Could human portrayals help the doctor-patient relationship, by getting people to relate to their physicians? Or does the knowledge that doctors can also make mistakes weaken trust?
“I’m not sure that these TV shows really enhance empathy toward the doctor,” says Dr. Alexandra Chabrerie, a primary care physician on faculty at Harvard University. “I think doctors are still sort of expected to know everything, especially when you have [characters] like House.”
But in real life, she notes, a diagnosis doesn’t fall on one doctor’s shoulders. “It takes a whole team of doctors to come together and solve problems,” she says. “For cancer, you have tumor boards and tumor conferences that talk about what the optimal approach is.”
Studies of modern medical shows have found fictional doctors’ professionalism disappointing at best. In an analysis of 50 episodes of Grey’s Anatomy and House, researchers found that the characters handled issues involving patient consent well 43 percent of the time. “The remainder [of the depictions] were inadequate,” the study says.
The analysis also found several incidents of doctors endangering patients without being punished, sexual misconduct (of course), and disrespect. The study notes that “88 percent of disrespectful incidents in House involved Dr. House.”
But despite all the inappropriate romances, and Dr. House’s rude mouth, the analysis found that there’s one arena in which TV doctors still shine: caring for patients.
“Caring and compassion when dealing with patients is particularly noteworthy, because it is the only virtue of professionalism we identified in which the exemplary portrayals outnumber the lapses,” the researchers write.
A lot of the out-of-control unprofessionalism in these shows does seem to be in service of the patients. On one episode of Grey’s Anatomy, two female interns confront their boss in the men’s bathroom, to convince him to do a risky operation. On the goofy Zach Braff comedy Scrubs, doctors treat patients who have no insurance, and bill the procedures to the insurance of patients who recently died. Fictional doctors do often go the extra mile for their patients. (There is actually an episode of Scrubs called “My Extra Mile.”) These portrayals may be why watching Grey’s Anatomy was linked to seeing doctors as more courageous, in another study. And seeing doctors as more courageous was subsequently linked to better patient satisfaction.
All the heightened drama and medical inaccuracies aside, Chabrerie says it’s the emotional challenges of being a doctor that these shows tend to get right.
“I do think the emotional aspects get brought up more in shows like Scrubs,” she says. (She’s not the only one—a 2009 Slate article says that despite the show’s “cartoonishness,” it’s “quite in tune with the real lives of doctors.”)
“In med school, this is what we did. We lay in our beds and watched Scrubs,” Chabrerie says. “At the end of the day, we see [the same things] all the time. We lose patients all the time. It’s never easy. [On these shows], the young doctor gets really upset, and the older, wiser doctor comes in and says ‘You have to let it go.’”
As it enters its 11th season, Grey’s Anatomy is the biggest medical show still on air. Others, like Hart of Dixie and The Mindy Project, have taken the “doctors’ personal lives” strategy that Grey’s made popular and run with it, all but abandoning the depiction of any actual medical treatment. But a decade of Grey’s dominance, combined with the longevity of other 21st-century medical shows (House got eight years, Scrubs got nine, ER, 15) surely takes a toll.
When a television show becomes a huge part of popular culture, it can influence even those who don’t watch it. “Even if you’re not watching the program, it creates kind of a cultural public opinion, a dialogue about the topic,” Chory says. “You hear things from people who do watch it. There’s a long line of research saying that one way media affects us is through our personal contacts.”
Ultimately, though, Chory says that the biggest influence comes from what you watch, rather than what’s on. And shows that aren’t on-air anymore can sometimes find new life on Netflix.
“The influence of repetitive watching of those medical shows, to me, is rather subtle,” Chung says. “We may not realize that our perception and attitude changes as a result of repetitive exposure to medical dramas because often the influence happens at the unconscious level.”
Though the hospital remains a compelling setting for fictional drama, we’re past the heyday of doctor-show dominance. Their influence surely lingers, but for those who can’t get enough rare diseases, there’s always the Internet.
“For my 40th birthday, my husband got me a framed sign that says ‘Please don’t Google,’” Chabrerie says. “My patients get so freaked out.” She adds that those who fall into WebMD holes are probably some of the same people who binge-watch House or Grey’s Anatomy.
Here are some things that are true. Anytime I have the mildest bodily discomfort, I become fully convinced I am dying. I’m also extremely reluctant to go to the doctor, a combination of qualities that makes being my friend a constant delight, I’m sure. I work on the Internet. And I love medical TV shows. Are these things related? I don’t know. I’m trying not to blame Shonda here, but, you know, old habits.