House MD: Good Ratings, Bad for Medicine

house_md_pillsAs TV season starts to wind down to the season finales, I can’t help but express my frustration at some of these medical dramas on television. I remember how fun it was as a medical student to watch the show “ER”, but how the relationship factor eventually made me lose interest. Unfortunately for some, in the real ER’s of the world, partner swapping is not a reality (at least not publicly).

Sure some relationships may develop between some of the staff from time to time, but I hesitate to say that it is no more often that what happens in any other workplace. And when it does happen, those involved usually like to keep it very private. Discussing what you and Nurse Janie did last night over CPR just hasn’t ever happened in my experience. But this issue is far from being the most publicly dangerous idea promoted by these shows. That goes hands down to the idea that ER doctors can do anything.

Watching ER, there were episodes when the ER doctors did c-sections in the back of a grimy ambulance after a gruesome car accident – and amazingly everyone survived! Happy endings all around. Unfortunately, the only C-sections we might ever get involved in are the emergency ones where mom is pretty much a goner and you’re worried about saving baby. There are no fine bikini cut incisions. Its blood and guts, and the baby’s chances are not very good either. Unfortunately, we also don’t take out your appendix or cure cancer.

Watching House MD though, things have been taken to an even higher level of unrealism. The docs on that show are not only walking encyclopedias of rare diseases, but they are also genetic specialists, nurses (all specialties), pharmacists, x-ray techs (who do CT and MRI), respiratory therapists, phlebotomists, social workers, abuse counselors, chaplains and private detectives. I personally have never gone through a patient’s trash or through their drawers to look for “clues”.

And House himself, as funny as he can sometimes be, would have been hauled off to jail a long time ago and lost his license for his interest in pornography and narcotic pain medication addiction. Just try imagining the guy from the Percocet video posted a few days ago being your doctor – not the kind of person we would generally associate with mega-book smarts if you know what I mean.

Yes, I know you are probably thinking, “dude chill out! It’s just a TV show”. So why does this matter? It matters because there are a lot of people out there who have a big problem between fiction and reality. They actually believe that we can do all these things and are very disappointed when we tell them we cannot.

I cannot even begin to count the number of times a patient has shown up in the Emergency Room saying, “I have been to my doctor and so many specialists and they can’t figure it out, so I decided to come here.” Then I have to explain to them how, unlike “House MD” or “ER”, I am more akin to “Scrubs”. I am pretty good with the common stuff especially if it has recently started (acute conditions). Once you get into chronic diseases (ones that have been there for a long time) or rarer conditions, then as much as I would like to stroke my ego, I am pretty lost.

I wish I could possess vast amounts of knowledge in several specialties. But I figure that since the people that go into those specialties have to spend several years honing their knowledge in that corner of medicine, it would be quite arrogant of me to assume that I can do their job so easily. I certainly get annoyed enough when someone training in dermatology or rehab medicine thinks they can step in and do my job, so I don’t want to be hypocritcal and do the same. These people have the training and specialized knowledge that don’t and they should be consulted. At least in “Scrubs” they usually use consultants and there are no “jack of all trades” doctors.

And in case you’re wondering, we also don’t have “quickies” in the medication or supply room.

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63 Responses to House MD: Good Ratings, Bad for Medicine

  1. Cello says:

    Anyone who comes into a doctors office and basing their wants and needs off a television show should be diagnosed as a retard anyway. Everyone knows in the real world House would have gotten fired a long time ago, but this was a good write up and I am glad you did it. The series finale last night was actually pretty entertaining for the most part. Good blog you have here!

    • John says:

      Come on guys chill out. If you where a doctor that was worth a damn, You wouldnt have went into such a boring field of medicine such as dermatology and rehab. Get a better specialty like cardio-thoracic surgery, Anestisia. Can u even do anything beside berscribe medicine for psoriasis

      • Amanda says:

        Bro you cant even spell… you have no room to belittle a dermatologist. With how you spell you couldn’t even graduate college let alone med school. So what is it you do for a living that is so grand? I have a sneaking suspicion that it isn’t a thoracic surgeon or an anesthesiologist.

  2. […] House MD: Good Ratings, Bad for Medicine « ER Drama: The Blog […]

  3. Tunde says:

    I love the show House MD. For me is very entertaining, and beyond that i do not think too much of it.

