Patients as customers, redux

As I said not so long ago, I blog under a pseudonym so I can be a little bit more honest about places where I work or have worked.  However, there’s honesty and then there’s imprudence.  Thus, even though it’s been years since I had anything to do with the hospital in question, it’s probably for the best that I comment as minimally as possible about the details of this article.  Suffice it to say that nothing in it came as a particular shock to me.

The familiar area outside the neonatal unit had been transformed: partitions had been put up, the maternity ward windows were completely covered, and even the hospitals’ security cameras had been taped over with paper. Guards with Secret Service-style earpieces roamed the floor.

“We were told we could walk no further,” Ms. Nash-Coulon said Monday. And when she and her husband, Neil, demanded an explanation, she added, the guard claimed, unconvincingly, “ ‘Well, they’re handling hazardous materials,’ ” even as a large group of people screened from view were passing through the main hallway he had declared off-limits.

It was just the first of a series of indignities that they and several other noncelebrity maternity patients say they experienced over the weekend, as Lenox Hill Hospital went all-out to protect the privacy of Beyoncé Knowles and Jay-Z, whose daughter, Blue Ivy Carter, was born there on Saturday.

I don’t really care all that much about how strenuously Lenox Hill Hospital fell all over itself to take care of little baby Blue.  (Apparently colors are in vogue as celebrity baby names.  Act accordingly.)  What caught my eye was this:

Ms. Silverman denied reports that the couple had paid more than $1 million to rent and redecorate a wing of the hospital as a private labor and delivery suite. But she noted that, like several other New York hospitals, Lenox Hill has “reinstated executive suites,” subject to availability, and at a price she would not specify.

Executive suites, you say?  Now that I find interesting.

The overlap between patients and customers is a long-standing concern of mine.  On the one hand, medicine is a business, and part of running a business is keeping the people who pay for your services happy.  On the other hand, there are often times when what the patient wants is in conflict with appropriate medical care.  Navigating the space between these two pressures can be tricky.  (As an aside, I am curious to see if my perspective on this changes as a newly-minted partner at my practice.)

I don’t really object if being cared for in a so-called “executive suite” brings extra pampering.  It’s nice to be rich.  Rich people can afford nice stuff.  It doesn’t offend me if a plush hospital room and a surfeit of nurses come to those willing to pay for those privileges.

What does bother me is if the hospital and its providers give better care to the wealthy, if resources are shunted away from those who legitimately need them.  And letting parents visit their premature infants without being harassed or without compromising their security by taping over the cameras is part of patient care.

I can understand why Ms. Knowles and Mr. Z would want to keep the wide-eyed public and the hounds of the paparazzi away from the delivery of their child.  It’s a shame that they have to be so anxious about it that even security cameras are a perceived threat to their privacy.  Being famous is uglier than I think most non-famous people can imagine.  But presumably Blue’s famous parents are happy with their status as superstars, and the malignant attention of hoi polloi is a price that must be paid.  It has its perks, including being wealthy enough that rumor of a one million dollar private birthing wing seems plausible.

The demands of celebrities for special treatment are nothing new and wholly unsurprising.  Obviously Lenox Hill Hospital has an interest in attracting a famous and affluent clientele.  But it erred when it acceded to requests that compromised the care and safety of its other, non-famous patients, and failed in its obligations to them.

Russell Saunders

Russell Saunders is the ridiculously flimsy pseudonym of a pediatrician in New England. He has a husband, three sons, daughter, cat and dog, though not in that order. He enjoys reading, running and cooking. He can be contacted at blindeddoc using his Gmail account. Twitter types can follow him @russellsaunder1.


  1. My child was in the NICU for months. It was absolutely the worst, most stressful, awful time of my life. Nothing else remotely comes close. If someone had told me I couldn’t visit him because a celebrity lucky enough to have a perfect healthy baby was worried she might not sell her pictures for enough money, I think I would have gone absolutely apeshit. (Is this a family blog?)

    And I love how a security guard thought it was a good idea that he tell a parent of a child in a NICU that the area was cordoned off because there were *hazardous materials*. Because that wouldn’t freak out a NICU parent at all.

    • Yeah, that was the part that struck me as well. They couldn’t have gone with “we’re remodeling,” or “we’ve had some temporary overflow from the cancer ward?”

      “There are hazardous materials” is what the government says about UFO crash sights in bad SciFi movies.

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