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The doctor is in ... your TV

Publication
Article
Medical Economics JournalMedical Economics October 2023
Volume 100
Issue 10

The physician's role in American culture.

The cast of “M*A*S*H” in 1972. Credit: 20TH CENTURY FOX TV / Album / Alamy Stock Photo (M*A*S*H)

The cast of “M*A*S*H” in 1972. From left: Larry Linville, Loretta Swift, Wayne Rodgers, Alan Alda, Gary Burghoff and McLean Stevenson.

Credit: 20TH CENTURY FOX TV / Album / Alamy Stock Photo (M*A*S*H)

If the father of medicine is Hippocrates, is Hawkeye Pierce his son? Is Agent Dana Scully his daughter? Is Dr. Pepper?

Doctors in pop culture have changed many times alongside the Americans who watch them, but one thing is for certain: They have never gone away and likely never will.

Medical shows — and the fictional doctors who lead them — meet at the intersection where pop culture, news, health policy and controversy collide. For good or ill, these shows help inform patients about their views on health care — with life and death stakes.

“The parade of doctor images across the prime-time stage therefore presents a pool of powerful images from which Americans draw their understanding of health care,” writes Joseph Turow, Ph.D., in his 1989 book, “Playing Doctor: Television, Storytelling and Medical Power.” Turow is the Robert Lewis Shayon Professor of Media Systems & Industries at the Annenberg School for Communication at University of Pennsylvania in Philadelphia. “In addition, the dramas’ compelling presentations of contemporary issues will mix with news and personal experience in shaping people’s reactions to the policy discussions about the organization of health care in society.”

If you watch a doctor drama from any era, you will notice how it reflected the time during which it aired. The first TV show about physicians was “Medic.” It ran on NBC from 1954 to 1956 and had a heavy focus on technology, a topic important to post World War II America. Doctors were portrayed as untouchable saviors. The narrator even introduced each show by saying: “My name is Konrad Styner. I’m a doctor of medicine. Guardian of birth, healer of the sick, comforter of the aged. To the profession of medicine, to the men and women who labor in its cause, this story is dedicated.”

Fast forward to 2004’s “House,” which introduces the television audience to Dr. Gregory House, a drug-addicted, prostitute-loving physician who was reckless and had a prickly bedside manner, but nonetheless, gets the job done.

From Styner intoning about the glory of the profession to House’s caustic and anti-social behavior, what is it about TV doctors that keeps America hooked? Some of the most popular television shows of all time have featured doctors front and center. Some of these shows are dramas, such as “ER,” “Grey’s Anatomy” and, of course, “General Hospital.” Some of them are comedies, such as “M*A*S*H” and “Scrubs.” And some shows paint the dark side of doctors, such as “House” and “Dopesick.”

No matter the genre, they all have something in common: Viewers can’t look away from TV doctors.

According to Robert J. Thompson, media scholar and founding director of the Bleier Center for Television and Popular Culture at Syracuse University in New York, three key components are responsible for the success of TV doctors: entertainment value, relatability and educational value.

First, medical shows are notoriously entertaining — audiences crave variety and answers. It doesn’t hurt that, by nature, a doctor is essentially a detective, and there’s nothing TV watchers like more than a mystery. “They must figure out whether the runny nose has anything to do with the rash and then if it does, how that all goes together,” Thompson says. “Isn’t the diagnosis essentially the solving of a mystery?”

There are also countless ailments to explore and a myriad of eras and situations to choose from. And, of course, when it comes to life and death, people find it hard to look away. After all, the highest rated television episode of all time is still the series finale of
“M*A*S*H,” which followed Hawkeye Pierce and other physicians during the Korean War. More than 100 million viewers tuned in to that final episode in 1983.

Second, relatability is key. Thompson says the most popular television subjects are doctors, lawyers and cops. Out of those three, the average person interacts with doctors the most frequently. “We all live in human bodies,” Thompson says. “Human bodies misbehave, and physicians are at the center of that. We have a general human sense toward self-preservation. The biggest problem that every single one of us shares is that we’re all going to die. And so far, it looks like there is no solution to that problem, but there is the possibility of putting that off as long as possible. Doctors are in charge of the science of keeping the human body from dying.”

In other words, it’s easier to imagine yourself in the waiting room at the doctor’s office than acting as a hitman in an episode of “The Sopranos.”

Third, there is always the chance to learn something new when watching a medical drama. Admittedly, this played a larger role before the introduction of the internet, when television was more influential in setting trends and distributing information.

“Early in television history, medical shows were one of the only ways people got information about medicine,” Thompson says. “But then the internet all of a sudden trumps that informational value, the obvious example being WebMD. Instead of deriving various bits of information about medicine through dramatized doctor shows, you simply get onto your device, and you put in your symptoms.”

But that doesn’t mean that medical shows have lost their pop, even if ratings no longer reach “M*A*S*H”-like numbers. These shows still have a strong influence on patient behavior.

