We all strive to provide excellent care to every single patient in the hospital regardless of the social status, insurance and income level. Yet, sometimes, a VIP patient, be it a city official or a local football star, is admitted to the hospital and everybody tries to go the extra mile to provide even better care. Better care could be the enemy of good care and in my personal experience, going the extra mile might, actually, lead to a worse outcome and this is why:

The hospital is like a big well-oiled machine. Every unit and every person in the hospital has their own routine. On the level of an individual physician, everything from seeing patients, interacting with nurses, ordering tests and reviewing labs goes according to an individual routine. It might be different for every doctor, yet it is necessary to provide consistent care and not to miss things.

Going the extra mile might interfere with that routine. Additional tests might be ordered and multiple consultants get involved “just to cover the bases”. Eventually, it becomes a situation with too many cooks in the kitchen. Physicians could be writing contradictory orders and things are being missed since everybody assumes that it is somebody else’s responsibility to follow-up on things. The heightened level of anxiety around the case might make physicians “to think outside the box” and lead to overdiagnosis and overtreatment.

Sometimes, it is better to fly under the radar and let people do their job the way they do it best.