Academic Paper: The Evolution of America’s TV and Film Doctors from 1960-2017

The Evolution of America’s TV and Film Doctors from 1960-2017
Meghan Bayer
University of Pittsburgh
22 June 2017

In the mid-1950’s, television viewers were introduced to a new genre of television. The new shows were primarily set in the hospital when doctors and nurses frantically scramble around to save their patients. Sometimes they would be successful in protecting their patients, and sometimes, despite their best efforts and technology, the patient would end up dying. As with most things, medical dramas have evolved since the first one aired in the 1950’s. Starting in 1961 with Dr. Kildare and Marcus Welby, M.D., continuing with Emergency! from the 1970’s, and moving into Awakeningsand Patch Adams from the 1990’s, before finishing up with the modern shows like Grey’s AnatomyHouse M.D., Private Practice, and The Doctors.
There have been many changes over the past nearly 60 years, but for the purposes of this paper, the following will be addressed: the gender differences of the TV physicians of 1960’s to the TV physicians of 2000’s, the differences in the portrayals of doctors in movies vs. televisions shows, the differences in the behavior of physicians on talk shows vs. those on medical dramas, the transition from a focus on the patient to a focus on the private lives of doctors, the changes made to TV medical dramas in hopes of making them realistic without allowing the show to be boring and modifications to the places in which doctors practice medicine. Doctors are often made out to be savior figures with a God complex because they are in fact handling lives and making decisions that determine who lives and who dies. Also, doctors have evolved, and the setting in which they practice has changed as well. Doctors can practice in hospitals, clinics, and a variety of other unconventional places. With a broad range of media texts covering different types of medical shows, many trends and changes to the role of the doctor on television or the big screen.
The first significant trend I want to explore is the gender differences of TV physicians of the 1960s to the TV physicians of the 2000s. Three of the most popular TV shows of the 1960’s and 1970’s are Dr. Kildare, Marcus Welby M.D., and Emergency!. In all these television shows, the doctors are all males and nurses are all female. The two leading doctors in Dr. Kildare are Dr. Gillespie and Dr. Kildare, who are both males. All of the nurses on the show are women, and the attendants (patient care technicians) are male as well. (Comack, 1971) In Marcus Welby, M.D., the two principal physicians are Dr. Welby and his assistant, Dr. Kiley. Their secretary-nurse Consuelo Lopez assists them. Again, we see that the males play the role of doctor and the females play the role of the nurse. (Victor, 1969) Similarly, in the 1970’s television series Emergency!, the two most prominent physicians Dr. Brackett and Dr. Early are both males, and Nurse Dixie McCall is a female. Even though they aren’t doctors, it is worth mentioning that paramedics John Gage and Randolph Mantooth are both males. In the 1970’s, women were not allowed to serve in emergency medical services (EMS). It wasn’t until the 1980’s that they started to fill that role by proving they could be “one of the guys and lift like the guys.” It is important to note this because this is one of the smaller details that changes across the decades. Women become more involved in a variety of different medical capacities. (Webb, 1972)
In the early 1990’s, we start to see a transition to some female physicians with the release of the movie Awakenings. While the main character, Dr. Oliver Sacks is a male, there are minor supporting roles in which we start to see a few female doctors every once in a while. (Marshall, 1990) Patch Adams, released in 1998 continued the integration of women as doctors with the addition of many female medical students in Adams’ medical school class. While they weren’t technically doctors yet, they were taking serious steps to achieve that goal, something we have not seen much of in the previous 25-30 years. (Shadyac, 1998)
Today, House M.D., Grey’s Anatomy, Private Practice, and The Doctors, like most modern medical dramas, have a mix of male and female doctors, as well as male and female nurses. House’s team consists of himself, Dr. Foreman, Dr. Chase, Dr. Cameron, Dr. Kutner, Dr. Taub, Dr. Hadley, Dr. Masters, Dr. Adams, and Dr. Park over the course of the show. That’s a total of six males and four female doctors in a primary role. Additionally, the head of the hospital, Dr. Lisa Cuddy, is also a woman in a position of power. On the show, there is a mix of male and female nurses primarily in the roles as extras. (Shore, 2004)
