Survey Report: When Actors Play Doctors on TV

LITTLE FALLS, N.J. -- Nine out of 10 respondents to a MedPage Today poll believe medical TV shows have an impact on the doctor-patient relationship.

  • by Managing Editor, MedPage Today
LITTLE FALLS, N.J., April 14 -- Nine out of 10 respondents to a MedPage Today poll say medical TV shows have an impact on the doctor-patient relationship.

But what that impact is depends on the particular show, according to more than half (53%) of the 1,555 respondents.

Those who put the small-screen offerings definitively in one bucket or the other split almost equally on whether such shows help (20%) or harm (18%) the doctor-patient relationship.

One physician assistant who came down strongly on the "harm" side said the shows create unrealistic expectations.

"It all started with Marcus Welby, whose approach to medicine was unrealistic at best," he wrote. "All the other shows make people think that we can either do every single procedure known to medicine in the ER, are all having sex with each other, or spend hours wringing our hands over patient care. If a TV crew filmed our ER, we would have a very boring hour."

"The inaccuracy of medical differentials on many of the shows concern me," said a colleague.

A doctor who said he trained at Cook County Hospital in Chicago, the alleged model for ER, found the show "very entertaining, but unrealistic. They were seeing the rarest cases on a daily basis and doing procedures normally deferred to medical or surgical specialties. I think the lay public came to believe that every code blue survived and expected it in real life!"

A nurse practitioner with an emergency department background said she "loved ER most of the time. I thought they had too much drama sometimes and not enough laughs." Her views on House were quite the opposite -- and were in line with the views of many respondents.

"House gives a very bad name to physicians and the medical profession. If he had been my physician I would have fired him after the first show," said one respondent.

"House is the worst on all levels," said another.

"The biggest hoax out there now is House," said a third. "I explain to my son that there are no scruffy Vicodin eaters who head a department and whose rudeness is tolerated while he sends a 'team' of pickaxe-bearing protÃ©gÃ©s to someone's home, where they proceed to break down walls and discover a rare infestation of nematodes that have somehow migrated to the patient's canals of Schlemm thereby rendering him blind! Bingo -- medical mystery solved? Please."

Finally, "House? Most institutions fire those involved in such behavior."

Although our poll mentioned only prime-time shows, one nurse reminded us that "a huge impact is actually being made by daytime TV-- namely soap operas. When shows like General Hospital or Days of Our Lives tackle subjects such as breast cancer or HIV, the number of people seeking care and screening actually goes up.

"Even though the presentation of the amount and kinds of care are often unrealistic," she continued, "some shows do get patients to seek the care they need, and not see the doctor as a god, just as a highly educated and trained and caring person, but a person the patient can relate to, so that is a very good thing."

Short-takes from other respondents:

  • "Scrubs has the best portrayal of nurses. Also, the only show that gets it right on type 2 diabetes."
  • "As a medical technologist, I am very disappointed that the laboratory is ignored in most medical shows. In real life, most doctors wouldn't know the first thing about how to crossmatch a unit or do a CBC or lipid profile."
  • "Frazier was the best show with the worst portrayal of psychiatry ever. I once had a patient ask me during an initial eval if I, or anyone else in my practice, did ' . . . what Dr. Phil does.' I think that about says it all."
  • "I think a show like St. Elsewhere gave an inkling of what a city hospital is like as a reality check."
  • "I don't know who teaches these actors how to play the role of a doctor but they do a horrible job."

One respondent said medical professionals can learn something from "the new shows like House and Grey's. They educate the general public on all the super bugs that have left the hospital and are out into our communities now.

"But more important, for the healthcare professionals, maybe sitting back one night and watching a related situation on a television show may just trigger a little more pride, effort, and innovative ways to reduce the risk from hospital-acquired infections."

A colleague sees the shows differently, saying the doctor-patient relationship is governed primarily by the personality of the doctor. So, he said, physician exposure to these shows would have more of an impact on the relationship than patient exposure. And not for the positive.

"Scientific studies of physicians who view such programs," he said, "might be expected to demonstrate a negative effect on their interpersonal relationship skills in general. I recommend that dedicated physicians limit their viewing of these programs if they are able to do so."