Are TV doctors empowering real patients?

Medical television shows are some of the oldest around — especially soapy productions like E.R. and General Hospital. Whether it’s comedy (Scrubs) or drama (Grey’s Anatomy), we eat up medical shows in every way, shape, or form, and we mourn them when they’re tragically dropped from the broadcast schedule. Some of us grow up watching them and want to become doctors — some of us even go on to become doctors. They’re a huge part of life and culture, as well as social attitudes, and what I’m curious about it this: Are they perhaps empowering patients? Especially as the diversity of offerings on television increases and the standard for narrative accuracy rises — though medical shows should by no means be interpreted as documentary-like depictions of working in medicine — patients may feel more confident about self-advocacy than before.

The question of patient empowerment is an interesting one. Historically, the doctor/patient relationship has been highly imbalanced, with doctors generally regarded as ultimate authorities, while patients are expected to comply with their care providers. “Doctor’s orders” is a popular slang term for a reason — and the idea of “difficult patients” is also a well-known concept. The idea that patients should be pliant and quiet is so widespread that patients are often nervous to speak up about serious issues (like allergies) and actually end up putting themselves at risk because they’re afraid of their doctors.

The rise in medical shows, though, is creating an interesting situation. Many laypeople feel they have a more extensive grasp on medicine than previous generations, and that they better understand the diagnosis, treatment, and management of disease. This isn’t necessarily true in all cases, but some of the most basic information in medical shows is accurate — and viewers can pick up a great deal of information about how various situations are handled in medical settings.

Along the way, they also acquire some sense of control over their health care. Patients who feel like they understand medicine are more likely to ask about options and understand those options when they discuss them — and to push back on a doctor if they feel a recommended procedure isn’t what they want or need. A better understanding of how medical tests are administered and interpreted allows patients to be more selective about agreeing to testing — drawing a line between necessary testing and procedures clearly performed for the purpose of bill padding.

Patients in this position can get themselves into trouble by consulting Dr. Google or refusing to respect the professional training and experience of their physicians, but self-advocacy isn’t a bad trait. It’s why some hospitals appoint patient advocates, and why some allow people to designate advocates from within their own families. Especially with complex medical conditions, the ability to ask questions and receive detailed answers is critical. Patients need to be empowered to make sound choices.

The treatment of some cancers provides an excellent example of what happens when empowered patients take the lead on their care. Since medicine is primarily orientated towards saving patients at all costs, when a patient is diagnosed, a doctor might simply recommend aggressive chemo and radiation, and possibly surgery as well. The goal is to save the patient’s life — not necessarily to consider her quality of life. The empowered patient, however, might ask to see the imaging studies, to get detailed and honest information on her prognosis, and to discuss her treatment options to determine whether she wants aggressive treatment, maintenance therapy, or palliative care.

I was struck by this issue in Frontline’s ‘Being Mortal,’ which explored end-of-life care and the fact that many care providers are reluctant to be fully honest with their patients. When patients aren’t aggressive about wanting a complete picture of the situation, their doctors can dodge the issue. Consequently, it’s key for patients themselves to self-advocate if they really want to know the extent of a condition and if they really want to make informed decisions about how to proceed.

Patients have lots of tools for developing more autonomy, including health and medical education, reference texts, working with care providers who offer empowerment tools, and more — but watching medical shows may be one way to do it, and it’s a potentially interesting one. If such shows are increasing levels of patient engagement and understanding, this provides yet another example of the way pop culture touches real life, creating immediate and real consequences for people as a result of their pop culture exposure. For every patient who makes a more informed personal choice because she remembers something from Grey’s Anatomy or she saw an innovative technology on The Night Shift, we’re progressing away from the “doctor knows best” culture and the damaging issues that come along with it.

Going to the doctor shouldn’t be a frightening experience. Like all professionals, doctors have a level of training, skill, and experience that should be respected, but they’re also mortal. They don’t have all the answers, they sometimes leap to assumptions about what their patients want, they act for their patients instead of considering them as individuals, and sometimes, honestly, they make mistakes. Patients who assert themselves are less likely to pay the costs of those mistakes, instead taking an active role in building the medical care they both want and need.

Sure, the inaccuracies on medical shows are irksome, especially when patients repeat them in the office, but does the good outweigh the bad here? We underestimate the critical thinking skills of audiences if we assume that they are incapable of weighing information and determining what is likely exaggerated or improbable.

Image: Doctor’s Office (Tools of the Trade), William Patrick Butler, Flickr