Anthony Mobasser, a Beverly Hills dentist, nearly swooned when he responded to a medical emergency and discovered the patient was the screen legend Elizabeth Taylor.

“It was an amazing experience. You have to act cool but you’re sweating inside. I just pretended that she was any other patient and I calmed down.”

That was in 1980. Since then Mobasser has treated many Hollywood stars and still, to this day, can feel a frisson.

“When we’re treating celebrities we have to go beyond our comfort zone. Celebrities demand much more than the average person and rightly so because they are in front of cameras and on the red carpet. But you have to know your limits. If you mess up, you have a problem.”

In extreme cases, a dead celebrity problem. Elvis Presley, Michael Jackson and Joan Rivers are among cases where fame appeared to pressure, dazzle or distract physicians into bad medicine. The phenomenon has a name: VIP syndrome.

It is not new. Walter Weintraub, a doctor who coined the expression in 1964, noted venerable examples. “The well-known cases of such historical figures as King George III of England and King Ludwig II of Bavaria clearly demonstrate that the treatment of an influential man can be extremely hazardous for both patient and doctor.”

With investigators probing the possible role of Los Angeles and Minneapolis-based physicians in Prince’s opioid overdose, the observation remains valid. Doctors who bend the rules to provide special care to special patients can end up killing them.

Doctors who bend the rules to provide special care to special patients can end up killing them

“There are doctors who give things that make no sense, for example growth hormones to make someone look younger,” said David Agus, a cancer specialist who treated Steve Jobs. “It makes the field look bad.”

Before his death in 2011 the Apple co-founder bombarded Agus with quack remedies. Agus, a professor of medicine and engineering at the University of Southern California, said he rejected them.

“The challenge is to stand up to people. My medical practice is about tough love. It’s very data driven. Steve fired me a hundred times and he’d call me back an hour later.”

Cancer specialist David Agus said some of Steve Jobs’s doctors strayed from solid medical science. Photograph: Bloomberg/Bloomberg via Getty Images

In addition to requesting unwise treatment, some celebrities have been known to pressure doctors to forgo invasive tests, or to not share information with colleagues to protect their privacy.

“There’s no question that people who are rich and powerful are treated differently than those who are not,” said John Connolly, president and CEO of Castle Connolly, which ranks physicians. “Physicians can be star-struck and swayed by powerful patients in directions that may not be the best. ”

It can be hard saying no to a high-profile patient who in addition to lucrative business can bestow prestige and glamour. The Hollywood Reporter uses Castle Connolly data to publish an annual list of “Hollywood’s top doctors” in which stars single out dentists, oncologists, pediatricians, obstetricians and other specialists for praise.

One article features Charlie Sheen posing alongside orthopedic surgeon, Bal Rajagopalan (aka Dr Raj), who boasts about a “miraculous” stem cell cocktail which supplies “tools to regenerate bone cartilage and turn back time”.

Unexpected celebrity deaths have illuminated the darker side of medical relationships.

It can be hard saying no to a high-profile patient who can bestow prestige and glamour

The midwest medical examiner cited Prince’s cause of death as “self-administered fentanyl”, a powerful opioid. Investigators are probing the musician’s suspected prescription drug addiction.

Michael Todd Schulenberg, a doctor in Minnesota, prescribed medication. Days before Prince died Howard Kornfeld, a California addiction specialist, sent his son Andrew, to meet Prince. Kornfeld has defended his treatment of Prince on social media.

Doctors were reportedly star-struck by Joan Rivers, even photographing her on the operating table. Photograph: Karen Robinson/The Observer

Fame appeared to be a factor in Joan River’s death in August 2014 during a routine procedure. Doctors were reportedly so star-struck and nervous they violated protocols. One took a photograph of the comedian on the operating table before she went into cardiac arrest. The clinic and doctors accepted responsibility for her death in a malpractice lawsuit.

Michael Jackson’s doctor, Conrad Murray, facilitated the singer’s request for propofol, a powerful surgical anesthetic, to help him sleep. A jury convicted Murray of involuntary manslaughter on the grounds the drug played a key role in Jackson’s death in 2009.

Doctors largely escaped public blame in the case of Jobs. The Apple chief refused to let them remove a pancreatic tumor and instead tried to treat it with a vegan diet, herbal remedies and acupuncture. When he later agreed to surgery the tumor had spread uncontrollably.

“For many high-profile patients who get a disease it’s the first time they’re not in control and it’s hard for them to get used to that,” said Agus, who started treating Jobs after the cancer had advanced.

“A lot of the time you have a high-profile person and they want, say, a herb from China, and they’ll search out someone who can provide that. Steve would send me literally dozens of things, asking about special mushrooms, or a treatment in Germany.”

Agus, an author and health guru who treats Silicon Valley billionaires, said some of Jobs’s doctors strayed from solid medical science. “He had some well known physicians telling him to do things that made no sense based on the data.”

Rick Friedman, an ear specialist prominent in the Hollywood Reporter’s list of top LA doctors, said famous clients could warp medical judgment. “Physicians are very human. I’ve no doubt that some who are star-struck can have clouded judgment.”

As the brother of a film studio executive, Friedman said he felt largely inoculated from celebrity worship but still felt a tingle with certain patients, such as a pop star who had lost hearing in one ear. “I try to keep my composure. I tell them I respect their work and get on with my job. I remember citing the Hippocratic oath at my graduation. I take it very seriously. ”

Mobasser, the dentist, recalled his excitement when Mel Tillis, the country and western star, summoned him at 2am to repair a broken front tooth on the eve of an important TV appearance. “Of course you get intimidated. But I got it done. You rely on your training and get fantastic results. He mentioned me on Johnny Carson and wanted to give me a horse as a present.”

Mobasser said he had turned away some famous patients. “Many times I’ve said no to a celebrity if I think they’re coming for the drugs. You have to do your duty. Unfortunately I do know colleagues who say yes. That is when morality comes into play – when you want to keep a celebrity just for the sake of having that patient. I’ve seen colleagues who do it and in the long run they have regrets.”

Elvis Presley is examined by an army doctor during his pre-induction physical in 1958. Photograph: Don Cravens/Time & Life Pictures/Getty Image

Elvis Presley’s death in 1977 from heart problems linked to prescription drugs is perhaps the most famous case of VIP syndrome.

Criticism rained on his physician, George Constantine Nichopoulos, also known as Dr Nick, who died earlier this year. He blamed Presley’s addiction on the singer’s west coast doctor, Leon Cole, who died a few months before Presley.

“He publicly blamed my dad for everything, claiming he was the bad guy, and that he, Dr Nick, was always having to clean up the mess and keep Elvis healthy,” said David Cole, Leon’s son. “Most people didn’t buy that hooey, but Dr Nick outlived my dad by quite a few years, so his version is the one enshrined in books.”

Cole said he knew from his late mother that his father routinely supplied morphine and quaaludes to Presley. “Dr Nick was supplying too, on a more daily basis, but my dad made a good fall guy, especially after he died and couldn’t fight back.”

Leon Cole’s own death bolstered the contention that treating an influential man can be hazardous for both patient and doctor. He took speed to work a near-24 schedule, said his son. “He had become so blasé about doling out narcotics to celebrities, he thought himself immune to the effects, but the amphetamines wore out his heart.”



