The care of prominent individuals and families has been a key element of medicine from its very inception and contributed in no small part to the respect, regard, and at times even political leverage that have been historically conferred upon physicians. The tension that can naturally ensue from having to be firm, to set limits, and to be an open critic of the behaviors of those in positions of power or strength can prove unsettling. In addition, clinicians may become tempted to "share the spotlight" with their celebrity patients and become preoccupied with their own image among their clinical peers. In the end, few practitioners end up being immune from, or feeling entirely comfortable dealing with, the challenges posed by the treatment of V.I.P.s. Even so, the needs and suffering of the V.I.P. are no different from those of the rest, and the obligation as physicians, to all in need of care, one and the same. This article evaluates related issues in the following sections: Dosing Care: Under- and Overtreatment as Countertransferential Risks; From the Outside Looking In: The Seduction of Living Vicariously; Three Practicalities: Privacy, Place, and Payment; and The Clinician as V.I.P.