How do the rich & famous get their most difficult medical conditions treated?
July 23, 2010 3:22 AM Subscribe
How do the rich & famous get their most difficult medical conditions treated?
The rich & famous (actors, politicians, CEOs, pro athletes) generally have access to the world's best doctors and have the money to pay for necessary tests or treatments. But then again, so do lots of regular folks: for example, I've usually been able to get appointments with the most prestigious doctors I could find (and gotten sufficient face time), and my employer's insurance plan has never denied a test or treatment I felt I needed. So what do the rich & famous get that I don't?
As an example, let's say that a high-status person -- Barack Obama, Bill Gates, or LeBron James -- starts getting mysterious headaches or backaches that prevent him from doing his job. He sees the world authority on this condition, but the doctor can't figure it out. The doctor knows that he must do everything possible to bring the patient back to health, so what does he do to get extra help? I can envision the following:
- Have colleagues come look at the patient as well
- Present the case to colleagues at a department meeting
- Email fellow specialists about the case over a professional organization's discussion list
- Write a case study in a medical journal and solicit feedback
Curious if anyone has insights about this.
The rich & famous (actors, politicians, CEOs, pro athletes) generally have access to the world's best doctors and have the money to pay for necessary tests or treatments. But then again, so do lots of regular folks: for example, I've usually been able to get appointments with the most prestigious doctors I could find (and gotten sufficient face time), and my employer's insurance plan has never denied a test or treatment I felt I needed. So what do the rich & famous get that I don't?
As an example, let's say that a high-status person -- Barack Obama, Bill Gates, or LeBron James -- starts getting mysterious headaches or backaches that prevent him from doing his job. He sees the world authority on this condition, but the doctor can't figure it out. The doctor knows that he must do everything possible to bring the patient back to health, so what does he do to get extra help? I can envision the following:
- Have colleagues come look at the patient as well
- Present the case to colleagues at a department meeting
- Email fellow specialists about the case over a professional organization's discussion list
- Write a case study in a medical journal and solicit feedback
Curious if anyone has insights about this.
You would probably be interested in this interview on the Daily Show with White House doctor to 3 different presidents, Connie Mariano. She's also written a book, which is why she does the interview.
posted by Mizu at 3:30 AM on July 23, 2010 [3 favorites]
posted by Mizu at 3:30 AM on July 23, 2010 [3 favorites]
At least in one case, have meetings with top people. About Senator Kennedy, before his surgery: "The surgery follows a meeting at Mass General on Friday, during which cancer experts from around the country discussed his course of treatment. At that meeting, Kennedy's own doctors were joined by doctors from the National Institutes of Health and the National Cancer Institute, as well as Friedman himself, according to a Kennedy intimate. At the end of the meeting, there was near unanimous agreement that he would have surgery at Duke, the confidante said."
posted by Houstonian at 3:37 AM on July 23, 2010 [1 favorite]
posted by Houstonian at 3:37 AM on July 23, 2010 [1 favorite]
You would probably be interested in this interview on the Daily Show with White House doctor to 3 different presidents, Connie Mariano. She's also written a book, which is why she does the interview.
Yeah, a rich person (like the president) can have a personal doctor on call 24/7 for any queries that might come up. It's a little extreme, but there's obviously a national security concern in having our president not keel over. For rich people with chronic medical conditions it would be pretty compelling.
Another thing would be easy access to "perscriptions". Lindsay Lohan has scripts for Adderall (why not bump her up to desoxyn?), Zoloft and even Hydromorphone(!) that she'll be taking in jail. Micheal Jackson had a personal doctor who used powerful anesthetics to put him to sleep (which killed him when the doc went for a sandwich or something)
posted by delmoi at 4:23 AM on July 23, 2010
Yeah, a rich person (like the president) can have a personal doctor on call 24/7 for any queries that might come up. It's a little extreme, but there's obviously a national security concern in having our president not keel over. For rich people with chronic medical conditions it would be pretty compelling.
