DMEJ

Duke Medical Ethics Journal

The Grey's Anatomy Effect: Unraveling the Impact of Medical Drama Shows on Patient Perspectives and Healthcare Systems

By Julia Williams

Although the television landscape constantly shifts, one medical drama is defying all odds through its unwavering fixation in the television business. Renewed for the 20th season last spring, Grey’s Anatomy is the longest running primetime medical drama. Grey’s Anatomy has attracted a wide audience, ranging all ages and ethnic groups. According to ABC’s president Ben Sherwood, roughly 200,000 Netflix viewers watch the 2005 Grey’s Anatomy pilot episode every month [2]. Although there are many different medical TV dramas such as ER, Chicago Hope, and House, Grey’s Anatomy has been most successful in transporting viewers through their TVs and phones and into the energetic environment of Seattle Grace Hospital (the hospital in Grey’s Anatomy).

Over the past couple of decades, medical TV dramas have become so popular that they have transitioned from just entertainment to being sources of medical advice. A survey of geriatric patients demonstrated that 42% of older adults named television as their primary source of health information [1]. Another survey also depicted that minorities are significantly more likely to recognize television as a valuable medical resource [1]. This influence that TV medical dramas have on society is recognized by the American Medical Association (AMA). In 1955, the AMA created the Physicians’ Advisory Committee for Radio, Television, and Motion Pictures to place guidelines and control the portrayal of medical issues on TV [1]. The formation of this committee was a beneficial step in regulating what sort of medical messaging can be televised. The fact that this committee was created recognizes the power that these TV shows, such as Grey’s Anatomy, have in influencing mass medical opinions. Journalists have adapted the “cultivation theory”, describing how TV violence shapes viewers’ perception of violence in the real world, to the healthcare system and hospital environment. This rebranding is known as the “Grey’s Anatomy Effect”. Although this effect may have some benefits, the majority of the consequences are negative because of the unrealistic portrayal of treatment prognosis, hospital dynamics, and exceptionally high expectations of the roles of doctors.

To show the extent of the differences between Grey’s Anatomy healthcare versus real-life healthcare, a research study was conducted screening 269 Grey’s Anatomy episodes versus 4812 patients from the National Trauma Data Bank National Program Sample [1]. In Grey’s Anatomy, the percentage of mortality of patients in the hospital was 22% compared to a far lower 7% in real life. Portraying that roughly one-fourth of patients in the hospital die, viewers become anxious about going to the hospital. Although death is an inevitable part of the hospital setting, inflation of mortality can make a hospital seem incompetent in treating patients and saving lives. This dangerous perspective can hinder people from trusting doctors in the hospital to tend to their health.

“Dr. Derek Shepherd was constantly known as McDreamy and his catchphrase was “It's a beautiful day to save lives.” … The doctor satisfaction in Grey’s Anatomy was off the charts and the expectations for the breadth of care provided by the surgeons were hard to match in real life.”

Furthermore, more patients on TV go straight from the ER room to the operating room, a whopping 71% versus 25% in real life. This greatly distorts viewers' perception of hospital procedures. If a patient falsely believes that they will go straight to surgery and, in reality, don’t, they can get frustrated with hospital staff. The patient would assume that the hospital workers are slow and incompetent when in reality, they are just following hospital procedure and the normal course of action. Another great discrepancy between reality and Grey’s Anatomy is the recovery time after surgery. Only 6% of patients in Grey’s Anatomy were transferred to the long term care unit in the hospital whereas, in reality, 22% of patients are put in long term care [1]. It makes sense that directors would not waste airtime on a rather boring depiction of patients’ post-surgery recovery. Nevertheless, the portrayal of either death or a super swift recovery, with no in-between, can create false expectations of medical treatment in a hospital.

Further supporting the fact that Grey’s Anatomy was made for entertainment more than anything, extremely rare diseases and odd presentations of illnesses are commonly included [2]. A striking example of this is in Season 3 Episode 23, titled “The Other Side of This Life.” (For anyone who has yet not watched this episode, be aware that there are some spoilers in this paragraph.) In this episode, Lexi’s mother comes into the hospital with a case of hiccups due to acid reflux. By the end of the episode, she is dead. The medical explanation behind this was that the surgery performed to treat the acid reflux led to bacterial endocarditis infection. This infection was treated with antibiotics but led to another infection called Clostridium difficile colitis which caused toxic megacolon. This condition ultimately resulted in a perforation in her colon that caused sepsis, organ failure, and eventually death [2]. Although this medical explanation detailed how a case of hiccups led to death, many viewers breezed over the logical medical clarification. Upon reflection of this episode, the majority of viewers summarized it as the hiccups leading to death, a widely inaccurate deduction. This naive conclusion is very dangerous as it can cause the general public to be more nervous about their health problems, believing that a specific, tame symptom is a sign of something more life-threatening yet extremely rare [2]. The increase in stress and anxiety pertaining to medical conditions was confirmed in a 2014 survey which showed how medical shows have a positive correlation with a more morbid outlook on medical conditions [2]. Although some might be proactive about their anxiety about their medical conditions and get professional advice, many are deterred from seeking out help because they are scared of an unfortunate diagnosis, or worse, ending up like Lexi’s mother.

