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Healthcare professionals portrayed on television before and during the COVID-19

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Introduction

  • The healthcare system has been portrayed on screens for the past several decades, and over the years their depiction has evolved. One of the earliest representations of doctors on screen was in the 60s. The portrayal presented an overtly positive image where physicians were compared to heroes and their image was highly positive (Quick, 2009).

  • The mid-90s brought in a sea of change in the representation of doctors, even though they were to a large extent portrayed positively, their characters were shown to be flawed and their mistakes were attributed to their own doings which made them come across more human (Quick, 2009).

  • TV dramas can influence their viewers’ perception of doctors and other healthcare workers, this can be better understood with the help of cultivation theory. At its core, cultivation theory speaks about how people who consume a lot of television often build the views based on the reality depicted on screen. (Morgan et al., 2015).

  • Even though there has been extensive research on doctor portrayal on screen, with the COVID-19 pandemic and increased attention paid to the healthcare system, it is necessary to understand how their portrayal stood at the start of the pandemic. In this study we will focus on how doctors are depicted in medical dramas in the pre-pandemic world.

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Role

Literature Review, Coder

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Team

Team of 3​

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Project Duration

4 months

Literature review & Research questions

Cultivation theory

  • Overexposed to identical content (Potter, 2014)

Race and gender

  • Key demographic factors in TV dramas

  • Portrayals of minorities are inconsistent (Michas, 2019)

RQ1: Are race and gender accurately represented in medical dramas?

Intelligence

  • 24% of medication advice given appropriately, 34% for mostly appropriate, 13% for partially appropriate, and 7% for inappropriate medication advice (Cowley, Naunton, Thomas, Waddington, and Paeterson, 2017).

  • Medication advice has only somewhat been released correctly

  • Audiences think that doctors in the real world are brave enough (Ouellette et al., 2021).

RQ2: Are the fictional medical professionals able to correctly diagnose and treat the patient’s problem?

Consideration and professionlism

  • Build perception of how doctors communicate to their patients (Quick, 2009).

  • Both personal and professional lives in dramas

RQ3: How much time do fictional medical professionals spend with their patients on medical dramas? 

RQ4: Are the fictional medical professionals dismissive or respectful towards their patients? 

Honesty and ethics

  • Lack of punishment of ethical and honesty violations (Czarny et al., 2010).

  • Violations of consent and deviation from standard medical practices (Czarny et al., 2010).

RQ5:  Are the treatment procedures and consequences disclosed to the patients?

RQ6:  Is the patient’s consent obtained by healthcare professionals prior to any operation? 

Methods

Content analysis

Sampling procedure

  • Analyzed Grey’s Anatomy, The Good Doctor, and Chicago Med due to their popularity in the United States.

  • Analyzed the seasons 3 and 4 of The Good Doctor, seasons 16 and 17 of Grey's Anatomy, and seasons 5 and 6 of Chicago Med. These seasons are chosen to compare the content before and after the COVID-19 pandemic.

  • The population of this study consists of 114 episodes total between the six seasons, and randomly selected five episodes from each season.

Coding methodology

  • A group of main characters on each show will be examined according to six different traits and behaviors: demographics, intelligence, consideration, professionalism, honesty, and ethics.

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Results

RQ1: Are Race and Gender Accurately Represented in Medical Dramas?

Gender

Race

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RQ2: Are Fictional Medical Professionals Able to Correctly Diagnose and Treat the Patient’s Problem?

RQ3: How Much Time Do the Fictional Medical Professionals Spend with their Patients on Medical Dramas?

3.39 minutes, it is 6x shorter than a typical patient-doctor interaction in reality (Statista, 2019)

RQ4 : Are the Fictional Medical Professionals Respectful Towards their Patients?

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RQ5: Are the Treatment Procedures and Consequences Disclosed to the Patients?

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RQ6: Is the Patient’s Consent Obtained by Healthcare Professionals Prior to Any Operation?

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Discussion

RQ1: Are Race and Gender Accurately Represented in Medical Dramas?

  • The finding reveals that there is clear overrepresentation and underrepresentation of African Americans and Asians respectively. Our study bolsters the previous research by Jain & Slater, which had similar results regarding representation on screen. According to Jain & Slater “This overrepresentation may be desirable from the perspective of providing role models and countering negative stereotypes, or, as others argue, may have negative outcomes by suggesting that discrimination or a lack of opportunity is a nonissue in this realm Asian American and IMGs were substantially underrepresented” (2013).

  • While coding the leader of the patient provider interaction is that across the shows coded majority of healthcare providers leading interactions with the patients are white males. Females and minorities were often sidelined to the supporting roles or excluded, this is something that is to be taken note of and further research on the same could give us a deeper insight if it is an issue across all the shows

RQ2: Are Fictional Medical Professionals Able to Correctly Diagnose and Treat the Patient’s Problem?

  • In post-covid seasons, healthcare professionals are more likely to correctly diagnose their patients in a delayed manner than pre-covid seasons. This immediate shift shows us how post the onset of the pandemic doctors are portrayed to have doubts and are sometimes unclear of the happenings and yet find the strength and perseverance to continue treating their patients through extraordinary circumstances. It shows that, even if doctors got it wrong in the first place or struggled to diagnose at first, they work hard to correct themselves. This shift in narrative could also be reflective of how real-life doctors toiled over the past year and a half through uncertain times and yet persisted. This establishes both credibility of doctors and at the same time depicts their humane side.

RQ3: How Much Time Do the Fictional Medical Professionals Spend with their Patients on Medical Dramas?

