Tune in to a medical drama today, and you're bound to get an eyeful of blood and guts and lots of banter about diseases, procedures and treatments.
That's the point. Attention to all the gory details by small-screen writers, producers and directors is a must, not only to suspend viewers' disbelief, but also to tell stories responsibly.
To that end, many shows rely on consultations with doctors and medical experts, provided by groups such as Hollywood, Health & Society, a partnership with the Centers for Disease Control and Prevention, the National Institutes of Health and the USC Annenberg Norman Lear Center, a research and public policy center, to help them accurately represent health-related story lines.
As a result, when doctors on "Grey's Anatomy," "ER" and "House" talk shop, they sound like they know what they are talking about.
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.
A recent small study by researchers at Yale University, for instance, showed plastic surgery reality programs such as "Dr. 90210" and "Extreme Makeover" played a significant role in cosmetic surgery patients' perceptions and decisions. Regular viewers cited the shows as influential in their decisions to consult a surgeon, and knew more about procedures than those who never tuned in.
Another study found organ donation was a primary story line in more than 80 episodes of medical dramas, police shows, comedies and daytime soaps in 2004 and 2005. The research, published this summer in the journal Health Communication, found that with a few exceptions, the topic was consistently presented in a negative or inaccurate light, which some say can ultimately affect people's decisions to become donors.
That's what another study, published in Clinical Transplantation in 2005, also concluded. Its researchers found that people who viewed organ donation unfavorably frequently cited what they'd seen on TV as evidence for their opinions.
"It's hard not to get kind of outraged when you see what's going on," says Susan Morgan, associate professor in the Department of Communication at Purdue, and a co-author of both studies. "You could start drawing this out to real human lives being lost."
Morgan points to story lines on soap operas such as "One Life To Live," in which the hospital's chief surgeon ran a black market for transplantable organs, and "Grey's Anatomy," in which a patient was prematurely declared brain-dead so her organs could be procured, as prime examples.
Some nurses have taken issue with their portrayal on these programs as well. "ER," for example, commonly depicts physicians doing the work nurses perform in real life, says Sandy Summers, executive director of The Center For Nursing Advocacy.
"People will go into the hospital and remark with surprise that the nurses did everything," Summers says. "They believe from watching these shows that physicians do everything."
Anyone who works in a hospital also will note that in real life there is nowhere near the degree of fraternization among residents, nurses and doctors shown on TV. Hospital staff do not all hang out at the local bar or coffee shop every night after work — and they're not typically having sex in the janitor's closet, either.
"People have families to go home to," says Dr. Jordan Safirstein, a cardiology fellow based in New York who runs StopPagingMe.com, a Web site that looks at the humorous side of being a doctor. "I wish it was more exciting and romantic."
Finding the right balance
While most medical shows make efforts to obtain accurate information, their plots will not always be perfect because they're caught in a balancing act, says Larry Deutchman, executive vice president of marketing and industry relations for the Entertainment Industries Council, a nonprofit founded by entertainment industry leaders to promote awareness of major health and social issues.
"To be entertaining and have your stories told has always got to take first precedent," he says. "Second is what can I do to make a difference with my work or minimize the harm. If you're taking that approach to what you're doing, more often than not you can come away with doing more good than not."
Small-screen medical dramas aren't always off the mark, though.
Donate Life Hollywood, a campaign launched this summer to eliminate stolen-kidney story lines, among others, from TV and film, heaped praise on "Extreme Makeover Home Edition" producers for featuring a woman whose son had died in a car crash and was an organ donor. After the show aired, online donor registration increased 200 percent in California over the previous week, a spike the campaign attributed to the show. "Intervention," an A&E reality show that profiles people facing drug and alcohol dependencies, and their families’ efforts to help, is another example of accurate, gripping TV, says Deutchman.
A new study by researchers at the University of Southern California, published this month in the Journal of Health Communication, also shows viewers of an "ER" story line about teen obesity, hypertension and healthy eating habits were 65 percent more likely to report a positive change in their behavior after watching.
Likewise, every TV producer has probably gotten a letter from a woman who decided to get a life-saving mammogram after being reminded by a program, Thompson says. And while medical shows teach us plenty that isn't accurate, they also can shed light on the health care bureaucracy, insurance issues and disease prevention, something fiction has no obligation to do.
"If you've been logging in from "Chicago Hope" to "Grey's Anatomy," you've gotten a lot of sophisticated information," Thompson says. "Just as you've learned some errors, you've learned some things you wouldn't have otherwise known."