WHEN I saw my first red blanket as a young medical student, I thought little of it.

One morning, as I rushed around a hospital in California on my daily rounds, I spotted an old man who lay in bed beneath a scarlet cover, a sharp contrast to the white linens wrapped around the other patients. He looked unremarkable, and I assumed he brought the blanket from home. So I moved on. He wasn’t my patient, anyway.

That afternoon, I overheard a discussion about the patient between two physicians. Instead of identifying him in the usual manner — age, gender, medical problems — one of the doctors said, “This is a red blanket patient.”

The significance became clear after I took care of my own red blanket patients: It was a marker of status. At that hospital, patient relations gave them to some C.E.O.s, celebrities and trustees’ friends. Although we weren’t instructed on how to treat the V.I.P. patients, the blanket spoke for itself: “This patient is important.”

Today, I work at a hospital in Massachusetts that gives the same white blankets to everyone. Yet I continue to see red blanket patients. Here, they are called “pavilion patients” because they pay extra to stay in private hotel-like rooms on the top floor, which come with gourmet food, plush bath robes and small business centers.