Back to Front PageVOLUME 6, NUMBER 4

Lights, Camera, and Constant Action Academic Medicine Moves to Prime Time

caption: Duke University Medical Center took center stage in the Discovery Channel's "Hospital" series. In this image, Duke's Greg Georgiade, M.D., removes sutures from a child who underwent cleft lip surgery. Photo: Discovery Channel

Television networks are finding that the truth can be more interesting - or at least generate higher ratings - than fiction. The wave of reality shows flooding TV has not left academic medical centers untouched. The Discovery Channel, the Learning Channel, and ABC, among others, have recently brought the real-life drama of academic medicine to living rooms. But why are teaching hospitals offering their inner workings to scrutiny, and how does this exposure affect their work and missions?

One major boon of reality TV, say the medical centers that have been showcased, is its potential to convey the day-to-day workings of academic medicine in a way that is personal and compelling. "The show not only helps educate patients, but it educates the population as well," says Gary Stiles, M.D., vice president and chief medical officer of Duke University Health Systems.

Since last September, Duke University Medical Center has been the star of the Discovery Channel series "Hospital," which concentrates on patients' diagnoses and treatments as well as the personal interactions between doctors, patients, and family members. Duke granted Advanced Medical Productions, the producers of "Hospital," unprecedented access to its facilities.

Dr. Stiles says the series illustrates academic medicine's missions of education, research, and patient care - and how they are becoming increasingly difficult to achieve. "Our system teaches the next generation of health care providers, provides a setting for research, and gives medical care to the community, but we don't get reimbursed for all of it. Now people can understand that extra dollars from Medicare are not a handout but help fulfill our missions."

Getting the message out about academic medicine was part of the impetus behind Duke's willingness to go before the camera. Dr. Stiles believes academic medical centers should use all possible forums to educate patients about health, the disease process, the academic health care system, and patient responsibilities.

He adds that reality TV doesn't gloss over the pain and difficult decisions inherent in academic medicine. Showing the whole story even if it doesn't have a happy ending helps viewers understand the ups and downs and emotional struggles academic physicians encounter daily.

What was the experience of being filmed liked? While she admits to finding it unnerving at first, Kathleen Clem, M.D., Duke's chief of emergency medicine, got used to the camera crews that became a regular fixture in her department. "I was glad I was able to show that the great majority of doctors really care for their patients, despite practicing in a difficult environment." Dr. Clem isn't famous because of "Hospital," but she says more Duke staff and patients recognize her. "That's a positive thing."

In 1999, Johns Hopkins agreed to be filmed by ABC around-the-clock for three months. The result, "Hopkins 24/7," aired in September to critical acclaim. Joann Rodgers, Johns Hopkins director of media relations, says collaborating and participating on a project this extensive required staff buy-in throughout the ranks of a system that has 16,000 employees and thousands of patients and visitors at any one time.

"There was an intense amount of internal communication and meetings prior to shooting an inch of tape," Rodgers says. Before any academic health system agrees to this type of exposure, she recommends that its administration be willing to place enormous resources into the coordination and commitment of the program and to negotiate with producers and colleagues to build trust.

Even though staff met regularly with the production team, Hopkins didn't control the outcome and not all of its community liked all of the show's portrayals. But Rodgers argues that the show has enormous credibility because it is an independent look at what academic medical centers do every day.

"There's a lot of misperception about what we do and why we are so expensive. We thought this was an opportunity to get people's attention and make Hopkins a character in a larger story about academic medicine," Rodgers says.

Duke and Hopkins are not the only academic medical centers to open their doors to television crews. In 1995, for example, the producers of the Learning Channel's "Trauma: Life in the ER" brought their cameras to the University of Pennsylvania. The most important element to the success of such a project, says Roseann Thompson, senior press officer at the University of Pennsylvania Health System, is staff buy-in throughout the process, including consent prior to the project.

While the popularity of NBC's fictional "ER" has spurred interest in academic medicine, it may have given some false impressions and made it even more important to educate the public about what physicians really face in a high-volume, inner-city emergency room, Thompson says. "The more people who realize the kind of care we provide, the more people we can help," she adds.

Feedback from all three shows has been overwhelmingly positive. While no one can measure the impact of these shows on the missions of health centers, all report numerous letters and e-mails from the public. Rodgers adds that "Hopkins 24/7" has been an enormous internal morale boost for the medical center, with employees extremely proud to be associated with the series. For its part, Duke has received a number of inquiries from people seeking copies of the show and information about featured diseases.

But Rodgers cautions against pinning hopes for increased funding or even goodwill on such shows. "You can't use prime-time, network television to solve your problems; a show isn't going to help you raise money. What it is going to do is help you tell the public a story that makes communities and the nation more fertile ground through which we can grow our mission and bring recognition to the things we need supported by the public."

- Jennifer Proctor

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08 February 2005