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How ‘Grey’s Anatomy’ affects patient expectations — and hospital policies

“The balancing act between the presentation of the realistic and the dramatic can actually result in a skewed perception of reality among television viewers,” the researchers stress.

Ellen Pompeo in a scene from the television program "Grey's Anatomy."
Photo by Derek Johnson/ABC

Spoiler alert: “Grey’s Anatomy,” the long-running hit ABC hospital drama, gives viewers a distorted impression of the realities of trauma care, particularly the speed with which patients recover from their injuries and go home.

The TV show, which takes place in the fictional Seattle Grace Hospital (known as Grey Sloan Memorial Hospital in more recent episodes), also has its trauma patients dying at a rate that’s three times higher than in real-world hospital settings.

Those are just a couple of the findings from research published Monday in the online journal Trauma Surgery & Acute Care Open.

Yes, you could argue that this is another “duh” study. It seems so obvious, after all, that television medical dramas distort what really goes on in hospitals. But understanding that distortion is important, as it can have some real-world effects: It can make people less satisfied with their own health care.

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“This is particularly relevant for trauma patients and their families,” write the authors of the study. “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.”

“Given the suddenness of physical trauma, there is no opportunity to pursue reputable sources of medical information to help prepare on 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,” they add.

Previous research has demonstrated that point. One study found, for example, that “Grey’s Anatomy” and other medical TV dramas tend to lead people to have overly optimistic expectations about the medium- to long-term outcomes that patients experience after receiving cardiopulmonary resuscitation (CPR) and to expect (incorrectly) that the success of CPR is equal across all age groups. 

Other research has found that not only do regular viewers of “Grey’s Anatomy” believe the show’s content to be credible, they also tend to perceive the show’s storylines to be realistic, a perception that was associated with a belief that real-world doctors are “courageous” — and with the viewers’ level of satisfaction with their own doctors.

Study details

For the current study, researchers from St. Joseph’s Hospital and Medical Center in Phoenix had two physicians and a nurse practitioner review all 269 episodes from the first 12 seasons (2005-2016) of “Grey’s Anatomy.”  Those episodes featured 290 trauma patients. The reviewers recorded demographic information about the patients (such as age and gender), as well as information about their injuries and what happened to them after they left the show’s emergency department  — whether they were sent to the hospital’s intensive care unit, for example, or right to the operating room.

The reviewers also calculated an Injury Severity Score (ISS) for each patient based on the show’s description of the injuries, and they estimated how long each patient stayed in the hospital. Length-of-stay was divided into two categories: less than or greater than a week.

The researchers then gathered similar information on 4,812 real patients from a national trauma databank.

The next step was to compare the portrayal of trauma experienced by the TV patients with the actual trauma sustained by the real-life patients. Here’s what the researchers found:

  • 71 percent of the TV patients went right from the emergency department to the operating room, compared with 25 percent of the actual patients.
  • 22 percent of the TV patients died compared with 7 percent of the real-life patients.
  • Among the TV patients who survived the trauma, only 6 percent were transferred to a long-term care facility, compared with 22 percent of the real-life patients.
  • Among the TV patients with serious injuries, 50 percent spent less than a week in the hospital, compared to 20 percent of the actual patients.

The severity of the patients’ injuries was relatively higher on television (an ISS of 14 versus 12 in real life). The TV patients were also more likely to be younger than their real-life counterparts (an average age of 34 versus 41) and female (30 percent versus 40 percent).

Avoiding false expectations

The study’s authors acknowledge the reason TV medical dramas don’t accurately reflect the real-life experiences of trauma patients: the shows require dramatic storylines — ones that have to be wrapped up within an hour.

Still, the public needs to be aware that such shows are not all that realistic.

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“The balancing act between the presentation of the realistic and the dramatic can actually result in a skewed perception of reality among television viewers,” the researchers stress.

For example, “trauma patients as depicted on television dramas typically go from the emergency department to the operating room, and survivors usually return home,” they explain. “[Yet,] as anyone involved in the care of patients at a regional trauma center knows, real-life patients are often managed non-operatively or with operations (sometimes multiple) performed at an interval to the time of admission, and depending on the burden of the injury, often require prolonged hospitalization and have disabilities requiring transfer to long-term inpatient facilities.” 

Doctors and hospital administrators also need to be aware of TV’s impact on patient expectations, the researchers add, for patients may blame the hospital and its staff if their experience with trauma departs much from what they’ve seen on shows like “Grey’s Anatomy.”

“Divergence of patient expectations from reality may, in fact, contribute to lower levels of satisfaction,” the study’s authors point out. 

That’s important to know, they stress, because patient satisfaction has become a major driver behind many hospital initiatives and policies.

FMI: You can access the study in full on the Trauma Surgery & Acute Care Open website.