Another drastic difference between Grey’s Anatomy healthcare and real healthcare is the competency and roles of the doctors. Although all the characters in Grey's Anatomy had their fair share of drama and baggage, the show is keen to portray the surgeons as superheroes since they, more often than not, figure out the problem and provide full attention to each individual patient [2]. Dr. Derek Shepherd was constantly known as McDreamy and his catchphrase was “It's a beautiful day to save lives.” Moreover, Shepherd was always adored by his patients as he constantly checked up on them and dedicated significant time and effort to each patient. The doctor satisfaction in Grey’s Anatomy was off the charts and the expectations for the breadth of care provided by the surgeons were hard to match in real life [1]. Dr. Ann Young, a pediatrician at Texas Children’s Hospital in Houston, points out how “patients don’t realize that doctors have very different specialties and their expertise doesn’t overlap” [3]. Dr. Young goes further to state that on medical TV shows, “every doctor is apparently a nurse, tech, radiologist, oncologist, anesthesiologist, code team member, ER doc, and more” [3]. TV doctors are seen placing intravenous lines and setting up pumps, tasks that are commonly performed by nurses [3]. In reality, when patients come in with these preconceived notions of how much their doctor will provide them, most doctors do not meet the standard of TV doctors such as Dr. Shepherd. When doctors might not meet these unrealistic roles, patients can get disappointed with their care. This discourse between the patients and the physician can inhibit effective administration of medical treatment and support.

Grey’s Anatomy, being such an influential platform for the spread of medical information, has been successful at times in bringing greater awareness of accurate health knowledge to the public. A study conducted on this claim found that 17% of Grey’s Anatomy viewers were inspired to speak to their doctors about an issue they saw on the show [4]. With accurate portrayal of information, this can prove to be extremely helpful in advocating for the general public to be educated about their health. Researchers used the content of Season 4 Episode 13, titled “Piece of My Heart”, to test how much beneficial medical awareness from the show was retained. In this episode, a HIV positive pregnant woman comes into the hospital adamant about getting an abortion because she fears that she will pass HIV to her child. Izzy, one of the doctors in the show, informed the woman that with proper treatment, she has a 98% chance of delivering a HIV free baby. Randomly selected watchers were questioned about their knowledge of HIV positive women giving birth [2]. A total of three surveys were given: one before the episode aired, one a week after the episode aired, and one six weeks later. A specific question pulled from the survey is as so: “As far as you know, if a woman who is HIV positive becomes pregnant and receives the proper treatment, what is the chance that she will give birth to a healthy baby, not infected with HIV?” [2] The correct answer to this question is that there is above 90% chance of having a healthy baby with proper treatment. The percentage of the participants that got it correct varied between the different surveys. Before the episode aired, only 15% of participants answered correctly. After a week of viewing the episode, a significantly larger 61% of participants answered correctly. In the last survey given six weeks later, 45% of participants retained the correct medical information [2]. The results of this study show how successful Grey’s Anatomy was in shifting viewer’s attitudes towards more accurate medical information, especially pertaining to HIV transmission to offspring. When the information being spread is inaccurate, the Grey’s Anatomy Effect is dangerous but, when it provides beneficial knowledge, it can be used as an effective tool to educate the public on accurate medical and health information.

What can be done? It is rather unrealistic and unnecessary to call to action a change of the show itself but rather how we perceive the show. If the issue with the Grey’s Anatomy Effect is not resolved by the television producers and writers, then it is up to the viewers and the clinicians to combat misinformation. Viewers must be steadfast in their understanding that these TV medical dramas are to be taken with a grain of salt. Being aware that these shows are intended for entertainment will help keep the fictional hospital setting separate from the real hospital setting. Moreover, if clinicians were to proactively ask patients about any health beliefs they have based on television or cultural beliefs, these misconceptions could be clarified early on [3]. This correction would enable more effective interactions between patients and physicians and ensure that physicians know how best to approach the patient’s needs. Furthermore, patients would ideally not hold physicians to such unrealistically high standards of all-encompassing care, ensuring that patients know what their physicians will provide them.

Grey's Anatomy, along with other TV medical dramas, has undeniably left a lasting impact on both entertainment and public perception of healthcare. The "Grey's Anatomy Effect" underscores the critical need for viewers and clinicians to discern between the show's dramatic narrative and the realities of medical practice. By acknowledging the entertainment value of shows like Grey's Anatomy and promoting open communication, we can bridge the gap between fiction and reality, ensuring a more accurate understanding of healthcare while preserving the positive potential of these influential platforms.

The effectiveness of the show to increase awareness of health topics encourages the Grey’s Anatomy writers to try to be as accurate as possible [1]. Outside consultants, such as physicians and global health professionals, team up with writers to depict as realistic of a hospital environment and patient conditions as possible [2]. Although these efforts are acknowledged and appreciated, the show is still intended for entertainment. Grey’s Anatomy hooks so many viewers because of its sensational drama [1]. Beth Hoffman, a researcher at the Center for Research on media, technology, and health at the University of Pittsburgh, argues that if a show is to be 100% realistic, then it would be a documentary [2]. Grey’s Anatomy is far from being declared a documentary, showing how despite examples of educating the public about medical issues, the show more often tends to mislead viewers.

Review Editor: Reena Kagan
Design Editor: Ashleigh Waterman

References

[1] Serrone, Rosemarie O, et al. “Grey’s Anatomy Effect: Television Portrayal of Patients with Trauma May Cultivate Unrealistic Patient and Family Expectations after Injury.” Trauma Surgery & Acute Care Open, BMJ Specialist Journals, 1 Jan. 2018, tsaco.bmj.com/content/3/1/e000137.

[2] Abbott, Brianna. “The Grey’s Anatomy Effect.” Pixel, 8 Dec. 2018, nyujournalismprojects.org/pixel/the-greys-anatomy-effect/.

[3] Haelle, Tara. “The Grey’s Anatomy Effect: When TV Warps Perception, Proactive Communication Is Key.” Medical Bag, 21 May 2019, www.medicalbag.com/home/medicine/the-greys-anatomy-effect-when-tv-warps-perception-proactive-communication-is-key/.