  • According to a report by Statista around 33% of US physicians spend about 17-24 minutes with their patients, 29% spend 13-16 minutes, 22% spend 9-12minutes, 11% take 25 minutes and only 5% spend less than 9 minutes. The results of the study show that the average time a doctor spends with their patient on screen is 203.48 seconds (3.39 minutes), this time includes both their interaction and surgery time, which is much lesser than the national average. There are multiple patient-healthcare professional interactions per show, but each singular interaction consists of approximately 8.07% of each episode, assuming each episode is 42 minutes long. Hence its important to note that the episode must convey the intended storyline within the time available and that could possibly be the reasoning behind the shortened interactions between doctor and patients on screen.

RQ4 : Are the Fictional Medical Professionals Respectful Towards their Patients?

  • Results show that both pre and post covid yielded similar results with an overall 81.8% being respectful towards their patients. Doctors portrayed to be respectful on screen could have positive effects on the audience perception of a provider’s attitude towards their patients, Since there hasn’t been a significant change in how this attribute is portrayed both pre and post covid-19 this type of media might not have had as big of an influence on people’s mistrust of the healthcare system as we originally thought.

RQ5: Are the Treatment Procedures and Consequences Disclosed to the Patients?

  • The results show that 66.9% of the time there is complete disclosure , 22.4% of the times they lied to the patients, the pre and post covid data do not indicate any significant difference.

RQ6: Is the Patient’s Consent Obtained by Healthcare Professionals Prior to Any Operation?

  • As far as consent is concerned, around 66.1% consent was obtained, and around 33.9% consent was either not obtained or partially obtained or not shown, 33.9% is a significant number. Also the pre and post covid stats regarding consent remain largely unchanged which makes us wonder that the 33.9% is a significant percentage where there is no clear consent obtained and it could have possibly influenced the viewers in how they perceive healthcare professionals obtain consent.

Takeaways

Impact

This research would help the entertainment industry to have better ideas while making healthcare television show in the future. Improving the reality of healthcare television shows is essential since they will be presented to a huge population.

What I learned

Understanding the difference between reality and how it is portrayed in media is essential to society. In this project, I learned that coding/analyzing media content needs to be very patient and detail-oriented so that we can generate more accurate outcomes. Also, doing an intercoder validity test is essential to ensure the research's efficacy.

References

Cowley, M., Naunton, M., Thomas, J., Waddington, F., & Peterson, G. M. (2017). Does the “script” need a rewrite? Is medication advice in television medical dramas appropriate? Journal of Clinical Pharmacy and Therapeutics, 42(6), 765–773. https://doi.org/10.1111/jcpt.12581

Czarny, M. J., Faden, R. R., & Sugarman, J. (2010). Bioethics and professionalism in popular television medical dramas. Journal of Medical Ethics, 36(4), 203–206. https://doi.org/10.1136/jme.2009.033621 

Figure 18. percentage of all active physicians by Race/ethnicity, 2018. AAMC. (n.d.). Retrieved December 2, 2021, from

https://www.aamc.org/data reports/workforce/interactive-data/figure-18-percentage-all-active-physicians-race/ethnicity-2018. 

Highmore, F., Dae Kim, D., Shore, D., Williamson, S. (Producers). (2019 & 2020). The Good Doctor, Season 3 [Television Broadcast]. ABC

Highmore, F., Dae Kim, D., Shore, D., Williamson, S. (Producers). (2020 & 2021). The Good Doctor, Season 4 [Television Broadcast]. ABC

Jain, P., & Slater, M. D. (2013). Provider portrayals and patient–provider communication in drama and Reality Medical Entertainment Television shows. Journal of Health Communication, 18(6), 703–722. https://doi.org/10.1080/10810730.2012.757388   

Koblin, J. (2021, January 12). Viewers’ streaming favorites? Old network TV shows. The New York Times. https://www.nytimes.com/2021/01/12/business/media/most-streamed-shows-nielsen.html 

Michas, F. (2019, August 9). Time Physicians spent with patient U.S. 2018. Statista. 

Retrieved December 2, 2021, from https://www.statista.com/statistics/250219/us-physicians-opinion-about-their-compensation/. 

Morgan, M., Shanahan, J., & Signorielli, N. (2015). Yesterday's new Cultivation, Tomorrow. Mass Communication and Society, 18(5), 674–699. https://doi.org/10.1080/15205436.2015.1072725 

Ouellette, L., Ritter, H., Shaheen, M., Brown, A., Huynh, V., Fleeger, A., Fleeger, T., & Jones, J. S. (2021). Are television medical dramas bad for our image? The American Journal of Emergency Medicine, 41, 235–236. https://doi.org/10.1016/j.ajem.2020.05.089

Potter, W. J. (2014). A Critical Analysis of Cultivation Theory. Journal of Communication, 64(6), 1015–1036. https://doi.org/10.1111/jcom.12128

Quick, B. L. (2009). The effects of viewing Grey's Anatomy on perceptions of doctors and patient satisfaction. Journal of Broadcasting & Electronic Media, 53(1), 38–55. https://doi.org/10.1080/08838150802643563

Rhimes, S. (Creator). (2019 & 2020). Grey’s Anatomy, Season 16 [Television broadcast]. Hulu. 

Rhimes, S. (Creator). (2020 & 2021). Grey’s Anatomy, Season 17 [Television broadcast]. Hulu. 

Tian, Y., & Yoo, J. H. (2018). Medical drama viewing and medical trust: A moderated mediation approach. Health Communication, 35(1), 46–55. https://doi.org/10.1080/10410236.2018.1536959  

Tops of 2020: Television. (2020, December 14). Nielson. https://www.nielsen.com/us/en/insights/article/2020/tops-of-2020-television/ 

Wolf, D. (Producer). (2019 & 2020). Chicago Med, Season 5 [Television Broadcast]. NBC.

Wolf, D. (Producer). (2020 & 2021). Chicago Med, Season 6 [Television Broadcast]. NBC.

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