House MD: Good Ratings, Bad for Medicine

May 12, 2009

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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