On Grey’s Anatomy, the gender of the doctors, residents, and interns is almost a 50/50 split with some individuals from both sexes serving in positions of power. Dr. Miranda Bailey serves as the Chief of Surgery, Dr. Richard Webber serves as the Chief of Residency, Dr. Meredith Grey is the Chief of General Surgery, and Dr. Alex Karev is the Chief of Pediatric Surgery to name a few people in leadership roles. As demonstrated, the split is roughly 50/50 on Grey’s Anatomy for doctors, and while there are several male nurses on the show, it seems that there are more females overall. However, that was difficult to quantify because all the nurses are supporting roles and primarily extras that frequently change. The main character for which the show is named is, in fact, a female as well. Regarding equality on the show, Grey’s Anatomy is one of the most balanced shows currently. (Rimes, 2005)
Private Practice, a television series directed by Shonda Rimes, the same director that brought us Grey’s Anatomy, developed this series as a spin-off of the successful Grey’s series. However, the show was disappointing to many of the people that had fallen in love with the original series. Again, the main character, Dr. Addison Montgomery is the head of the practice and happens to be female as well. The female doctors (Dr. Naomi Bennett, Dr. Charlotte King, and Dr. Amelia Shepherd) outnumber the male doctors (Dr. Samuel Bennett, Dr. Cooper Freedman, and Dr. Pete Wilder) four to three. Also, the practice has a female psychologist, Violet Turner.  In this series, Shonda Rimes brings some serious girl power to the entertainment industry. (Rimes, 2007)
The cast of The Doctors is constantly changing, but there is usually at least two females in the group of five to six doctors depending on the episode. The males have always outnumbered the women on the show. (Hermstad, 2008)
One of the most noticeable differences is the portrayals of doctors in movies vs. televisions shows. In both, they are often seen as savior figures because they are supposed to save lives. Doctors seem more human when they get scared or cry, but in the public’s eye, they are not expected to be allowed to cry. They get scared too and research backs this up. Did you notice that most of the conditions that House and his team diagnose are either neurological or infectious in nature? The neurological diagnosis is the diagnosis that they try to stay away from the longest. This is a phenomenon that medical students and young doctors are afraid of diagnosing neurological disorders known as neurophobia. So they will pursue any diagnosis other than the neurological diagnosis. This neurophobia is believed to affect some of the logical processes of doctors. The presence of this phenomenon portrays doctors as being scared individuals. Being scared or having emotions is not always a bad thing either. Emotions are useful for doctors to allow them to connect to their patients. Although these moments are often rare and fleeting, they can be comforting to the patient. Neurophobia is demonstrated in many episodes when the doctors always include lupus in the differential diagnosis. Generally, lupus is not a neurological disorder, which might explain why the doctors are always hoping that it is lupus. It is less scary to them. (Thomas et, al., 2009)
Many of the TV doctors have a God complex or a sense of superiority. Over the last 60 years, differences in the ways doctors treat their patients and their colleagues have developed. For instance, Dr. Kildare starts out as a bumbling resident and eventually becomes an excellent, cool doctor by his third year (season 3) of practicing. On the other hand, Dr. Meredith Grey was smooth, even as a resident, but has more of a God complex. Kildare and his assistant Dr. Kiley seemed more human than many of the modern TV doctors. The same can be said for Dr. Brackett from Emergency!, who is an incredibly kind, humble, and personable doctor. (Webb, 1972) Patch Adams is one of the last movies with a doctor who is not extremely full of himself. He cares for the kids and not only does he want to heal them physically, but he also wants to heal them emotionally too. (Shadyac, 1998)
While Lawrence and Jewett’s have a definition for the classical monomyth and the American monomyth, it leaves the potential for a third category to arise. This third monomyth could be an average person in an average world filled with problems that responds in an incredible (seemingly supernatural or superhuman) way. Some doctors on TV fit this description, in that they are average people in an average world, but they have a capacity to save lives in their line of work. Now saving lives and improving the individual’s quality of life is their job. However, it is not something that everyone gets the opportunity to do. Therefore, it could be perceived as “superhuman,” especially when the odds are stacked against the patient and the doctor does something radical to save their life. Some modern examples of this type of monomyth would be Meredith Grey, Dr. House, Dr. Brackett from Emergency!, and Dr. Montgomery. Lawrence and Jewett’s definitions of the classical monomyth and the American monomyth don’t work particularly well to describe doctors. (Jewett et, al., n.d.)
