You’re more likely to die in a fictional hospital

This may or may not come as a surprise, but it turns out that gleaning medical knowledge through watching fictional hospital dramas on the telly is not actually the wisest of ideas.

That’s the finding arising from two separate analyses just published – one concerning the series The Good Doctor, and the other looking at the long-running show Grey’s Anatomy.

In the latter case, a team of researchers led by surgeon Jordan Weinberg of St. Joseph’s Hospital and Medical Centre in Arizona, USA, binge-watched 12 seasons of the popular drama and compared the treatment of 290 fictional patients portrayed therein with the real-life outcomes for 4812 patients on the 2012 National Trauma Data Bank – an aggregation of hospital cases compiled by the American College of Surgeons.

The good news is that the death rate at the Seattle Grace Hospital – the made-up setting for the series – is three times higher than the US average. On the show, in 269 episodes, 22% of featured patients died, compared to just 7% in real life.

Beyond that, however, the procedures and storylines shown in Grey’s Anatomy are so far divergent from what happens in proper hospitals that Weinberg and his colleagues are concerned that viewers may derive unrealistic expectations of hospital experiences.

This, they suggest, may contribute to lower levels of patient satisfaction.

On the telly, the researchers found, 71% of patients admitted to emergency went from there straight to an operating theatre, while in reality the figure is only 25%.

Among the television patients who didn’t actually die in the ambulance, the emergency department, on the operating table or in the wards, just 6% were subsequently transferred to a long-term care facility, while in genuine hospitals the measure is more like 22%.

And just as fictional death rates were exaggerated, so too were recovery rates. In patients with serious injury, half of them were discharged after less than a week. The National Trauma Data Bank figures showed that only one in five – 20% – of real people had the same good fortune.

Writing in the journal Trauma Surgery & Acute Care Open, Weinberg and his co-authors suggest the discrepancies arise as a function of storytelling.

“Although realism is an integral element to the success of a television drama set in a contemporary workplace, be it a hospital or police department, the requirements for dramatic effect demand a focus on the exceptional rather than the mundane,” they write.

“Hence, American television medical dramas tend to rely on storylines that feature rare diseases, odd presentations of common diseases, fantastic and/or quirky injuries, and mass casualty events, all framed within a ‘realistic’ representation of a typical US hospital.”

Meanwhile, in the medical profession newsletter MedPage Today, John Higgins of the McGovern Medical School at the University of Texas takes a swipe at the popular series, The Good Doctor – which features autistic savant Shaun Murphy as its central character.

Higgins concedes that the show portrays “quite accurately” the travails of Murphy, but takes issue with a recent episode in which the star eventually makes an unexpected – and very clever, of course – diagnosis of a patient’s heart problems.

Murphy’s reasoning is deeply flawed, Higgins finds, explaining that the symptoms portrayed are inconsistent with the explanations advanced.

Introducing Higgins’ analysis, MedPage Today staff writer Molly Walker notes that “in this particular instance, the show’s medical savvy on basic electrophysiology and anatomy may be lacking.”

Both analyses add to a growing body of research looking at how medical television dramas affect viewers. A 2017 study led by Brian Primack of the University of Pittsburgh School of Medicine in the US, found the picture to be unclear.

Reviewing 19 studies that looked at the influence of the programs Grey’s Anatomy, ER and House, Primack and colleagues found that 11% of them derived a negative impact on public health-related knowledge, while 32% found the opposite and the rest found no clear outcome.

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