    Concerning the relationship issues at ER, well maybe you haven’t been in too many places, or you are too naive, or in denial or just covering up. Things do happen, rather you like it or not, and i am sure you have seen it, and yes people know about it. I am not saying every one is doing it, but there are people who are pretty busy doing things other than patient care.

  4. Brenna says:

    I love to watch House, but I also don’t believe everything I see on t.v. The thing that cracks me up about House is that Chase appears to be the only surgeon in the entire hospital, and he does it all. Brain surgery, skin grafts, you name it!

  5. hannah says:

    Dunno if House would have been fired for the narc addiction. Drs tend to be good at circling the wagons when it comes to other drs’ addictions.

    But, yeah. My mom has a lot of weird/chronic/complex problems that are medical/psychological/behavioral/social in nature. All I ever hear is: “Oh, I just need a House to fix to me!” like someone like him actually exists.

    (I also find it funny how there’s always /one/ diagnosis. You might get a secondary complication, but it’s always one diagnosis.)

    • ER Doc says:

      Thanks for your comment Hannah. It is kind of true what you say though about circling the wagons. They really make too much effort some times with docs who go to work drunk or those using narcotics. I imagine it must be due to the low number of docs and efforts to preserve them.

  6. Sapphire says:

    I watch House MD regularly and I get a laugh out of his weird behavior because I know it is only a show and that a guy like that in real life would be lucky to even be admitted to medical school never mind becoming a doctor. The only people that think this stuff is real are the same bunch who probably try to imitate car chases they see off of television in other words idiots!

    • ER Doc says:

      Its sad though isn’t it how many people do imitate car chases? And totally agree that he would have never made it past the med school interview. Can’t imagine his character trying to appease anyone in an interview process. He would probably start calling them names and making fun of them.

      • Jack says:

        I can see why doctors don’t like this show…the fact is in real life 95 percent of doctors are idiots…and when they see a great fictional doctor it is only rational to lash out on entertainment for their own inadequacies…chill out its just entertainment, its not a TV shows fault that doctors usually suck…At least on TV we get to see doctors who really impress us even tho it is just fictional.

    • Andy says:

      6 year of Medical school, 2 years of internship, 3 years of medical residency and 4 more years of slog to become a gastroenterologist and I landed on this blog 4 years after it was written to hear a Jack-off say “Most doctors are idiots, usually suck and dislike House to cover up their own inadequacies”. Wow – and all because I googled ; “How come House’s residents do all their own procedures ?” And being a Gastroenterologist, even if I am a Physician, most of my day is full of procedures- endoscopies, ERCPs, Liver biopsies, Ascitic drains, so on and on and on. Serves me right for trying to find something meaningful on the internet.

  7. Esther says:

    I haven’t watched any House — so I probably shouldn’t express an opinion, but oh well. I can understand the draw of the character (the previews are funny), but I have never been one to equate television with real life. That’s kind of why I watch television (and explains why I’m such a huge sci-fi fan). On the other hand, some people will believe anything. Bravo for posting this truthful article and admitting your limits. I prefer real doctors to fake ones and I think it’s interesting that different physical and psychological complications interact and make things very complex instead of simple and wrapped up like the end of a tv episode (or a long run on sentence . . .).

    • ER Doc says:

      I’m like you Esther – I love sci-fi because TV is my escape and the last thing I want to do is revisit a hospital even in my time off!

  8. Jude says:

    I agree, things happening often enough in the hospital, and every department. Especially ER, surgery and ICU<CCU. High pressure drives some workers to find relief? …or just human nature.

    House MD is a cool show , and that it is, a show, nothing else. Go home, get a beer, sit down and laugh all the way to the end of the movie, seeing what kind of a stupid mistakes they are making. hahaha Love it.
    Anyone who take it seriously, they need to get their head examined.

  9. Nurse K says:

    Oh, come on, who hasn’t had a quickie in the med room? Should I pick the fat doc with the bad toupee or the one a foot shorter than I with a Napoleon complex? With so many good choices, how can I possibly limit myself to just one?

    A mish-mash of somatic complaints usually allows for at least one deadpan “It’s all you, House” when I hand over the chart.

  10. Marco says:

    I don’t like House for all the reasons given in this post. However, I think it would be a blast to be the MD consultant who picks the diseases the writers create the show around.