I’m a doctor, and I play one on TV

“Meredith Grey saying that you should get your colonoscopy is going to reach millions more people than I could ever reach in my career as a doctor,” says Hope T. Jackson, M.D., an assistant professor of surgery at George Washington University School of Medicine and Health Sciences in Washington, D.C.

Jackson was also the first resident medical adviser for seasons nine and 10 of “Grey’s Anatomy.” On the show, she worked with the other medical advisers and writers to make sure scenes and story lines were as accurate as possible, such as coaching actors on how to pronounce tricky medical terms and showing them how to hold instruments properly. She would also receive a copy of each episode before it aired to make sure everything was perfect.

“I have patients who come and talk about things that they saw on television, which I think is great because it empowers patients to learn,” says Jackson. “I don’t ever get offended if they’re telling me something that’s inaccurate. I take it as an opportunity to teach and educate the patient, which is our No. 1 priority.”

As of 2023, “Grey’s Anatomy” is officially the longest-running medical TV show on air. The show has broken barriers, specifically when it comes to diversity and gender roles. Unlike the medical dramas that came before it, it focuses on successful, ambitious women, many of whom are women of color.

“It was the first time I ever saw a Black woman surgeon, and that was important in terms of how I could visualize myself becoming a surgeon,” Jackson says. “I think we’re just now starting to have a conversation about some of the inequities in medicine.”

Another medical show currently breaking barriers is “The Good Doctor.” The main character, Dr. Shaun Murphy, has autism and savant syndrome. It also focuses on the difficulties of medical training, such as long hours, hazing and burnout, prominent issues for real-life physicians today.

The physician behind — and occasionally in front of — the camera on “The Good Doctor” is Oren N. Gottfried, M.D., a board-certified neurosurgeon practicing in Raleigh, North Carolina. In addition to advising the staff writers of “The Good Doctor,” he also serves as the medical adviser for “Chicago Med.”

“Anything that looks good or went right, that wasn’t because of a Google search or chance. That was because an adviser and a writer trusted each other,” Gottfried says. “Just to have a patient go in the operating room and have the equipment look real, that means there is someone on set (who) really knows what they’re doing.”

This attention to detail and accuracy apply to the storylines as well, Gottfried says. In the current crop of shows, gone are the days when the physician is the superhero. House, for all his eccentricities, is basically a superhero MD. The latest shows, however, often focus on the dark side of the health care system.

“There are times (when) you do have to show where the system failed,” Gottfried says. “Shows are now more likely to show the difficulties in medicine, and they have to. We’re not afraid to show the struggle behind the struggle — the doctors’ struggles.”

The social media physician

As mass media such as television and newspapers gave way to the internet, social media and a fractured media landscape, more doctors have taken on public roles in the media. As patients become more connected and hungrier for more information, physicians have stepped in. TikTok is now one of the most popular apps in world, but it isn’t all funny videos — there is also a growing base of physicians who use the app for educational medical outreach.

Adam Goodcoff, D.O., is an emergency medicine resident physician in Chicago with almost 2 million followers on TikTok. His video demonstrations cover a wide variety of topics, from sutures to nose bleeds, and have been liked more than 50 million times.

“I think social media has given physicians back a bit of a voice,” Goodcoff says. “The social media physician era is a much more accessible and real version of physicians. There’s no reason that you shouldn’t be privy to ‘what are the signs of a UTI (urinary tract infection)?’ or ‘what could be a sign of appendicitis?’ It’s available on Google. Why not have it presented in a more concise and engaging manner?”

Goodcoff points out that patients who take Advil, for example, don’t realize how it actually works. “Spoiler alert: It has no idea where you’re hurting. It affects the whole body,” he says. “It’s fun to inspire the light bulb moment for folks. To be able to do that for millions of people at a time is what makes it so rewarding.”

Amber Robins, M.D., MBA, is another physician looking to educate the masses. In addition to practicing family medicine in Virginia, she is a best-selling author, journalist, and cofounder of the Women in White Coats blog. Her bylines have appeared on HuffPost, Buzzfeed, Medium, ABC News, and PBS NewsHour.

“A lot of times in the office space or hospital space, we’re not able to give that extra education; we only have a couple of minutes for patients,” she says. “Being able to use a platform to talk about topics — I think that’s most helpful.”

Robins also coaches other physicians who are interested in becoming involved with medical media. She says it’s often fear that prevents physicians from educating.

“I started, and a lot of people were like, ‘Oh, you’re very brave’ because people can pinpoint you and say, ‘Well, Dr. Amber Robins gave this information,’” she says. “People are afraid to be in those spaces because they don’t want to give the wrong information.”

And physician fear and distress about misinformation only worsened during the COVID-19 pandemic.

