What medical dramas get right — and wrong — about hospital work

The reviews are in: Healthcare workers said medical drama shows have become more accurate but long standing issues, such as overstating cardiac arrest success rates, have yet to resolve.

There are broad brushstrokes most medical shows get right, such as the aching work of long shifts and the compassion between healthcare workers and their patients. The more minute details are often left off the script, hospital workers and leaders told Becker's, such as the daily administrative burdens, how EHRs replaced paper charts years ago or how multiple people are involved in a patient's treatment rather than one physician. 

Oh, and trysts before shifts are not as common as Hollywood might make them out to be. (Looking at you, Grey's Anatomy.)

"Their ability to have intimate relations at work is overstated — usually they have very little downtime when on call, call rooms are often shared [and] there are many other people around," said Matthew Weissman, MD, chair of the medicine department at New York City-based Mount Sinai Beth Israel.

Other than some entertainment liberties, life seems to imitate art: Rose Glenn, chief marketing officer of Ann Arbor-based Michigan Medicine often asks, "How can I help?" — a catchphrase also attributed to the main character on New Amsterdam, Dr. Max Goodwin (Ryan Eggold). 

What healthcare workers think

Many said they understand entertainment takes precedence over ensuring 100 percent accuracy, adding these shows are meant for general audiences, not for teaching medical students or to act as a documentary. The most common complaint among healthcare workers was how often medical dramas misrepresent the survival rate of cardiac arrest, which can lead to unrealistic patient expectations. 

A study published in 2021 analyzed 216 cardiopulmonary resuscitation attempts shown in 836 television medical drama episodes. The researchers found the CPR techniques to be mostly inaccurate, from the incorrect compression depth or rate to paramedics having more successes than physicians and nurses. There is also the issue of Hollywood showing CPR saving more lives than it does in real life.

"Not only does this waste a chance to teach audiences the life-saving skill of CPR, the shows often overstate the success of CPR, leading to more complicated conversations in real life about end of life planning and do-not-resuscitate orders," Dr. Weissman said. 

A separate small study found medical shows depicted more medical errors than U.S. hospital data, with many of the depicted errors occuring in physicians' diagnoses and operations. 

The research analyzed eight shows, including ER, Scrubs, Grey's Anatomy and Chicago Med, and found the dramas mainly avoided reporting said errors to the victim. Overall, 49.2 percent of the medical errors were not reported in the episodes. Forty-seven percent were reported but no legal action was taken, and only 3.7 percent of reported errors resulted in legal action against the provider. 

In reality, healthcare workers often worry about malpractice suits, Dr. Weissman said.

Neil Gandhi, MD, emergency medicine regional medical director of Houston Methodist Hospital System, said the medical shows are mostly accurate and can translate complex cases in layman's terms. Some medical shows sensationalize working personalities, he said, such as arrogant physicians who take advantage of nurses and what he calls "hero physicians" who save the day by themselves. 

"Medicine is extremely complex and we require a large number of physicians, nurses and other staff members to come together to get a complete picture of a patient and to make a complete diagnosis," Dr. Gandhi said.

Karen North, PhD, a pop culture expert and the director of University of Southern California's Annenberg Program on Online Communities in Los Angeles, said dramas require characters with bigger personalities — and more unethical ones — to propel compelling storylines.

"It's somewhat realistic," Dr. North said, "but they take character traits, including character flaws, and amplify them because it allows them to write an interesting character drama."

Despite these issues, many agreed most medical shows are a net win for their profession as it increases public interest and knowledge of how healthcare works.

How medical show consulting works

To improve their accuracy and fill in spaces on scripts that just say "medical," many shows hire consultants and advisers, such as Oren Gottfried, MD, and Brandy Hattendorf, MD. 

Dr. Gottfried is a professor at Duke University in Durham, N.C., and a medical consultant for shows including The Good Doctor and Chicago Med, and Dr. Hattendorf is an associate professor at Keck School of Medicine in Los Angeles, an attending pediatric cardiologist at Children's Hospital Los Angeles and a consultant for The Good Doctor

Their processes slightly differ, but overall, they collect healthcare stories from various sources, such as medical journals and stories from friends but never their own patients; pitch ideas to the writers; and receive feedback on whether a pitch has already been done, requires too much time or could pique viewers' interest. 

