American Morning

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June 30th, 2009
06:37 AM ET

Doctors and celebrities – Money over ethics?

[cnn-photo-caption image= http://i2.cdn.turner.com/cnn/2009/images/06/30/jackson.rehearsal.art.jpg caption="Michael Jackson rehearses at the Staples Center on June 23, 2009."]

Most of us will never feel the healing hand of a concierge doctor.

A what?

A CONCIERGE doctor. They’re the ones who devote all or most of their time to a single, very wealthy client. Think Michael Jackson.

On June 15, Dr. Conrad Murray wrote a letter to his patients saying he would “cease practice of medicine indefinitely” due to a “once in a lifetime opportunity.” The sound of opportunity knocking was no less than the "King of Pop," Michael Jackson.

Murray had turned to practicing concierge medicine.

It was Murray who as Jackson’s personal doctor was at his side during the moments when the pop star’s life started to slip away last week. And it is Murray who was questioned by police and who is the subject of much unproven speculation about the role of prescription drugs in the death.

Murray’s lawyer, Edward Chernoff, has vigorously denied that his client prescribed the painkillers Dermerol and Oxycontin to Jackson. He described all of that as “rumors”.

Medical ethicists, while not commenting specifically about Murray, take a very cautionary view towards any doctor who devotes all or most of his time to a single patient.

“It can be intoxicating,” says the University of Pennsylvania’s Art Caplan. “When you’re going to hire yourself out as a solo physician, you’re really tempted to say this is really going to be glamour and this is going to be big money. However the problem is it also means a very demanding patient.”

In other words, it’s hard to say no to that kind of patient.

Caplan: “It’s difficult to be a concierge doctor in the sense in which the temptations to try and please your patient are too great. And I think the temptation is not to listen to your peers and not to have someone looking over your shoulder, which I think is the essential check and balance of good medicine. It’s tempting to be out there on your own egotistically saying, I can handle everything. I think that leads to danger.”

Besides the seduction of being near a celebrity, there’s the challenge of not getting to close to the patient.

Referencing a common saying among doctors, NYU Langone School of Medicine Psychiatrist Vatsal Thakkar told CNN, “We should not treat friends, family, or ourselves...It goes back to setting up situations where we might deviate from the type of care that we provide. And you know, if there is a dual relationship, hypothetically in a situation, that could be a complicating factor.”


Filed under: Entertainment • Health
soundoff (27 Responses)
  1. Ellie, MD

    I think the media are focused more on the digging up DIRT and GOSSIP on Michael Jackson than reporting on his legacy and his humanitarian efforts as an Entertainer. It's sad, but true.

    It's almost like they are more focused on reporting on the BAD rather than ALL the good that Michael Jackson has done his entire life.

    July 1, 2009 at 11:04 am |
  2. Chamorrita, MD

    Celebrity doctors have become the biggest DRUG DEALERS in the world. NO ONE is monitoring this drug problem being pandered by licensed doctors. HELLO.

    California has more celebrity doctors doing anything and everything for their famous clients. Let's call it like it is. These doctors are making thousands and thousands of dollars dealing in prescription drug trafficking!! They've become LEGAL DRUG DEALERS! Bottom line.

    Michael Jackson is NOT the exception to this drug addiction epidemic, he's only just another drug addict being supplied heavily by many different doctors!! His story is NOT surprising, nor is it shocking by any means,

    So until law enforcement starts addressing this massive problem, there are going to be MORE Elvis's, MORE Michael Jackson's, More John Belushi's, more Keith Ledger's, etc. We're going to see more and more younger celebrities DYING from doctor prescribe drugs!!!

    Michael Jackson is NOT the first or the last to die from doctor prescribed DRUGS. There will be MORE DEATHS to come.

    July 1, 2009 at 10:04 am |
  3. Michelle

    Do we really need to know all the dirt and rumors about Michael?
    I would rather remember him for the great entertainer that he was.
    CNN leave him alone and get on with more important issues in the world.
    Do we want our dirty laundry aired when we die??? I for one don't.. I want my family and friends to rememeber who I was and what I brought to them in my lifetime.

    Enough is enough CNN he is dead and gone get over it!