“During the beginning and through the pandemic, physicians were considered heroes, but a lot of times we weren’t considered humans,” says Robins, who stresses the importance of continuing to speak up and fighting medical misinformation. “Being able to be a part of media and being able to be a spokesperson for medicine, whether it be educating or advocating for our patients, (are) essential.”

The hypocritical oath

There is still a dark side. Critics contend that some physicians, such as Dr. Oz (Mehmet Oz, M.D.), have strayed too far from the surgery room and into the limelight. Others, like Dr. Phil, (Phil McGraw, Ph.D.), are not physicians, although McGraw does have a doctoral degree in psychology.

Oz is no stranger to controversies. On paper, he is extremely credible. He is a triple-certified, Ivy-League-trained surgeon with several patents, but many compare him to a modern-day snake oil salesman. He got his start on daytime TV by appearing on “The Oprah Winfrey Show,” where he was dubbed “America’s Doctor.” This led to his own TV show,
“The Dr. Oz Show,” which ran for 13 years.

On it, he heavily featured the “benefits” of psychic mediums, homeopathy and diet pills — none of which are backed by science. In fact, a 2014 study published in the British medical journal The BMJ analyzed 80 recommendations aired on “The Dr. Oz Show” from 40 episodes and found that evidence supported only 46% of the claims made.

“Recommendations made on medical talk shows often lack adequate information on specific benefits or the magnitude of the effects of these benefits,” the study authors wrote. “Approximately half of the recommendations have either no evidence or are contradicted by the best available evidence. Potential conflicts of interest are rarely addressed. The public should be skeptical about recommendations made on medical talk shows.”

Robins and Jackson agree.

“What happens within the media is that you have to do things to keep people coming back to you,” Robins says. “When these things deal with the health of people, this can become a problem.”

“In terms of a doctor having a television show, I think there’s a role for it. You just have to be very careful,” added Jackson. “The more you’re in that world, the less you are actually in the patient world.”

COVID-19 and the future of the TV doctor

One of the byproducts of the COVID-19 pandemic was real-life drama in real-world medical settings, from intensive care heroics by physicians and clinical staff to fights over the spread of misinformation when it came to vaccines and other treatments. There has been ongoing controversy since 2020 surrounding doctors spreading misinformation and whether they should be disciplined. California, for example, passed a law that would punish physicians who spread misinformation about COVID-19 and treatments for it, including license suspensions and revocations.

Although most physicians stressed the importance of social distancing and vaccination, others were dismissive or offered dangerous alternative treatments. Oz was an early proponent of hydroxychloroquine, which has never been approved by the FDA to treat COVID-19.

Another celebrity doctor, Drew Pinsky, M.D., an internist and addiction specialist, stated in late 2020 that COVID-19 was “press-induced panic” and that the odds of dying from it were like being hit by an asteroid. He then contracted COVID-19 in December 2020 and apologized.

The pandemic’s aftershocks also spread into medical TV shows. For a 2021 study, researchers watched 60 episodes from five different medical dramas that aired from Nov. 1, 2020, to May 1, 2021: “The Good Doctor,” “Grey’s Anatomy,” “Chicago Med,” “The Resident” and “New Amsterdam.” The findings, published in JAMA, showed that 35 episodes addressed the pandemic or its consequences.

Among the pandemic episodes counted, “The Good Doctor” logged the highest number with 15 episodes, followed by “Grey’s Anatomy,” with 13 episodes.

Who knows? Maybe this trend will continue and inspire another beloved medical TV series — this one about a burned-out unit of physicians on the front lines of an increasingly tense political environment.

It’s hard to say what future doctors in pop culture will look like. Many hope that the trend of diversity will continue, specifically when it comes to issues of race and wealth in the health care system.

“I think we’re just now starting to have a conversation about some of the inequities in medicine,” Jackson says. “‘Grey’s (Anatomy),’ ‘The Resident’ and ‘New Amsterdam’ … have started to talk about this.”

Others note an upward trend of positivity, of providing the viewer with “feel good” stories that Americans need now more than ever. “When you love your characters and the world and sense of tone, you don’t need an insane amount of plot to put into 42 minutes of television,” Jason Clodfelter, Sony Pictures Television Studios co-president, said according to an IndieWire interview. “It feels like every time we turn around, we’re being pummeled by something else. The notion that we can be a part of telling stories that offer a little hope, a little faith, a little positivity — that is what the audience is craving and looking to broadcast TV for.”

Thompson sees a bright future for physicians in pop culture. “There is nothing to indicate that the genre of popular storytelling about physicians is going to go away at all,” he says.

At the end of the day, a physician is a detective, an educator and a human. Even if the interest in physicians as fictional characters fades away, real-life physicians will still be solving mysteries, curing patients, and teaching the next generation of physicians, all the while navigating their own complex lives.

“I think there’s plenty of drama in medicine,” says Jackson. “There’s so much in what I do every day that is really heart-wrenching, beautiful and amazing.”