Medical dramas - the pros and the cons.

Opinion

There has been increasing interest in the field of medicine and in the social life of patients as well as health care providers in the realm of the media, namely, films and television shows. Table 1 lists some popular television series that are based on events germane to the medical field [1-7]. These shows constitute a genre in television, the ‘’medical drama.”

Table 1.

Select medical dramas listed alphabetically. [Copyright: ©2012 Al Aboud.]

The Show	Remarks
Emergency!	Emergency! Is an American television series that combines the medical drama and action-adventure genres. It was produced by Mark VII Limited (Jack Webb’s company) and distributed by Universal Studios. It debuted as a midseason replacement on January 15, 1972, on NBC, replacing the short-lived series The Good Life, and ran until September 3, 1977. Emergency! was created and produced by Jack Webb and Robert Cinader, both of whom were also responsible for the police drama Adam-12. The show focuses on paramedics John Gage and Roy DeSoto (played by Randolph Mantooth and Kevin Tighe) of the Los Angeles County Fire Department’s Station 51 (actually Station 127 in Carson, California), and the hospital emergency room staff (played by Robert Fuller, Julie London and Bobby Troup) with whom the paramedics work to save lives. It was also the first show to feature paramedics who help rescue victimized or hurt patients. Emergency! and Adam-12 were similar in that they featured dedicated civil servants handling two or three varied and unrelated incidents during a typical shift.Despite not being a Top 30 series for six seasons, Emergency! was still an audience favorite show, and despite good ratings, it was canceled in 1977. However, the show returned as a series of six “Movie of the Week” specials between late 1977 and the spring of 1979.Years after the cancellation of the series, it was sold into syndication, TV Land, and RTV [1].
ER	ER is an American medical drama television series created by novelist Michael Crichton that aired on NBC from September 1994 to April 2009. It was produced by Constant c Productions and Amblin Entertainment, in association with Warner Bros. Television. It is set primarily in the emergency room (ER) of fictional County General Hospital in Chicago, Illinois. The show ran for 15 seasons, becoming the longest-running primetime medical drama in American television history. It won 23 Emmy Awards [2].
Grey’s Anatomy	Grey’s Anatomy is an American medical drama television series. It follows the lives of interns, residents and their mentors in the fictional Seattle Grace-Mercy West Hospital in Seattle, Washington. The pilot episode, “A Hard Day’s Night” premiered in March 2005 on ABC.The first episode watched by 16.25 million viewers, and the first season finale attracting 22.22 million viewers. The show is one of the most watched prime time television series [3].
House	House, also known as House, M.D., is an innovative take on the medical drama in which the villain is a medical malady and the hero is an irreverent, controversial doctor who trusts no one, least of all his patients. [4]It is debuted on the Fox network on November 2004. The show’s central character is Dr. Gregory House (Hugh Laurie), an unconventional medical genius who heads a team of diagnosticians at the fictional Princeton Plainsboro Teaching Hospital (PPTH) in New Jersey [5].Dr. Gregory House (Hugh Laurie), devoid of bedside manner and dealing with his own constant physical pain, uses a cane that punctuates his acerbic, brutally honest demeanor. His behavior often borders on antisocial, but House is a brilliant diagnostician whose unconventional thinking and flawless instincts afford him a great deal of respect. An infectious disease specialist, he thrives on the challenge of solving medical puzzles in order to save lives [4].House celebrated its 100th episode milestone in February 2009.The finale of the show’s sixth season aired in May 2010 [5].
Nip/Tuck	Nip/Tuck is an American drama series created by Ryan Murphy, which aired on FX in the United States. The series focuses on McNamara/Troy, a plastic surgery practice, and follows its founders, Sean McNamara and Christian Troy. Each episode typically involves the cosmetic procedures of one or more patients, and also features the personal and professional lives of its main cast.The show began in 2003, and the sixth and final season started airing October 2009, and concluded the series in March 2010, with the 100th episode [6].
Scrubs	Scrubs is an American comedy-drama television series created in 2001 by Bill Lawrence and produced by ABC Studios. The show follows the lives of several employees of Sacred Heart, a teaching hospital. It features fast-paced screenplay, slapstick, and surreal vignettes presented mostly as the daydreams of the central character, Dr. John “J.D.” Dorian, who is played by Zach Braff. The show’s title is a play on surgical scrubs and a term for a low-ranking or insignificant person (at the beginning of the show, most of the main characters were medical interns, one of the lowest ranks in the medical hierarchy).Scrubs premiered in October 2001 on NBC. During the seventh season, NBC announced that it would not renew the show. Shortly after the seventh season finale, ABC announced that it had picked up the series for a new season and in January 2009, the eighth season of Scrubs premiered on ABC. The ninth season, which premiered on December 2009 on ABC, features several new cast members and is set at a new facility. On May 14, 2010, it was announced that Scrubs was officially canceled by ABC [7].

A medical drama can be defined as a television drama in which events center on a hospital, an ambulance staff, or other medical environment [8]. Dr. Kildare, which first aired in 1961, is generally considered to be the first medical drama on American television. The show was a success and, soon thereafter, the medical drama became a popular television genre.

In the United States, most medical dramas run one hour long and, more often than not, are set in a hospital. Most current medical dramas go beyond the events pertaining to the characters’ jobs and portray some aspects of their personal lives. For example, a typical medical drama might have a storyline in which two doctors fall in love [8]. Communications theorist Marshall McLuhan, in his 1964 work on the nature of media, predicted a big success of this particular genre on television because such a medium “creates an obsession with bodily welfare” [8]. These shows have high viewership ratings. For example, the television series House was among the top ten rated shows in the United States from its second through its fourth season; in the 2008–9 season, it fell to nineteenth overall. Distributed to 66 countries, House was the most watched television program in the world in 2008 [5].

Health care providers, in particular, have become more interested in this type of drama and are not only watching the television shows, but are also keenly observing their medical content. There are even websites dedicated to physician reviews on these television series. They review them for medical accuracy [9] and give medical opinions, breakdowns, and expert commentaries on each episode [10]. These television programs have received many awards and critical acclaim. However, they are often controversial in their frank depictions of violence, sexuality, recreational drug use, and surgical procedures [11-16]. This type of drama originated in the United States, but many other countries are developing their own versions of medical dramas [8].

There are some who contend that these television shows can be useful in reinforcing the principles of medical ethics, professionalism (i.e., communications skills, patient confidentiality, and bedside manner, including sensitivity and empathy), history taking, and clinical examination especially for medical students and junior doctors and that they could even replace lecture-based modules [13]. Some even argue that the medical drama is a narrative genre that may foster better emotional engagement with a patient, and moral imagination resulting in a more ethically sensitive student of medicine [11-13]. Some authors think that they may have an impact on the public in that they might be disseminating fundamental principles of medicine in the context of entertainment [14]. In some episodes of these shows, ordinary people are seen saving lives by performing cardiopulmonary resuscitation and other first aid procedures.

It might be that these dramas are putting medical professionals and the medical field in general in a less than flattering light to the public, possibly affecting the confidence they may have in doctors. For example, the doctor in the show House does not wear a lab coat. In my opinion, this can be viewed as non-professional.

The social lives and personal behaviors of doctors in a given show from one country might not be viewed well by viewers in another country with a different cultural back-ground. Is the target audience for these shows the health care provider or the public in general? Is the medical content of these shows accurate?

Only the future will tell what impact this type of drama will continue to have on the public. In this author’s opinion, doctors and filmmakers should come together to produce what is of benefit as well as of entertainment to public.