Published Oct 26, 2026 | 10:00 AM ⚊ Updated Oct 26, 2026 | 10:00 AM
Pressure from patients or relatives can also lead to additional investigations that may not improve treatment decisions.
Synopsis: Two AIIMS surgeons have warned that preferential treatment for influential patients at public cancer hospitals can delay surgery, increase medical risks and divert scarce resources from other patients. In an opinion paper in Oncology Reviews, they describe cases in which pressure from patients, relatives and hospital officials led to prolonged hospital stays, unnecessary tests and departures from standard medical protocols.
Preferential treatment for influential patients at public cancer hospitals can delay treatment for others waiting for surgery, while prolonging hospital stays beyond medical necessity, two surgeons at the All India Institute of Medical Sciences (AIIMS), New Delhi, have warned.
In an opinion paper published in Oncology Reviews, Mukurdipi Ray and Hema Siri Kottu of the Department of Surgical Oncology at the Dr BR Ambedkar Institute Rotary Cancer Hospital, AIIMS, examine “VIP syndrome”.
The term, coined by Dr Walter Weintraub in 1964, describes situations in which high-profile patients receive preferential treatment that deviates from standard medical protocols.
Drawing on their breast surgery practice, the authors say three patients could have undergone surgery in the time occupied by a single patient whose admission to a private ward was unnecessarily prolonged.
“Surgeons may encounter requests for unnecessary prolonged hospital stays from patients or their caregivers, especially in private ward admissions. This extends the disease-specific mean duration of hospitalization beyond what is medically necessary,” the authors write.
Such prolonged admissions reduce the turnover of hospital beds and operating capacity, potentially delaying care for patients awaiting treatment, they argue.
The paper describes a 58-year-old woman with advanced ovarian cancer who was admitted and operated on without adequate preparation because of management pressure.
“These pressures extended beyond admission, influencing decisions such as prolonged ICU stays postoperatively, which are not necessary,” said the authors.
Delayed mobilisation contributed to basal atelectasis, a partial collapse of the lung, followed by pulmonary complications. Her hospital stay extended to 12 days, compared with about five days for patients undergoing similar surgeries.
The authors warn that demands for early surgery can also expose patients to avoidable risks.
“VIP patients often request special considerations such as early surgeries or preferential treatment in outpatient departments (OPDs) and wards. However, rushing surgeries without proper pre-operative optimization, such as managing recent smoking history or uncontrolled diabetes, can increase perioperative complications significantly,” they said.
Pressure from patients or relatives can also lead to additional investigations that may not improve treatment decisions.
The authors describe a 60-year-old woman with early breast cancer whose relatives insisted on a PET-CT scan despite concerns about misleading results in regions with high tuberculosis prevalence.
“Her PET CT showed increased uptake in mediastinal lymph nodes, and she had to undergo endobronchial FNAC (Fine needle aspiration cytology) for adequate staging, which only turned out to be reactive. Delays caused by such demands can lead to disease progression and worsened outcomes,” said the authors.
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VIP syndrome can also emerge when doctors treat fellow medical professionals or their relatives, the authors say.
They describe a 65-year-old woman, the mother of a doctor working at the hospital, whose ICU stay was prolonged despite concerns about hospital-acquired pneumonia. According to the paper, her relative intervened in postoperative medication decisions, discontinued intravenous fluids independently and requested prolonged antibiotics without medical necessity.
“Even within the medical community, when treating fellow doctors, there can be a tendency towards overcaution, leading to undue anxiety over minor conditions,” said the authors.
Administrative pressure can create similar challenges. In another case, a 56-year-old woman underwent colon cancer surgery and recovered without major complications. A first-year resident removed her surgical drain according to protocol, but the next day the department head received an email from the director’s office seeking an explanation.
“Patients with connections to the medical field (like the family of a medical resident) may have heightened expectations regarding their treatment. They expect the drain to be removed by department head based on their status,” the authors wrote.
They warn that such interference can place clinicians under undue pressure even when they follow established procedures.
The authors say incomplete medical histories and demands based on unreliable information can further complicate treatment.
They describe a 40-year-old woman with ovarian cancer who did not disclose that she was a carrier of beta-thalassaemia trait. She subsequently developed postoperative bleeding and required another operation because of an anastomotic leak.
The authors also caution that patients who arrive with predetermined diagnoses or treatment plans based on online information may find it harder to trust medical advice.
“With access to abundant medical information online, some patients arrive with preconceived diagnoses and treatment plans, often from unreliable sources. This can lead to distrust in medical professionals and challenges in establishing effective doctor-patient communication,” they said.
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The authors argue that the central concern is equitable access to care in hospitals with limited beds, staff and operating theatre capacity.
“VIP patients may expect more frequent visits from their treating surgeons, which can strain resources in busy healthcare settings like government institutions in India. This extra time spent on one patient could otherwise benefit other patients in need,” said the authors.
They warn that when doctors and nurses devote disproportionate attention to high-profile patients, others may experience delays or receive less attention.
“The resources and attention devoted to VIP patients can indirectly affect non-VIP patients. When physicians and staff are preoccupied with high-profile cases, the care and attention given to regular patients may diminish, leading to delays or substandard treatment,” they wrote.
The authors recommend five measures to address VIP syndrome: strict admission criteria, better communication with patients and families, allocation of care according to clinical need, support for security personnel and clear hospital admission, ICU and discharge protocols.
“Effective communication is crucial in managing expectations and addressing concerns. It may be beneficial to ensure that the patient feels heard and understood while politely explaining the rationale behind treatment decisions,” said the authors.
They also call for consistent rules limiting preferential treatment when it risks compromising care.
“Setting clear limitations on accommodations for VIPs and establishing uniform protocols can help prevent deviations in care,” they wrote.
The authors do not argue against all special accommodations. Instead, they say adjustments should not compromise the quality of care or access for other patients.
“While special accommodations for high-profile individuals may be acceptable if they do not compromise access or the quality of care for others, healthcare providers must be vigilant,” they wrote.
They call on hospitals to document such cases, encourage institutional discussion and establish uniform policies to protect equitable care.
(Edited by Dese Gowda)