    Marco

  11. […] that many doctors think Scrubs is the most realistic medical show on television. According to ER Drama,  the least realistic – no surprise – is House, MD: Watching House, MD though, things have been […]

  12. Zao Thanatoo says:

    I think it helps one to understand House, M.D. when one begins to recognize that it is a contemporary re-interpretation of the Arthur Conan Doyle’s classic drug-addicted rationalistic mystery-solver: Sherlock Holmes. The parallels between the two are often not-so-subtle, but always enjoyable.

    Scrubs is far more “realistic,” I must admit.

  13. includao says:

    The poor little ER Doctor who admits lack of knowledge is envy of MD House, a fictional character, a drug addict, a wacko agnostic/atheistic brilliant science-investigator.

    Perhaps you have encountered some medical genius in your life. Not some fictional uber-genius like House, but someone who appears to be arrogant like House is or, let’s say, far more intelligent and capable than you.

    I sense an ego disturbance over all your post sir.

    • ER Doc says:

      How could I possibly hide the truth in the face of such piercing psycho-analysis? You are so right and now I sense urges that I buried deep inside my unconscious beginning to surface. Could it be the traumatic lolly pop accident I witnessed as a child? Or maybe I have always secretly hoped to dance on Broadway and just “envy of MD House” because he gets to be on TV? Oh please help me advice dispenser with your fortune cookie wisdom and Joey-from-Friends-like insight.

  14. SONNET says:

    Hi
    Let us call them super doctors

  15. Caveat: I’m an ER veterinarian.

    I once took a Great Pyrenees with a hemoabdomen to surgery (after extensive owner counseling about likely bleeding hemangiosarcoma). Got in, suctioned 5 liters of blood, autotransfused, worked like mad, found metastatic cancer EVERYWHERE. Recommended euthanasia on the table. Owner elected to do so.

    Afterwards, she didn’t want to pay her $2200 bill. I tried to elucidate why over a 45 minute phone conversation. At the end, she finally gets quiet and then says, “well, I felt like we were pressured to go to surgery when the prognosis was guarded. I figured since they’re always so hot to go to surgery on Grey’s Anatomy that you must be, too.”

    I was stunned speechless.

  16. I wish I’d made that up.

  17. thedon says:

    Ok, why don’t you try to think of the meaning of the show. Sure, NORMAL doctors don’t know many of the rare diseases, but, since you obviously didn’t watch the first season, these doctors, which are part of a certain sector in the hospital, are a group that does 1 case a week, so they have the time to be at each test run. Also, since they are part of this group that specifically treats patients that cannot be figured out by the other doctors, it is obvious that they are trained to know the rare diseases. Stop think you know everything like the typical doctor you are and try to understand something first.

  18. Kratos says:

    I really don’t like the notion of specialists.

    The human body is a complex machine and doctors are the body’s mechanics.

    How stupid it would be if you went to a repair shop and the guy the repair shop hired couldn’t rebuild your transmission because “all he knows are breaks”.

    Far more valuable is the guy/gal who knows every part of the business and can do it all and do it all well.. because he/she can see the connections between the various systems and see systematic patterns. Maybe its a rare gift to have someone who truely knows it all..

    But thats who I want to be my doctor. Geniuses. If you are not a genius, then what are you doing being a doctor? LIVES ARE AT STAKE!! You don’t get a second chance to catch something early on that if left untreated could kill someone!!!

    Unlike the car which worse case they screw it up we just buy a new car.. you can’t buy a new you.

    So pardon us if we expect alot of from you guys n’ gals in the medical profession. OUR LIVES ARE LITERALLY IN YOUR HANDS. So.. you better know your stuff.. and you better work together.

    And yes.. maybe if some of you guys did check out the trash or the living conditions of someone with a disease you might figure out more about whats going on.

    stop being human (and acting like your super human) and start being super human and act like your human.

  19. Liz says:

    This is a way after the fact entry but I couldn’t resist!

    I hate House, MD while my husband loves it! I’m a nurse.

    I always tell everyone that the most realistic medical show on tv is ‘Scrubs’!

  20. Suki says:

    This television drama has been a gateway for bringing ideas of medicine and healthcare to the masses.
    House Medical Division ranks at the top of the list reaching a big audience in many different countries, and the number of viewers is constantly growing.