In the last two decades or so, a new type of medical show has become popular daytime television. On these shows, real life doctors treat real life patients on the air. This has led to some differences in the behavior of doctors in medical talk shows and those on medical dramas. On medical talk shows, they refer out to other doctors for treatments, like on The Doctors and the Dr. Oz Show. (Oz, 2009) On medical dramas, it’s a story, and within that storyline, patients are treated, but treating the patient is not usually the priority. However, on talk shows, they are dealing with real people that are being affected by real life medical problems. For example, on one episode of The Doctors, a patient with complex regional pain syndrome, a neurological pain syndrome, is featured. On the show, they briefly discuss her history with the syndrome, before offering her several therapies at no expense to her to try and treat her condition.  In this case, there’s no do-over if they mess up a treatment or an intubation versus doctors on medical dramas. It can be difficult to compare the two because you are comparing real life doctors with real patients to doctors played by actors to patients played by actors, but there are still some fundamental differences between the two. (Hermstad, 2008)
Another notable transition has been a shift from a strictly professional portrayal of a doctor to a focus on the private lives of doctors. Obviously, doctors are human, so like us, they are going to have personal problems. The shift has been from not divulging any details about the doctor’s own life to telling viewers everything about their personal lives and relationships. Grey’s Anatomy is full of failed relationships and divorces (Callie and Arizona, April and Jackson), marriages between two staff members (Meredith and Derek, April and Jackson), sibling rivalry (Derek and Amelia), death of friends and staff members, traumatic tragedies (plane crash that killed Izzy, injured everyone onboard, and caused Arizona to lose her leg, Derek’s death by car accident), and being sent to jail (Karev). These are some of the major personal aspects explored by the shows, but there are a variety of smaller everyday things the doctors deal with as well. (Rimes, 2005) In House M.D., Wilson deals with a cancer diagnosis, Cuddy deals with adopting and raising a kid, while trying to run a hospital and keep House from getting arrested, House deals with chronic pain, a Vicodin addiction and being arrested, Thirteen is diagnosed with Huntington’s Chorea, the genetic disease that took her mother as a child, Chase deals with family problems, and Foreman deals with racial discrimination as a result of being African-American. (Shore, 2004) They all have issues. In Dr. Kildare, Marcus Welby, M.D., Emergency!, and Awakenings, the doctors were portrayed in a strictly professional manner. The focus was always on the patients, and while the doctor may have personal issues going on, they were never revealed to the patient or the audience. From 1960 to 2017, we have a seen a shift from a purely professional portrayal to the revelation of more details about physician’s personal lives.
In early times, when medical technology wasn’t as sophisticated, the number of errors made on television was substantially less. As a result, we have seen significant changes in the type and amount of medical inaccuracy of TV medical dramas. Today, we see CT scans upside down, nasal cannulas, and stethoscopes on backward, medical procedures being done out of order, and doctors calling out the wrong dosages of medications. The average layperson would not know that a lot of this stuff is happening, so the entertainment industry can get away with these inaccuracies, but for those of us with medical training, it frequently makes us scratch our heads. Many directors hire real-life doctors to provide medical advice for the show to make the show as accurate as possible. The majority of these errors were not issues for Dr. Kildare and Marcus Welby, M.D. because the technology was not yet used and the shows were much simpler regarding illnesses and treatments.
