Do TV Medical Dramas Skew Patient Perceptions of Quality Care?

February 20, 2018 - Medical dramas on television are obscuring patient perceptions of quality care and expectations of a positive hospital experience, creating what some researchers are calling the “Grey’s Anatomy” effect, according to a new report published in BMJ Trauma Surgery & Acute Care.

This effect can have a negative impact on patient satisfaction scores, which tend to falter when healthcare professionals do not meet patient expectations for care and treatment.

Previous research has indicated that patient perceptions of healthcare are skewed from watching medical dramas on television, the researchers explained.

“Cultivation theory suggests that the portrayal of social reality on television ultimately shapes the viewer’s perception of social reality in real life,” the research team said. “As a result of the artistic license taken with the presentation of doctors, patients, and illness on television, viewers of medical dramas may develop a distorted perspective regarding prevalent health issues in the real world.”

To their credit, medical drama writers do consult healthcare professionals to ensure accuracy of some elements of the medical plotlines. While storylines are clinically accurate, the time constraints and necessity to create intriguing storylines have led to some warped perceptions of the healthcare experience.

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“The public’s familiarity with the real-life hospital course and recovery from major injury is limited to personal experience, so it is conceivable that, for many, expectations are largely shaped by the portrayal of traumatic injury on television,” the researchers explained.

“Given the suddenness of physical trauma, there is no opportunity to pursue reputable sources of medical information to help prepare one for a hospital stay and/or operative procedure (unlike in the setting of other illnesses, such as cancer), resulting in further reliance on perceptions from mass media.”

The team specifically sought to understand how medical dramas skew the perceptions of trauma care. Patients undergoing treatment for a traumatic injury do not have time to research their medical conditions prior to hospitalization, meaning many of them rely on the experiences they have seen on TV.

The researchers viewed the 269 episodes from the first twelve seasons of popular medical drama “Grey’s Anatomy.” The team recorded certain elements of the fictional patient experience including recovery time, mortality, use of long-term care facilities, and triage of care into the operating room (OR).

The researchers identified fictional patients experiencing hospital stays less than one week by using temporal cues from the show.

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“If a patient’s hospital course was resolved within what appeared to be less than one week per the episode’s temporal cues, and the patient did not reappear (still hospitalized) in subsequent episodes, then that patient’s length of stay was deemed less than one week,” the researchers said.

The team then compared this to actual data on trauma treatment and recovery from the 2012 National Trauma Databank (NTDB) National Program Sample.

In total, the researchers analyzed 290 fictional characters from “Grey’s Anatomy” and over 4,800 real patients from the NTDB dataset.

Mortality was higher on television than in real life, with rates reaching 22 percent on “Grey’s Anatomy” compared to 7 percent on the NTDB dataset.

Most TV patients went straight from the emergency department into the OR, at a rate of 71 percent compared to 25 percent in real life.

Only 6 percent of “Grey’s Anatomy” patients transferred to long-term care facilities following trauma care, compared to 22 percent of real life patients.

Half of television trauma patients stayed in the hospital for one week or less, compared to 20 percent of real life patients with the same length of stay.

This portrayal of rapid recovery can lead patients to believe that their own treatment will be quicker and easier than it actually will be. Creating this false reality can be a detriment to patient satisfaction. Patient satisfaction is often defined has the providers’ ability to meet patient expectations of care.

When providers do not meet these expectations, patients may perceive their care as subpar.

“In an era where patient satisfaction is a major component of the quality initiatives of healthcare institutions and a pay-for-performance measure in many physician compensation plans, it is important to develop awareness of the drivers of patient satisfaction,” the researchers pointed out. “Divergence of patient expectations from reality may, in fact, contribute to lower levels of satisfaction.”

There are some pitfalls to the study, the researchers acknowledged. Although the research team determined that trauma care outcomes are different on television than in reality, there is scant evidence confirming that this disparity actually influences patient perception of care.

“In fact, patient’s expectations after injury in general remain relatively unclear, and exploration of this area may offer insight that could lead to both improved patient satisfaction and engagement in the recovery process, ultimately leading to better outcomes,” the team asserted.

Going forward, the researchers are looking into understanding baseline patient expectations for care, including expectations for trauma treatment. Additionally, the team will be evaluating how well healthcare providers meet patient needs related to patient-provider communication, return to home care, and return to everyday functionality.