can reduce patient turnover and restrict access to beds and surgical services for other patients. Furthermore, Prof. Ray warned that allowing social status to influence treatment decisions can erode public trust, damage staff morale and undermine a positive workplace culture.
Doctors Call for Transparent Hospital Policies
To address VIP culture, the authors recommend introducing transparent admission and discharge criteria, consistently applying clinical protocols, improving communication with patients and their families, and providing institutional support to doctors who follow established medical guidelines. At the same time, patients must retain the right to ask questions, understand their treatment options and seek second opinions. However, healthcare institutions must ensure that such rights do not translate into pressure to override sound clinical judgement. The authors stress that hospitals should prioritise patients according to the urgency of their medical conditions rather than their social or professional influence.
Evidence-Based Care Must Remain the Priority
The opinion paper highlights the importance of fairness, clinical independence and responsible resource management in healthcare. As reported by thetimesofindia.indiatimes.com, although the authors draw on clinical cases and professional experience rather than measuring the prevalence of VIP culture across hospitals, their observations underline the potential risks of allowing influence to shape medical decisions.