    Tv series concentrate much of the episode on the diagnostic process of patients with rare conditions, and it also portrays the life of a chronic pain sufferer: Doctor Gregory House, the star of the this drama.
    Researchers which works with Doctor House, start making consultation, practicing and testing when researching the medical facts before confronting themselves with the fictional Dr. Gregory House, who always had the right answer in his pocket.

    I believe that this TV series is currently one of the best program broadcasted in TV, despite in more than one occasion authors seems to diverted the plot to a sort of Beautiful trying to bring a bit of suspense and something new to continue catching the audience attention.

  21. psycho-cat says:

    i also love house md, but i have to admit, the most realistic medicine show until today has been “scrubs”
    pretty funny too, at least their firsts seasons.

  22. Doctor Who says:

    “And in case you’re wondering, we also don’t have “quickies” in the medication or supply room”

    Perhaps you should…..

  23. Bell MD says:

    House was based on sherlock holmes, and sherlock holmes was based on a real doctor. So I think a doctor like House can exist.

  24. xfstef says:

    I am a fan of the show, and no, I am not trained in medicine. Still I feel like I have to say this…
    House is not just some usual doctor, and neither is his team, so I am guessing that you either don’t know the show all that well, or that you have an inferiority issue, cause you’re just a boring specialty md and all the cool people (that do have quickies in the medication or supply room) often mistake you for beeing smarter then that.

    From what I can tell from your post, you’re probably not happy about beeing in medicine, and you’re trying to take it out on tv shows which are obviously NOT REAL…

    And people stop saying some show is “more” real then the other, that’s just stupid, it’s either fake or real.

    What this blog should of been about, is an example (or more) when the show house was wrong about what went on in it. Proving those special conditions were handled poorly by house and his team. That’s what I am interested about… I don’t care he’s addicted, it’s just a show he doesn’t get to really treat anyone…also what’s up with the porno ? you do know those are only sarcastic jokes that he makes. They never showed house watching pornography or in a serious situation about it, if you can’t see that, then I probably wouldn’t want you as my doctor.

    Once again, I am greatful for not living in the usa… people that go berserk on tv shows obviously is a new reason to write up on my DON’T GO IN THE USA list.

  25. Pat Fiat says:

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  26. hkjhk says:

    are u doctor?if so u most have taken ur degree in Amazonia because my doctor knows most of the diseases they talk about in the show…dude quit being an md is not for u and become a nurse….asshole

  27. kevinc says:

    i like the show House. its very entertaining and its an well written. of course its not going to be 100% real. the main actors would only have bit parts in it if so… this is a show that focuses on the diagnostic team. NOT the entire medical staff… although i do find it funny that Chase is the all mighty surgeon who can handle any surgical procedure… however his character is good for the show so im glad they kept him involved in some sort of capacity. as for people expecting YOU to do and know all the things Houses team on the show does… they are the immature ones… OBVIOUSLY that is the ENTIRE point of the show… that there is this suffering soul who happens to be a one of a kind brilliant doctor and diagnostion … thats the whole point … is that we would all love to think that if we were to be suffering from some horrible un explained illness, then we would happen to find a one of a kind doctor such as Greg House. obviously that is not the real world… or is it… i think there is SOME factual idealism with in the show… example… my mother a number of years back, checked into a local arizona hospital because she kept nearly fainting anytime she begin driving the car. they checked her out and said it was just a bit of a side effect from her acid reflux meds that she had been taking for the past year since the time she was diagnosed with acid reflux… interestingly enough… her acid reflux had been getting progressively worse the past couple of months before she begin the near fainting spells. while she was in the hospital they gave her some medicine to try and help with the headaches she had developed since she had arrived that they thought might be tied to an inner ear dissorder she had been diagnosed with a few years earlier as well… now is where it gets interesting… the medicine they started her on made her begin to get extremely ill and actualy begin some internal bleeding (so they thought) so they took her off the new treatment and said “the headaches would go away in time, and wrote off the internal bleeding as nothing more then the medication she was illergic to” and sent her out the door… this is all after running her through about 3 tests and an MRI. as she was about to leave a doctor not even working on her case noticed her struggling to get her footing as she got off the bed. she is pretty heavy and has a bad hip so her stuggling in most peoples eyes wouldnt be a big deal… but because he was being extra mindful having “heard about some of her other symptoms in passing” (he said) … he asked her “why is it hard to step down” she said “because my side hurts, its from the pain from my hip” he said “that shouldnt make your side hurt” he (personaly) ultra sounded her side immidiately, and found she had a gangreenous gullblatter … he told her she was littleraly an hour or less away from it busrting and that it would of killed her… once it was removed her acid reflux issues (she had had for a number of years), her headaches, and her near fainting spells, all went away…. oh and of course her side stopped hurting. the doctor that found the ultimate problem, figured that the reason she had been begining to faint when she was in the car was because the lumbar support on her back was pressing against her gulblatter which was so septic that it was causing her system to shut down.

