One doctor delivered test results to Prince’s home. Another sent his son, who wasn’t a physician, on a cross-country flight to bring medication to the music star.
It’s not clear if any doctor could have averted the fentanyl overdose that killed the singer in April. But his death may offer evidence for how the special treatment often afforded the rich and famous can result in worse health care than ordinary Americans receive. It’s a pattern identified in medical literature as early as 1964 and it has a name: “VIP Syndrome.”
“There are a number of red flags that go up,” said Dr. Robert Klitzman, who directs Columbia University’s bioethics master’s program. “Prince was one of the wealthiest musicians alive. Did he get appropriate care? VIP Syndrome may have been involved.”
First described by Dr. Walter Weintraub of the University of Maryland School of Medicine in a 1964 paper, VIP Syndrome is shorthand for how the influence of wealth and the allure of fame can cause doctors to veer into risky territory when they cater to the demands of a star or his entourage.
Stars may reject medical advice or demand ineffective or harmful treatments. Star-struck doctors may order unnecessary tests or not enough tests. Hospital administrators may meddle in decisions if the patient is a potential financial donor.
The timeline of events surrounding Prince suggests missed opportunities, experts said, including a close call less than a week before he died on April 21.
On April 15, Prince’s private plane made an emergency stop in Illinois on a flight from Atlanta back to Minnesota. The Associated Press reported that first responders gave him an antidote commonly used to reverse suspected opioid overdoses.
“You’d think someone would say, ‘Let’s get him into treatment,’” Klitzman said. Instead, a week passed before Prince’s associates called a California addiction and pain specialist, Dr. Howard Kornfeld.
Authorities have not said whether he had a prescription for the fentanyl and, if not, how he obtained it.
Much about the musician’s care remains unknown. Was Prince – who reportedly suffered from hip and knee pain related to years of athletic stage performances – already seeing doctors well-versed in the risks of opioids? If he became addicted to painkillers, did anyone consider referring him to a nearby and highly regarded treatment option, Minnesota’s Hazeldon Betty Ford?
The actions of Dr. Michael Todd Schulenberg, a Minnesota family physician, are also under scrutiny.
He told investigators he prescribed medications for him, but a search warrant did not specify which drugs. Schulenberg arrived “on the death scene” at some point.
To guard against VIP Syndrome, the Cleveland Clinic published nine principles of caring for VIPs in 2011. The document warns doctors against bending the rules.
In the end, doctors must monitor a tendency toward any unusual practices, said Lerner, author of “When Illness Goes Public: Celebrity Patients and How We Look at Medicine.”
“When you’re contemplating superhuman or very heroic, unorthodox behavior in your zeal to help a famous patient,” Lerner said, “that’s where you’ve got to take a deep breath and reassess.”