Do Doctor Dramas Make for Bad Docs?

The following of medical television dramas among doctors-to-be has been under increased scrutiny in recent weeks as a study by Canadian physicians published in the journal Resuscitation showed that many medical students do not know how to insert a breathing tube into a patient properly -- and that in addition to citing poor training, many medical students also mentioned that they had learned from television medical dramas.

The authors went through two seasons of "ER" to observe the insertion of breathing pipes -- known as intubation -- in episodes and found that of the 22 times the procedure was performed in a typical situation and was visible to the cameras, it was never done properly.

"While few would suggest that medical dramas can be held responsible for physician performance, it has been previously suggested that they can significantly influence beliefs," the authors wrote.

Intubation is a particularly suspect procedure for learning through television because it is not often taught as part of the required medical school curriculum. Many doctors will not have to perform it in their specific areas, so it is typically taught during anesthesia training or in emergency medicine electives, and it is often used in emergency situations, which makes it a prime action for television.

For Doctors, Practice Makes Perfect

"Intubation is one of the many skills that physicians use with patients, and it's one of the skills where there is a life and death component," said Sinz, noting that it needs to be done both well and quickly.

For real doctors, it takes plenty of practice to get it right.

"It takes about 10 to 20 intubations to learn how to intubate someone relatively safely and relatively successfully," said Dr. William Hurford, chairman of the department of anesthesiology at the University of Cincinnati Medical Center.

In his hospital, Hurford said, students are shown a video, and are then taught repeatedly in a simulated setting before doing it for real in the emergency room, preferably under less stressful conditions, which is not always the case.

"A lot of physicians learn in a code situation," said Hurford. "We obviously don't encourage that."

Hurford noted that while he knows students watch medical dramas, they have never used what they see on TV as an excuse for an improper intubation.

"They've never given me that excuse. ... Maybe they're just too embarrassed to admit it," he said.

Real Doctors on Fake Television

But while doctors' learning in the wrong place is a newer alarm, there has long been a worry about the impression medical dramas give patients about doctors.

A 1996 study published in the New England Journal of Medicine found that successful CPR was performed on television 75 percent of the time, while even optimistic estimates suggest it will only revive someone 15 percent of the time.

The authors noted that this might give the public unrealistic expectations, although, as Dr. John Lantos told, they could never prove this.

The drama of a television show, said Lantos, a professor of pediatrics and bioethics at the University of Chicago and at the Center for Practical Bioethics in Kansas City, Mo., can help teach doctors about some medical issues, even if not the procedures.

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