Some shows are very realistic, but the majority are overly dramatized. Now, dramatization is critical to the success of most medical dramas, but Scrubs is proof that it does not have to be the whole series. Statistically speaking, Scrubs is the most realistic modern medical show, from the way the doctors act toward their patients, the way they act towards each other, the medical procedures, and the general running of the hospital. (Lawrence, 2001)  It is not as dramatized as some of the other modern shows, like Private Practice or Grey’s Anatomy and it has the lowest average of medical inaccuracies. (Tapper, 2010)
One fundamental difference that we have seen in medical dramas from 1960 to the present is the setting in which the medical care takes place. For most of their history, medical dramas have been traditionally set in a hospital. Then, in 1972, the world was introduced to the very successful military medical drama, M.A.S.H. One of the main reasons why M.A.S.H was so successful is because not only did it focus on the military, but it also came during the period where the United States was involved with the highly controversial war in Korea. However, the launch of M.A.S.H marks one of the first times that medical care is taking place outside of a hospital in a large tents or field hospitals. Many of the patients on the show are younger men who have been injured in the line of duty. Almost all of them require surgery. The majority of the show is spent addressing the war and the number one injury on the show, gunshot wounds. There is minimal variability in the conditions that these medics are treating, which is believed to be a part of the reason the show lost some steam with the American public after running for 11 seasons. With the change in the medical setting, we see a shift in the credentials of the people treating patients. In the Army, the majority of medical personnel are medics, meaning they’ve received extensive medical training, but most have not gone to medical school to become a doctor. There are a few doctors on the show, but the majority are medics, and this was a new concept for TV viewers. While M.A.S.H was very successful, the repetition of the same injuries each episode combined with the lower level medical skills of the characters led to the show’s end in 1983. (Gelbart, 1972)
One of the lesser known, but still successful medical shows is a British television series called Doc Martin. The pilot episode premiered in 2004, and it ran for seven seasons. The main character, Dr. Martin Ellingham is a surgeon in a London hospital when he suddenly becomes afraid of blood. This causes him to move to the small fishing village of Portwenn and open up a clinic. His social awkwardness and bluntness frequently get him in trouble. He pushes everyone that cares about him away until he finds the love of his life and they have a child that he comes to adore. During this main storyline, he is taking care of patients in his surgery. As long as there’s no blood, he is fine. The sight of blood causes him to gag and sometimes vomit, an irony that makes the show so amusing. While he is working in his small freestanding clinic the majority of the time, occasionally he will head out into the community to care for people in their homes. This clinic is several hours from a hospital, so Dr. Ellingham is forced to deal with the majority of medical cases, no matter how big they are. The series ends with the family of three living happily ever after. The majority of Doc Martin after the pilot episode is set hours from a hospital and that makes for an environment challenging to even the most skilled of physicians. This is the single most impressive aspect of the series. There is speculation that the series will be revived within the next year or two and it remains to see what is up with Doc Martin, his family, and the people of Portwenn. (Minghella, 2004)
2009 brought Royal Pains, the popular medical drama featuring brothers Hank and Evan Lawson. Dr. Hank starts out at a hospital in New York, and when he decides to save a kid over the hospital benefactor, his superiors are angered, and he is fired. After a year of pouting, he is convinced to come to The Hamptons and open up a concierge medical practice. This means that while Hank is occasionally at the hospital and can send patients to the hospital for additional testing, he primarily sees them in their home or wherever they are when illness or injury strikes. While Hank always has at least one patient with a dramatic past, he is always on standby for an older man with a fatal genetic disease. Because of this gentleman, Boris, is so rich and people want him dead, there is always drama in Hank Lawson’s life. The show is about 50/50 medical and personal life. In his own life, Hank is dealing with girlfriends, Boris, his brother’s awful financial advice, and the repeated imprisonment of his father. Just when he thinks he has life figured out, something else happens to rock the world again. This split between a medical drama and a comedy made the show successful, as it ran for eight seasons before concluding its run. (Rauch, 2009)