    so i think there is SOME basis for defending the legitimatecy of the show. yes i realize that much of it is dramatized and non of it is actualy real… but the idea of a doctor addicted to pain killers and continuing his job is not that far out of reality at all… and pronography is not illigal the last time i checked… as well… i have been treated very rude by a number of doctors who think they are completely right and that the patiant is an idiot and a liar… the idea of all those extremely rare cases all in one hospital… that would be near immpossible… the idea of the MAIN diagnositic team all doing MOST all the work would be odd but not fully out of range of reality, if the whole reason a patiant came to that particualar team of specialist is because they were about to die and the specialist performing the blood work, administering the medicine, or doing some other thing that normaly a nurse or other doctor would do could be the difference between life and death because the specialist was knows they may be able to see something that a regualar doctor or a nurse would miss… then that is very possible. so i think in that light the show stands on its own two feet very well.

  28. kevinc says:

    sorry about the extra comment on here. but i had to comment on someone elses comment really quick…

    Kratos … that is funny stuff… well just so you know there ARE people who are specialists in ONLY working on breaks. but that poitn aside … i dont think someone needs to be a genius to be a doctor… however, i DO think they should be extremely passionate about their work. and that is what i love about House. the character of Greg House has a passion for figuring out the puzzle and he is infact a genuis. so that combination makes it impossible for him to give up… and that is the point of the show i think… that if someone had an illness that was undifinable by most ‘text books’ that there would be some doctor who was so intent on solving our case and connecting the various knowlege he/she had learned and studied on over the years, that our lives or the lives of our loved ones would be saved before it was too late. the other gift they present Hosue with possessing, is the ability to properly delegate and manage egos. this is actualy symbolic of a specific personality trait called “melancholy” … people with this personality type tend to be detached and far less social or sometimes possesses little to no social skills, yet are intent studiers of what interests them. they also tend to be the best at delegating tasks and understanding what makes others tick, and have NO interest in being noticed for their work… only getting the pieces of the puzzle put into place for their own sanity. i would hope that EVERY doctor would take their job serious enough to understand that patiants lives are in their hands. but one cannot expect every doctor to be a genius … its a nice thought Kratos, but unrealistic with all the people who need someone who just has a basic knowlege of medical facts… but it WOULD be awesome if there were some true Genius doctors around … like one at each hospital in the world. that would be really cool.

  29. J says:

    House is such a jerk I can’t believe people can get past even just his continually smug face ready to speak something something Diasblo-Cody-ish.

  30. mannerly says:

    Speak for yourself about the quickies in the supply room and the partner swapping. Ha.

  31. Bob says:

    Now that I have Sling technology with DISH Network, I can use my iPhone to see all the shows of House from my DVR anywhere I have a 3G connection. Being that I am a customer and employee of DISH I can’t recommend the TV Everywhere feature enough to anyone on the go!

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  35. neutrinoide says:

    If you think Dr house was about medical mystery. You are a simpleton.

  36. It is natural that things were a little bit exaggerated in the name of a good spectacle but at least the TV program inspired many people to pursuit a medical career and now more doctors prefer multidisciplinary approaches. I heard the House MD production team used a symptom checker called ESAGIL (http://esagil.org) for medical diagnosis.

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  50. Kumar says:

    I know you’re trying to make a point that House is not a portrayal of a typical hospital setting. But I find that redundant and misleading. The show never portrayed the setting as normal. They repeat it over and over again that it’s the only place in the country where doctors get to do what they do. In fact, in one episode House says that he is the first one to have the job. He says that to Thirteen. This is similar to how Sherlock claims to the be first consulting detective in the world; Sherlock Holmes is not a normal detective.

    Also, there are several mentions in the show of house getting fired multiple times before his job at Princeton Plainsboro.

    Not every scientist invents something as impactful as Einstein. Einstein is not a typical scientist. Not every graduate recommendation reads, “He is a mathematical genius.”

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