Novel Malpractice by Ronda Wells

Are you guilty of what I call novel malpractice? As a physician and fiction writer, I see repeated medical errors in novels, movies, and television shows. Some are minor flaws and necessary to fit the story in a one-hour television show—of course, we all know a heart transplant takes longer than the allotted five minutes, so we suspend our disbelief and keep watching to see if our heroine survives.

In a novel, though, outright mistakes can stop the reader (including editors) or pull them out of your story. Click To Tweet

In a novel, though, outright mistakes can stop the reader (including editors) or pull them out of your story. Even some recent award-winning books have contained a major medical faux pas or two. I’ve collected a few, so to test your knowledge, here’s a quick quiz. If you have a medical background, this does not apply.

(Theme song to Jeopardy will now play in your head as seconds tick away . . . )

Common Confusions Quiz

  1. Neurologists operate on the brain. T or F
  2. Osteopaths are not real doctors. T or F
  3. Psychiatrists and psychologists mean the same thing. T or F
  4. Family Practitioners and General Practitioners are both board-certified. T or F
  5. All doctors must complete a residency to get a state medical license. T or F
  6. Optometrists do eye surgery; opthalmologists only fit you for glasses. T or F
  7. Medical school takes four years. T or F
  8. “The Match” is an online dating service for doctors. T or F
  9. All doctors are created equal. Medical doctors can be a PhD, DO, DPM or MD. T or F

Okay, let’s see how you did. Answers:

  1. You’ve just killed a character if you allow a neurologist, who is a board-certified physician who completed extra training in nervous system diseases and is not a surgeon, to operate on your character’s brain.
  2. Osteopathic physicians are real doctors who train at four-year medical schools of osteopathy that also teach osteopathic spinal manipulation. Osteopaths use D.O. behind their name like I use M.D. They are trained in residency programs alongside M.D.s and can enter all specialties.
  3. Psychiatrists are M.D.s who complete a residency in psychiatry and can prescribe medications. Psychologists, who may have a PhD in psychology, are not physicians and generally cannot prescribe medications except in certain states under the authority of a physician. Psychologists are licensed mental health professionals.
  4. Family Practitioners must complete a Family Practice Residency and then pass a board examination given by the American Board of Family Practice. While family practitioners practice what is called general medicine, a general practitioner (G.P.) can be any licensed physician doing general practice who is not board-certified in Family Practice.

Noting a trend? Read on . . .

  1. While most states require passing a state licensing exam or the equivalent, board certification is not usually required to obtain a medical license. Each state medical board is different and the requirements for licensure vary by state. Some states require a minimum of completion of one-year of residency (internship), others don’t. Your best bet as a writer is to read the licensure requirements for the state under the particular state’s medical licensing board.
  2. Optometrists (O.D. behind their name for Doctor of Optometry) do not perform eye surgery and generally fit you for glasses or contacts. They can also treat eye diseases such as glaucoma. Opthalmologists are medical doctors who complete a residency in ophthalmology and operate on the eye, cataract surgery being the prime example. Opthalmologists can also prescribe eyeglasses and contacts and frequently treat rare or more complex eye diseases such as macular degeneration or retinal detachment.
  3. While most medical schools are four years, some offer an advanced pathway that can be completed in three years. Some schools offer a combined M.D.-PhD program which can take six years or longer.
  4. False, although many doctors wish it were that easy to find a mate. “The Match” refers to an official national computer algorithmic matching system between graduate medical students at the end of the senior year and residency programs. Each programs ranks candidates in a desired order and candidates rank their desired programs in order. The computer does the magic, and you are “matched” with a program, like a sports draft.
  5. Gotcha! If you only have a PhD, you are not a medical doctor although you may use the title doctor. Many M.D.s also have PhD’s, therefore it could be true, from a certain point of view. D.P.M.’s are better known as podiatrists, who are medical doctors and perform surgery up to the knee, although most limit their practice to the foot and ankle. As discussed, D.O.s are medical doctors just like M.D.s.

How well did you do? If you scored all nine, congratulations. If you missed a few, you may have committed novel malpractice, but at least in this case, that won’t get you sued.

Follow future articles for more medical topics of interest to writers. Like how to properly poison, maim with knife and gunshot wounds, avoid cliché diseases, and where to get accurate medical information for medical scenarios. If you have any questions or suggestions, feel free to contact me via my website (

An award-winning writer, Ronda Wells hails from the Midwest and is married to a physician. Board-certified in Family Practice, she switched to Occupational Medicine after a stint in private practice. For the last thirty years, she has been a medical director in the health reinsurance industry and case-manages transplants. She has written and published medical policy and guidelines for multiple companies under their name, but her real love has always been fiction. She has just received an offer on her first novel, Harvest of Hope, and is developing a medical suspense series.