Another thing would be easy access to "perscriptions". Lindsay Lohan has scripts for Adderall (why not bump her up to desoxyn?), Zoloft and even Hydromorphone(!) that she'll be taking in jail. Micheal Jackson had a personal doctor who used powerful anesthetics to put him to sleep (which killed him when the doc went for a sandwich or something)
posted by delmoi at 4:23 AM on July 23, 2010
Best answer: Speaking from some personal experience there is often intermediary doctors who collect information and manage a bunch of specialists. As someone else mentioned, there is a fair amount of travel to specialists around the world who are identified by these intermediary doctors. Often there are conference calls between specialists to discuss emerging treatments including those on still in trial.
In some cases specialist facilities are created at the homes of important people for supportive care such as for dialysis or transfusion of blood products. At least in one case I am aware of a high profile patient admitted in a foreign country under an assumed name where only a handful of doctors knew the true identity of the patient. This is less common.
The key difference between the treatment they get and the rest of the people sometimes is that the accepted 'best' treatment for a certain disease is based not only on the efficacy of the treatment but on cost effectiveness and its 'invasiveness'. In many cases these people are willing to override it in order to improve chances. e.g. a 1 year follow up MRI to detect recurrence of cancer is based on lives saved per unit cost over a large data set. If money is no object someone might opt for more frequent screening if that could potentially mean better treatment for this one individual.
There are also companies which will try and personalise treatement options for the rich and famous. One example is here and a slightly different take is here.
I am looking to evaluate them to see how good they are to see if I can recommend them.
posted by london302 at 4:26 AM on July 23, 2010
In some cases specialist facilities are created at the homes of important people for supportive care such as for dialysis or transfusion of blood products. At least in one case I am aware of a high profile patient admitted in a foreign country under an assumed name where only a handful of doctors knew the true identity of the patient. This is less common.
The key difference between the treatment they get and the rest of the people sometimes is that the accepted 'best' treatment for a certain disease is based not only on the efficacy of the treatment but on cost effectiveness and its 'invasiveness'. In many cases these people are willing to override it in order to improve chances. e.g. a 1 year follow up MRI to detect recurrence of cancer is based on lives saved per unit cost over a large data set. If money is no object someone might opt for more frequent screening if that could potentially mean better treatment for this one individual.
There are also companies which will try and personalise treatement options for the rich and famous. One example is here and a slightly different take is here.
I am looking to evaluate them to see how good they are to see if I can recommend them.
posted by london302 at 4:26 AM on July 23, 2010
I think the only thing that money and power gets you in the medical world is not having to jump through hoops. There is less of a hierarchy of treatment, where doctors have to tell you to "improve your diet for a month" or "take baby aspirin for a month" and see if it goes away. You got headaches? Into the scanners and you get the best treatment money can buy.
posted by gjc at 4:30 AM on July 23, 2010
posted by gjc at 4:30 AM on July 23, 2010
You might be interested in the case of Steve Jobs' liver transplant. Even though he's a billionaire, he couldn't just pay for a liver or even to move up the list (at least in the US)... what he could do, however, was get himself on multiple transplant lists in states where the waiting list is shorter. Here's an article about it.
Anyone could do this, theoretically, but you have to travel to and get an evaluation at multiple hospitals to get on multiple lists - and insurance won't generally cover that.
posted by alaijmw at 4:33 AM on July 23, 2010 [2 favorites]
Anyone could do this, theoretically, but you have to travel to and get an evaluation at multiple hospitals to get on multiple lists - and insurance won't generally cover that.
posted by alaijmw at 4:33 AM on July 23, 2010 [2 favorites]
I agree with Coobeastie about the travel aspect. I live in a smallish town that's a bit out of the way, and celebrities will come here for a specific doctor's care.