    July 1, 2009 at 7:12 am |
  4. dawn

    It is really sad of the passing of Michael Jackson, but I'm really upset with the way people are talking about his children. Michael has raised his children and he is the only father that they knew. Do these people realize the upset that they are putting on these children. These children are having to deal with the loss of their father, let alone now having to deal with people saying that they are the father of the 2 oldest children. This has never come out while Michael was alive, why bring it the surface now. What these children need to know, is that they will be raised by those who have loved them and will continue giving them the love that they deserve. The family that these 3 children know is the family that they have been around since birth. I wish people would stop talking about the children, and let them continue on with life with their grandma Jackson. Money can't by love. Love starts at birth, and these children had lots of love from their father Michael Jackson. Think about the hurt that this is doing to these children.

    July 1, 2009 at 12:27 am |
  5. Elizabeth Ashley - Nurse

    The enablers are the doctors on record with access to the drugs they administered him.. Second his private M.D., if what his lawyer said on national TV is true, was there with Michael in the last minutes of his life and failed to intervene with correct cardiac crisis protocol procedures to save his life. Before this is all over all of Michael's physicians on record will be investigated but no one was there in the final moments to save his life but his private M.D. Michael's family and Lisa Marie were worried and tried to intervene but they have no direct control over the activity of a drug addict adult. Yes, Michael had issues from way back but he also had lupus and lupus pain with joint inflammation causes intense unrelenting pain. These patients are usually placed on narcotic pain administration to control the severity of their constant pain. Michael did not ask to become a drug addict and it appears he chose this one primary M.D. to help manager his pain so he could stop going to all the other enablers you mentioned.
    Thanks, Liz from Texas.

    June 30, 2009 at 11:49 am |
  6. nancy

    Why blame the Doc? All those "other" enablers in Jackson's life are partially to blame also. Jackson himself should have known better then to take all those drugs. WHERE was his family? Of course, they are there now to divy up the goods.

    June 30, 2009 at 11:19 am |
  7. Elizabeth Ashley - Nurse

    Addendum: Michael Jackson's Private M.D.& other physicians has access to obtaining Demerol & other Narcotics under their M.D. & DEA license WITHOUT a script made out in Michael Jackson's Name to be filled so no record would exist in Michael's name or in his pharmaceutical records. You need to check under the doctors credentials to see which narcotics he obtained under his name for his office and how often filled. This falls with in the DEA jurisdiction of investigation. Elizabeth from Texas

    June 30, 2009 at 11:16 am |
  8. Elizabeth Ashley - Nurse

    As a Critical Care and Level I Emergency Room Nurse of twenty five years certified in basic and advanced Cardiovascular Life Support, Michael's M.D. knew his history, knew to carry a medical bag with Narcan and IV access for other drugs in case an overdose occurred in order to keep him alive until EMS arrived and a mega code could be ran while in route to the E.R. Dept. Michael had a pulse this meant he was savable. Demerol is given IM or IV. Who ordered it and gave the injection ? If this Cardiologist was Michael's only private physician he is responsible to know all this information and manage Michael's health care in a safe, compotent, prudent manner? As a Cardiologist its medical school 101. When doing effective CPR you need a hard surface. The bed compressions and one hand CPR that was reported to have been done by him makes this physician look so stupid and incompetent! Check with the American Heart Association for CPR guidelines. One hand basic CPR is used for children around 5 – 10 years in age. Even for a 90 – 100 lb individual two hand compression on a hard surface is done. The strength and depth of compression is controlled by the compressor and we realize in some people with brittle bones they may get a fractured or broken rib from compressions but bones heal and we would rather have that person alive. In the medical field we all know Michael O.D. went into respiratory arrest which triggered his cardiac arrest. Heart disease was ruled out by autopsy. He was found with a pulse. He was savable. Period. By reports from people and pictures taken just before his death he was in fine condition and the autopsy was negative for cardiac heart disease. He had a known history for drug abuse and drug rehab with opiate abuse listed in his medical records. You have friends and his ex-wife Lisa Marie telling the world she left him because he was heading down the same path as her father Elvis. A physician friend went on national TV and knew he O.D. Toxicology will prove this. Michael's private M.D. may not have given him the drugs he O.D. on but he is responsible for not keeping him alive. Proper basic CPR is taught to teenagers and this guy is a Cardiologist? Those final moments were crucial and he was savable. God bless you Michael Jackson. Rest in Peace. Elizabeth from Texas.

    June 30, 2009 at 9:21 am |
  9. R H Pike

    Did no one notice that he started his job A WEEK BEFORE MICHAEL DIED? I think it's clear he was trying to please his patient more than he was trying to be ethical. Trying to impress the new boss – giving him whatever he wanted. Isn't this obvious?

