Thank goodness they’re not real doctors, they only play them on TV

This article was originally on a blog post platform and may be missing photos, graphics or links. See About archive blog posts.

You didn’t think a doctor would actually try to make a patient sicker to boost his chances of moving to the top of the heart transplant list, did you?

Of course not. Neither did Matthew Czarny, a medical student at Johns Hopkins University in Baltimore with an interest in bioethics. But he previously documented that more than 80% of medical and nursing students watched hospital dramas TV, and they might be influenced by what they saw. So he set out to undertake a “systematic analysis” of the examples set in two popular prime-time dramas: “Grey’s Anatomy” and “House M.D.”

(In case you were wondering, “E.R.” wasn’t in the analysis because DVDs weren’t available for the season Czarny and his colleagues wanted to study. “Nip/Tuck” was excluded because it “frequently included extremely outlandish situations.”)

What kinds of lapses in professionalism were observed? The researchers flagged:

• A doctor trying to steal marijuana
• A doctor plagiarizing someone else’s research
• A doctor telling another to invent a diagnosis to get a patient off their hands
• A doctor trying to revive a patient so that he has the opportunity for further punishment

In addition, the researchers tallied 178 incidences of interpersonal relationships between doctors and other healthcare providers. Only nine of them were deemed to be “depictions of exemplary instances of professionalism.” That’s right, 5%.

The good news (at least for patients) is that almost all of those instances involved doctors behaving badly toward one another. On “House,” a whopping 88% of these encounters involved Dr. House (perhaps not surprising to those who follow the show).

In contrast, Czarny and colleagues write, “’Grey’s Anatomy’ shows nearly the entire cast of physicians being disrespectful to each other or patients at one time or another, but no one character is universally disrespectful.” It’s hard to tell whether this is a good or a bad thing.

The TV docs did better when it came to relationships with their patients – 28% of those encounters were exemplary. They did comparatively well when it came to getting informed consent for risky procedures – 43% of those discussions were deemed exemplary. They also respected patients’ wishes to refuse further treatment about half of the time. (One hopes the figures are much higher in the real world.)

Not surprising, a big problem on the shows is sexual misconduct. In real life, the Assn. of American Medical Colleges doesn’t explicitly characterize sexual misconduct as a breach of professionalism, but the researchers added it to their study anyway.

Good thing. In two cases, doctors correctly declined advances from their patients. In the remaining 67 cases … well, let’s just keep in mind that these shows are soap operas.

The study will be published in the April issue of the Journal of Medical Ethics.

-- Karen Kaplan