They might do a case study if the case is very very unusual, but I don't think a case of "oh, bad headaches, don't know what to do" is actionable. From my understanding, case studies aren't published to solicit other opinions, they are published for educational purposes.
posted by emkelley at 4:34 AM on July 23, 2010
They might do a case study if the case is very very unusual, but I don't think a case of "oh, bad headaches, don't know what to do" is actionable. From my understanding, case studies aren't published to solicit other opinions, they are published for educational purposes.
posted by emkelley at 4:34 AM on July 23, 2010
Saudi royals have a longstanding relationship with the Cleveland Clinic. I heard rumors that they could/would "rent out an entire floor" for privacy and unparalleled attention. I don't know if that's true or not, but VIPs there can purchase different (non-medical) tiers of service.
posted by availablelight at 4:52 AM on July 23, 2010
posted by availablelight at 4:52 AM on July 23, 2010
They go to the Mayo Clinic.
posted by banishedimmortal at 5:22 AM on July 23, 2010
posted by banishedimmortal at 5:22 AM on July 23, 2010
Well here are my two experiences with famous people at the doctor, although I don't know what they were there for:
(1) (Singer) Debby Harry was sitting in my (former) dermatologist's waiting room. Then the dermatologist came out himself and gave her a warm hello, shaking her hand, and they went back together. When it was my turn an assistant called my name from the entrance to the "back offices" and I got up and went back there, unaccompanied.
(2) (Singer) Michael Bolton was sitting in my internist's waiting room. Then the doctor came out himself and gave him a warm hello, playing his hand on Michael Bolton's shoulder. The doctor said a few words (I imagine something like "I'll be with you in a few minutes"), and went back into his examining rooms. A little while later Michael Bolton was called in.
So, my conclusion, based on an n of 2, is that celebrities get personally greeted by doctors, sometimes (n=1) and are seen as soon as possible.
posted by DMelanogaster at 5:41 AM on July 23, 2010
(1) (Singer) Debby Harry was sitting in my (former) dermatologist's waiting room. Then the dermatologist came out himself and gave her a warm hello, shaking her hand, and they went back together. When it was my turn an assistant called my name from the entrance to the "back offices" and I got up and went back there, unaccompanied.
(2) (Singer) Michael Bolton was sitting in my internist's waiting room. Then the doctor came out himself and gave him a warm hello, playing his hand on Michael Bolton's shoulder. The doctor said a few words (I imagine something like "I'll be with you in a few minutes"), and went back into his examining rooms. A little while later Michael Bolton was called in.
So, my conclusion, based on an n of 2, is that celebrities get personally greeted by doctors, sometimes (n=1) and are seen as soon as possible.
posted by DMelanogaster at 5:41 AM on July 23, 2010
Placing, not playing.
posted by DMelanogaster at 5:42 AM on July 23, 2010
posted by DMelanogaster at 5:42 AM on July 23, 2010
So what do the rich & famous get that I don't?
Potentially, the best of everything, which means more than your doctor's time.
The best doctor in the world can fix your knee, but now you need a physical therapist for rehab. Guess what? You get the best physical therapist in the world, too.
posted by Cool Papa Bell at 6:15 AM on July 23, 2010
Potentially, the best of everything, which means more than your doctor's time.
The best doctor in the world can fix your knee, but now you need a physical therapist for rehab. Guess what? You get the best physical therapist in the world, too.
posted by Cool Papa Bell at 6:15 AM on July 23, 2010
Justa note: the president isn't wealthy and doesn't pay for his care in any event. The US taxpayers do.
posted by dfriedman at 6:21 AM on July 23, 2010
posted by dfriedman at 6:21 AM on July 23, 2010
Here is a list of notable patients who have visited the Cleveland Clinic over the years.
posted by vkxmai at 6:32 AM on July 23, 2010
posted by vkxmai at 6:32 AM on July 23, 2010
You should read about JFK's medical treatments in An Unfinished Life.
posted by The Straightener at 6:33 AM on July 23, 2010
posted by The Straightener at 6:33 AM on July 23, 2010
They don't necessarily get better treatment or have access to treatments that the rest of us don't, but as gjc indicates, they can bypass a lot of the bureaucratic headaches and get more responsive attention from their providers. As a lot of the hassle with health care has to do with money, the ability to simply pay cash will get you through a lot of doors in a hurry.