    June 30, 2009 at 9:06 am |
  10. Daphne

    It is a question of ethics AND competence. ANYONE spending two months with someone using opiods or other drugs should have a sense of it...especially a doctor!!! The FAT paycheck blinded this doc and/or truly he was incompetent. If Michael was under his care then I believe the doc holds the responsibility.

    June 30, 2009 at 8:50 am |
  11. Rachael Iyageh

    In any area of practice one runs into gray areas whether you treat one or hundred. I believe concierge doctors are a novel concept. As a nurse, I would give anything to have one patient whom I can focus on solely to provide proper and adequate care for, something that is sorely lacking. I hesitate to lay ang blame at dr. Murray's feet till the results of both autopsies are out. No medical professional can avoid treating friends and family it just may not be done officially. They ask you questions at dinner, outings, call you right after a doctor's visit about their problems and you offer advice, make suggestions crowning it with "speak to your doctor". To expect celebrities to walk into a dr office like a regular joe is to ignore the very special life they live, a life different from mine. Privacy cannot be guaranteed these stars classic example George clooney received emergency care in a new jersey hospital and you have staff members who were not part of his treatment team looking into his chart, invading his privacy just because they could. Concierge doctors are the only alternative the rich and famous have not only to receive the care they believe they need but to ensure their privacy.

    June 30, 2009 at 8:11 am |
  12. J.

    Dr. Murray and all his other enabling Dr.'s killed him !!! Just like Elvis and anna nicole smith . Murray was not board certified had no admitting rights to any hospital and DID NOT know how to do CPR .. keeping Michael on the bed !!! He shouldn't be a dr of a dog nevermind for Michael Jackson and now Michael is DEAD for no reason !!!

    June 30, 2009 at 7:57 am |
  13. Rachel

    Murray's lawyer said Jakcson's body was "still warm" when para medics arrived, well I believe body remains "warm" hours after person expires??? Also it seems to me the first thing one does if you suspect someone is in imminent danger is call 911. He didn't have a phone in his bedroom? Maybe. But certainly Doc Murray should have had one? He didn't "desperately try to save his life"; he probably contributed to his demise by not calling 911 immediately after finding Jackson unresponsive?! A cardiologist – perhaps, when was the last time he (Murray) was CPR certified? Hello performing CPR on the bed? "Once in a lifetime opportunity for Murray"? I don't think so!!!!

    June 30, 2009 at 7:43 am |
  14. Marion White

    This Dr. may not be criminal but he was incompetent in ER procedures. With a weak pulse he could have used a defib device; rich people have them. Calling the emt would have had intibation device and oxygen right away but instead he chose to just handle the situation alone. The best ER docs I have ever worked with would never have done this alone. A tube needed to be inserted and drugs administered immediately to restart the heart this doc worked alone for 30 mins. He really contributed to Michaels low chance of survival.

    June 30, 2009 at 7:38 am |
  15. Aubrey

    CNN I expect more of you. Comic Sans is not an appropriate way to display the news. You're not teaching a kindergarten class, you're reporting the news. You pretty much just undermined your professionalism. Nice job.

    June 30, 2009 at 7:33 am |
  16. Nwanneka Onelum

    It is unfortunate that ethical misconduct is fast destroying our system today, ranging from our government to specific professions. Under the medical ethics, concierge medicine is very risky, part of which Dr. Conrad Murray may be experiencing over Michael Jackson's death. However, Michael Jackson was an adult and in his right senses of choosing what he thought was best for him and his lifestyle. Please, lets just allow Michael Jackson to rest in peace; at one point in our lives, we have made wrong choices and sometimes bear the consequences too.

    June 30, 2009 at 7:10 am |
  17. Nwanneka Onelum

    It is unfortunate that ethical misconduct is fast destroying our system today, ranging from our government to specific professions. Under the medical ethics, concierge medicine is very risky, part of which Dr. Conrad Murray may be experiencing over Michael Jackson. However, Michael Jackson was an adult and in his right senses of choosing what he thought was best for him and his lifestyle. Please, lets just allow Michael Jackson to rest in peace; at one point in our lives, we have made wrong choices and sometimes bear the consequences too.