In 2011, the TV show Hart of Dixie premiered, and it featured a young, ambitious surgeon named Dr. Zoey Hart who is brought to Alabama against her will to run her father’s medical practice with his unpleasant longtime partner. In the heart of the south, the medical clinic is small, freestanding facility in a town called Blue Bell. There’s no hospital affiliated with it and the capacity to perform procedures and tests more than something simple is severely limited. In fact, other than a few small exam rooms, a waiting room, and a reception desk, the clinic is not all that big. In fact, it serves as a primary care place for routine checkups more so than for acute care. While Dr. Hart and her partner are capable of caring for many ailments and injuries, the facility is not very sophisticated, thus limited their scope of practice. This differs drastically from other modern shows like Scrubs and Grey’s Anatomy where they are always near the next level of care, machines required for testing, specialists, and nearby operating rooms that are available should they become necessary. (Paymer, 2012)
Additionally, it is not infrequent that someone in town is seriously injured, for instance, in a farming accident, and they get trapped. Whenever there is a substantial injury, Dr. Hart is usually called to the scene to help out. The medical care is coming to them, which is not an unusual thought as we have EMTs and paramedics in most areas. However, the average doctor does not make house calls. All of this leads to exciting drama, and as I mentioned earlier, there is a heavy focus on the personal lives and interactions of the doctors versus the actual medical aspects. Hart of Dixie is so different from other medical dramas, and it has such a heavy focus on the personal issues instead of the medicine that I am reluctant to call it a medical drama, but there is certainly a strong medical component. (Paymer, 2012)
Call the Midwife premiered in 2012 and it is currently in its seventh season. This show is unique in that while it is filmed in the 21st Century, it is set in the early to mid-1950s. Set in one of the most impoverished areas of London, Call the Midwife follows the journey of a young nun living in a convent that specializes in providing midwifery to lower income women. The focus of the show is primarily about the struggles of the sisters to keep their facility running more than personal turmoil. However, every once in a while, an episode will focus on the private lives of the midwives. The medical care provided is always exclusively midwifery, and the nuns make house calls. Very rarely does someone come to their facility to give birth. The idea is that they got to where they are needed the most in the community. (Lowthorpe, 2012)
The medical sophistication is non-existent. There are a few simple tools they keep in their bags, but they rarely use them. Most of the time they can get by with ordinary household items like towels, blankets, hair clips, and scissors. Unlike the other two TV shows I mentioned, all of the medical care in Call the Midwife takes place in the patient’s own home, which in the mid-1950’s is not as radical of a thought as it is now. This series has found ongoing success because the ideas behind it are so novel to us today. If someone were to watch this period drama in the 1950’s, they probably would not find it as appealing. (Lowthorpe, 2012)
Many complex changes and trends have taken place over the past 60 years, but some of the most notable ones are: the gender differences of the TV physicians of 1960’s to the TV physicians of 2000’s, the differences in the portrayals of doctors in movies vs. televisions shows, the differences in the behavior of doctors on talk shows vs. those on medical dramas, the transition from a focus on the patient to a focus on the private lives of doctors, the changes made to TV medical dramas in hopes of making them realistic without allowing the show to be boring, and changes to the setting in which doctors practice. There is no shortage of media texts consisting of various types of medical shows which allow us to track and study the many trends and changes to the role of the doctor on television and the big screen.

References
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Lawrence, W., IV (Director). (2001). Scrubs [Television series].
Lowthorpe, P. (Director). (2012). Call the midwife [Television series]. BBC.
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Tapper, E. B. (2010). Doctors on display: The evolution of television’s doctors. PMC. Retrieved June 5, 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2943455/.
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