Question of the Week

May 26, 2009


Over the years there have been a lot of prime time TV shows set in hospitals.

Whether people watch the shows themselves or hear from friends, there is the tendency to talk about medical information that they remember hearing somewhere, even if they don't remember exactly where. This can complicate things for both doctors and patients who then need to sift through the truth and the fiction when a real diagnosis is given.

"[M]any shows rely on consultations with doctors and medical experts... That doesn't mean, however,that they get everything right. Experts say medical dramas often inaccurately portray organ donation, the range of doctors' expertise and nurses' roles, not to mention the level of hospital romance that takes place. 'If you want to learn how to treat your kidney stones or your kid's rash,' says Bob Thompson, director of the Center for the Study of Popular Television at Syracuse University, 'you should no more watch a medical drama to get accurate information on how to treat symptoms than watch "The Simpsons" or "Married With Children" for clues on how to raise a child.' Sounds reasonable. The problem is people get a lot of information from TV shows on many subjects -- including medicine and health care -- without realizing it. After a while, you may not remember where the details or your impressions came from, you're just sure they're true."

When there is truth mixed in with fiction, it can be difficult for some to know which is which. While some inaccuracies are harmless or funny, it can be frustrating for medical professionals when they see potentially dangerous medical inaccuracies portrayed.

"Talk to medical professionals hooked on medical TV -- they're easy enough to find -- and you'll find they have a love-hate relationship with the shows. They pretty much love to hate everything the shows get wrong. 'I enjoy these shows because they are so unrealistic that I don't feel like I am at work,' says Suzanne Miller, MD, a recent Stanford emergency medicine resident who is starting a practice in Washington, D.C. ... But underlying the wacky story lines, these shows do offer a few grains of truth about the world of medicine, say the professionals. Residency is really hard work, medicine is an art not a science and doctors wrangle daily with ethical issues. ... The funny thing is, many doctors and students take the shows seriously. Their senses of humor flatline when confronted with inaccuracies they deem dangerous."

Wherever the information is coming from, if it is presented in an engaging way (which most television shows hope to do), it can be memorable. As those memories solidify, people build an expectation for reality based on what they have seen time and time again--even if they have seen it in a fictional setting.

"For UF [University of Florida] health experts, one of the biggest transgressions a television producer or moviemaker can commit is an inaccurate portrayal of a disease and its symptoms. 'If things are being portrayed inaccurately or misrepresented by description, that is potentially dangerous to people. It is, to an extent, medical education for the patient because people tend to internalize what they see and read, for better or worse,' Holtzman says. 'That is probably the biggest thing I would like to see portrayed accurately.' A 2003 article in the journal Sociology of Health & Illness showed that 'ER' viewers found the show to be not just entertainment, but also an information source. And a 2002 study in the European Journal of Medicine found an association between watching medical dramas and overestimating survival chances following CPR."

While doctors are bothered that patients are being confused by inaccurate or potentially dangerous information, it is not just the patients who are being fed misinformation.

"When physicians at an Alberta hospital asked why so many medical students and residents were using a faulty technique for inserting life-saving breathing tubes in patients, they received an unexpected answer: It's television's fault. Many of the doctors in training said they had learned the procedure from watching medical dramas. And a subsequent analysis of the show ER revealed its fictional MDs and nurses performed intubations incorrectly almost every time. The findings, just published in the journal Resuscitation, revive an intriguing debate over whether entertainment TV has an obligation to portray medicine accurately, and underline what some see as chronic flaws in the system of training Canada's physicians."

Sometimes the information can be dangerous; sometimes it can be confusing. Sometimes it can lead patients to think that there are treatment options available that may not be a good idea in real life.

"The two-hour [season finale of Grey's Anatomy] depicted Izzie and her fellow doctors agonizing over how to treat her melanoma -- a deadly form of skin cancer -- that had spread to her liver, bowel and brain. Because of the location of her brain tumor, doctors presented her with two unattractive options: surgery that could leave her with severe memory problems or a highly toxic drug called interleukin-2, or IL-2. In fact, doctors never recommend IL-2 for melanoma that has spread to the brain because it can cause bleeding and strokes, says Otis Brawley, chief medical officer at the American Cancer Society. If doctors are concerned about the risks of surgery, they recommend radiosurgery, in which doctors focus intensive radiation on the tumor, he says."

Questions of the Week:
Do television shows (such as "House" and Grey's Anatomy") have a responsibility to portray medical information accurately? Do you think it would affect how viewers interpret the information if there was a disclaimer at the beginning of each episode? What should you, as a viewer, keep in mind as you are watching TV programs that portray medical situations and information? Based upon conversations you have had, how factual do you think your friends and family members think fictional medical shows are? If you watch medical TV shows, do you ever question the accuracy of the medical information discussed?

Please email me with any ideas or suggestions.
Note: Due to increasing amounts of SPAM sent to this account, please include "QOW" in the subject line when sending me email.

I look forward to reading what you have to say.

Health Community Coordinator
Access Excellence @ the National Health Museum

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