    Nwanneka Ato
    Baltimore-Maryland

    June 30, 2009 at 7:07 am |
  18. Dr. Ivan Lugo

    "Primum non nocere" , or First, do not harm, is the principal tenet taught in healthcare education and most students self-select to study the medical profession based on a deeply seated passion for helping people. That should not be confused with the desire to exercise greater autonomy in medical decision making and the new models of care emerging in the U.S. as is the latest "concierge/personalized" care that is becoming a popular alternative to many healthcare provides who are looking for alternatives from academia and the business-run enterprises that dictate treatment- sometimes solely based on the patients ability to pay for quality care. Whether a doctor decides to treat one patient or a 1,000 patients a year, is not a question for non other than that individual who paid out more than $250,000 in education, dedicated more than 13 years of college and graduate work, and has reached a point where he/she simply does not want to be dictated how to treat his or her patients. Let's not go down the road to paint this viable ethical healthcare practice option in the US as an elitist social malady. Our demographics and confusing and complicated healthcare system in the US does have room for new models of care, especially one that gives more personalized attention to our patients-be that one or 1,000.

    June 30, 2009 at 7:04 am |
  19. Chris S.

    Who would you trust more, a public doctor that takes fifteen minutes to diagnose and treat you...., or one that you trust as a friend who can also spend entire days finding problems and searching for solutions?

    June 30, 2009 at 7:02 am |
  20. Annett

    Why on Earth would you solicit the opinions of viewers regarding the veracity of a doctor's treatment vis a vis Michael Jackson? Unless one is a doctor privy to the medical history of a patient, it is virtually impossible to form any decisive conclusions regarding a person's death. I have always admired and respected CNN, but it appears that it has chosen a sensationalistic path that is beneath its former standards.
    Sincerely,
    Annett

    June 30, 2009 at 6:59 am |
  21. Paul

    You say doctors should not treat their friends. What about small towns where you know all of the docdtors? Are you required to refuse the doctor who is your good friend and go to the doctor you dislike or distrust? The old rule was that doctors should not treat close family members. There was no prohibition from treating friends or neighbors.

    The relationship between Michael Jackson and the doctor seems more like a patron-client that equal friends. Did the doctor have other patients or did he just twiddle his thumbs until Michael called?

    June 30, 2009 at 6:54 am |
  22. bill ray

    DOES MONEY COME BEFORE ETHICS. THE SHORT ANSWER TO THAT IS YES. IN EVERYTHING, NOT JUST DOCTORS.

    June 30, 2009 at 6:54 am |
  23. Debbie Anderson

    I think it would be wonderful to have your very own doctor! Why would Michael Jackson want to go to the doctors office like the rest of the world, it is very different for a celebrity!

    I would also like to add how sad his passing really is, we have lost such an icon! I also think he was a very sensitive soul that felt so hurt by the world and the horrible things they said and accused him of when all he wanted to do was be the best he could and entertain us "the World". All of us wondered in amazement when his looks kept changing and not for the better, but all he was wanting was to be the best that he could. I couldn't imagine the torture and pain he felt as the world let him down. It really is a shame that someone has to die to be shown the love and devotion, which is all he wanted when he was with us!
    God Bless him, his children and family. aloha.... Debbie aka Kepi

    June 30, 2009 at 6:51 am |
  24. Melissa

    Yes, celebrities need personal drs. I am not a celeb, but I am a professor who has a critical illness now. Every time I go to the dr., I see too many people who know me. Privacy is needed for all people, and I can only get it when I travel four-five hours away from my home. How far would Jackson have to travel to get that privacy?

    June 30, 2009 at 6:50 am |
  25. Laina

    It's a great service for people who can afford it. Who wouldn't want a little more of their doctor's time these days. A concierge doctor MUST maintain ethical boundaries with their patient and stay in control of their medical care. The wealthy and/or famous patient shouldn't be able to decide what medications are dispensed because they heard that it helps them to lose weight, or stay alert on set or take away the pain, etc. That should NEVER be in their hands and an ethical doctor knows that.

    June 30, 2009 at 6:50 am |
  26. Howard

    I think the media is running this Michael stuff(for lack of a better word)in the ground. They are grasping for something to say and there isn't anything. If he wanted his own personal doctor,why not? People have their own personal trainers etc. why not a doctor?

    June 30, 2009 at 6:49 am |
  27. Jeremiah Johnson

    If I could afford a concierge doctor, I would have one myself.

    June 30, 2009 at 6:43 am |