We're not talking about getting appointments with doctors you can't otherwise get appointments, but we are talking about getting those appointments expedited, or getting appointments without having to go through your primary care physician and three other specialists first. We're not talking about special wings or dedicated hospitals, but we are talking about private rooms and home care.
It's more a difference in degree than a difference in kind.
posted by valkyryn at 6:38 AM on July 23, 2010
We're not talking about getting appointments with doctors you can't otherwise get appointments, but we are talking about getting those appointments expedited, or getting appointments without having to go through your primary care physician and three other specialists first. We're not talking about special wings or dedicated hospitals, but we are talking about private rooms and home care.
It's more a difference in degree than a difference in kind.
posted by valkyryn at 6:38 AM on July 23, 2010
Oh, and this isn't necessarily a bad thing. Imagine the chaos which could ensue if a celebrity or politician just waltzed into your local waiting room. They'd get no peace, normal patients' visits would be disrupted, no one benefits. The privacy implications are pretty awful too. So while it may appear unfair, and may even be unfair, in many cases that doesn't mean that there's a better way of doing things.
posted by valkyryn at 6:41 AM on July 23, 2010 [1 favorite]
posted by valkyryn at 6:41 AM on July 23, 2010 [1 favorite]
Justa note: the president isn't wealthy
Um yeah, they pretty much all are.
Benefits for the rich in my understanding:
- discretion
- quick access
- fewer concerns about missing work etc for recuperation times
- easy access to imaging and advanced procedures
- extensive non-physician care (rehab, nutritionists, etc.)
posted by ghharr at 6:50 AM on July 23, 2010
..."rent out an entire floor" for privacy and unparalleled attention.
A number of hospitals in Boston have facilities and amenities that cater to the VIP crowd. The Phillips House at Mass General is one example.
posted by ericb at 7:34 AM on July 23, 2010
A number of hospitals in Boston have facilities and amenities that cater to the VIP crowd. The Phillips House at Mass General is one example.
posted by ericb at 7:34 AM on July 23, 2010
The privacy issue is big here. I know an MD who has treated "some people in the media scene" here in Atlanta (that's the only way they were identified: could be CNN, could be any part of the Turner behemoth, or could be high-profile local news folks), and he has a separate exit from his office. You come in one door, you go out the other so that people in the waiting room don't say "Hey! That was Boring Economy Buzzkill Guy! And he has a follow-up appointment with labwork! I wonder if he's sick?" because you have to stand there and pay and schedule at the front desk.
As valkyryn says, that immediate entry saves everyone trouble, and lessens the number of times that the physician has to deflect questions from subsequent patients about Boring Economy Buzzkill Guy and why he was at the gastroenterologist's office.
posted by catlet at 11:00 AM on July 23, 2010
As valkyryn says, that immediate entry saves everyone trouble, and lessens the number of times that the physician has to deflect questions from subsequent patients about Boring Economy Buzzkill Guy and why he was at the gastroenterologist's office.
posted by catlet at 11:00 AM on July 23, 2010
There's plenty of hospitals and private practices that openly advertise their special treatment for wealthier patients.
posted by nakedcodemonkey at 1:53 AM on July 24, 2010
- VIP/Concierge suite with complimentary internet access, plasma-screen TVs, and gourmet refreshments...Message or video chat with your physician from anywhere in the world... *
- visits to your home or office *
- physician-initiated research on difficult or unusual patient complaints and concerns (sometimes extending to patients' family members) *
- If a patient needs to see a specialist, the MD2 doctor will help find the best ones and even go to the appointment (emphasis added)
posted by nakedcodemonkey at 1:53 AM on July 24, 2010
This thread is closed to new comments.
But it can actually happen that if you're rich and famous you can actually get worse medical care - in the deaths of both Michael Jackson and Heath Ledger it has been suggested that there might have been some measure of doctors not wanting to say no to drug requests. Some rich people have 'their' doctor who gives continuity of care; others jet set around the world seeing the best person whereever they are, which can lead to lack of knowledge of medical history, poor continuity of care, over-prescribing and so on.
posted by Coobeastie at 3:28 AM on July 23, 2010