The House Effect: Are Real Patients Misled by TV Docs?

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FOX / Everett

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But the question is whether dramatic devices on television have any bearing on the perceptions of real-world viewers. If past research on the impact of entertainment is any indication, it wouldn't be surprising if they do. One study in 2007 identified what has become popularly known as the "CSI effect": because of the public's increasing familiarity with technology and the importance of scientific evidence — due in part to media coverage of real scientific advances as well as the trumped-up technology on TV shows like CSI — juries have become more demanding of forensic evidence in courtrooms. In the study of more than 1,000 people who had previously served on juries, many said they would vote to acquit if no such evidence was presented, even if they otherwise believed the defendant to be guilty. A 2009 report by the National Academy of Sciences further found that the CSI effect was helping to foster a misguided sense — even among judges and lawyers — that forensic evidence is infallible.

Does this effect translate to the field of medicine? Past research suggests that TV docs can sometimes serve as educators. A 2007 study looked at the effect of a single episode of the long-running medical drama ER on viewers' understanding of their own health. Researchers from the University of Southern California found that an episode in which a teen girl was diagnosed with high blood pressure and encouraged to eat more fruits and vegetables appeared to edify the audience, resulting in self-reported healthier eating habits and a better understanding of hypertension and weight issues among surveyed ER viewers.

In some cases, people may grasp health information better when it's presented as fiction rather than fact. A study published in the January issue of the journal Human Communication Research found that college-age women who had watched a drama involving teen pregnancy were more likely to report in a poll two weeks later that they planned to use birth control regularly, compared with those who had watched a news report on the topic. (The same effect wasn't seen in men who watched the drama, however.)

Still, a co-author of the new JME study, Ruth Faden, who is the director of the Berman Institute of Bioethics, says there isn't much evidence to support a negative "House effect" in real-life medical settings. She cites a 2002 report in the European Journal of Emergency Medicine as the closest to showing misconceptions about medical-procedure expectations derived from fictionalized TV depictions: in that study, researchers surveyed 820 young adults about their TV-consumption habits, knowledge about cardiopulmonary resuscitation (CPR) and their expectation of survival of a patient who undergoes CPR in the hospital. The survey found that people who watched medical dramas were more likely than people who didn't to overestimate survival rates for patients needing CPR.

But when it comes to real-world situations involving medical ethics, the issues are usually not as clear-cut. So while viewers of Grey's Anatomy may find Seattle Grace's medical staff to be frivolous and unprofessional, Faden doubts they believe "doctors and nurses are regularly as discourteous or indifferent as some of the characters." Faden admits to being a fan of House. "As a normal watcher myself, I don't think most people come away thinking there are lots of Dr. Houses out there," she says.

Rather, she says the high drama in TV hospitals probably does little more than spur dinner-table conversation about the ethics of medicine, possibly including complex topics like end-of-life care and access to health care — "big questions that we face in our society," Faden says. Indeed, to encourage such useful conversation among the public, she and a group of colleagues recently formed an initiative to get TV and movie producers to collaborate with medical ethicists when creating content. "From our standpoint as scholars in bioethics, we see great opportunity," she says. "The thing about scripted television shows is how frequently they appear, coming out 20 and 25 times per year. They engage millions of people around the world, so the opportunity for bringing public attention to these issues is enormous."

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