If a pitch gets picked, consultants then offer more details when prompted and receive outlines and scripts for review. It's then a back-and-forth between the advisers and the writers before the scenes are shot. Occasionally, the show's staff will call the consultants from set asking questions including, "Can you send pictures?" and "I found this on the internet, is this what you're talking about?" Dr. Hattendorf said.

Dr. Gottfried, who has worked as a medical adviser for 13 years, said he jots down pitch ideas in "the little gaps of time [he has] away from a very busy practice."

"Instead of eating lunch, I help with shows," he said. "In general, what it takes is when there's a break in between appointments or I'm driving between hospitals or I wake up at 3 a.m. instead of 5 a.m., I'm reading scripts and providing medical notes to the writers [and] I'm getting emails asking to bring new stories.

"I try to keep the medicine real, keep the entertainment value at a high point and not sacrifice anything with it."

Both said the process is collaborative but, ultimately, the network makes the final call because there is only so much information to pack in a 42-minute-or-so episode following multiple plotlines. 

There are also organizations that work to correct medical misinformation in the media, such as Hollywood, Health & Society, a research and outreach center based at USC that connects shows and movies with scientific experts. 

HH&S not only helps medical shows and movies but also children's programming and sci-fi. Curious George, 90210, Euphoria, Doc McStuffins, Glee, Malcolm in the Middle and Pretty Little Liars are a few of the 1,100-some TV shows and pilots HH&S has worked with, according to its website.

Kate Langrall Folb, program director of HH&S, said she is more focused on ensuring nothing is "glaringly inaccurate." She is not too concerned about whether an emergency room physician is strangely also the oncology surgeon or if people in operating rooms are forgoing protective gear. Rather, she cares that medical health information about topics like HIV/AIDS or COVID-19 are accurate. 

With more than 300 consultations a year, HH&S prioritizes what it consults on. If screenwriters ask for dress codes, the program will lay them out, but these hospital shows only have a few minutes of medical scenes while the rest of the episode is mainly dedicated to interpersonal drama, she said. Thus, it is more important the "heart disease information is accurate than if someone wears a hairnet." 

Ms. Folb said there is sometimes tension between writers and consultants, "but they ultimately listen to us," she said, laughing. For example, in a recent consultation, a writer pitched an idea related to a breast cancer cure and the consultant said it was irresponsible. 

"They get their ideas deflated but they ultimately respect the consultants," she said.

Dr. Hattendorf echoed Ms. Folb's comments: "Hopefully we give people a taste and make it as real as possible but none of us would claim we're teaching medical students or teaching a procedure," she said. "The purpose of the show is not to teach people how to be doctors — you'd have to go to medical school for that."

Why they are so popular

Medical drama shows tap into a universal feeling of what it means to be human, according to Dr. North, who previously worked in hospitals. 

Anybody or their loved ones can someday require a hospital visit, a fear that allows the genre to live through decades and generations, Dr. North said. 

"People watch it because of the symbolic nature that a medical problem can have," she said. "A medical struggle is a tangible metaphor for any struggle people have."

Dr. North compared the fear of medical emergencies and hospital shows to the fear of abandonment and Disney's inclination to depict orphaned children; these are human struggles at different life stages amplified on screen that "teach us how to master our own thoughts and fears." 

Many healthcare workers said some of their favorite medical dramas include ER, The Good Doctor, Scrubs and New Amsterdam for reasons ranging from watching their specialty displayed on-screen and identifying with the characters to the humor injected in the genre. 

Dr. Hattendorf said medicine is not all about making a diagnosis or performing a surgery: It is also about human connections, and sometimes the physician-patient relationship takes precedence over the 100 steps involved in a surgery. 

"I hope that those who are critical of the shows are able to take a second look at the inspiration, look at the fact that it connects people to medicine and makes them have a warm, fuzzy feeling toward the plights of healthcare workers and patient's issues," she said. "It also exposes them to diseases and medical conditions that perhaps they wouldn't be exposed to. And maybe inspires them, as well."

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