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Nice post here by a medical student contemplating the effect of television doctors on the flesh and blood practice of medicine: http://boards.medscape.com/forums?128@158.qasxa9gFZrf@.2a09cdc7!comment=1

I'm not a doctor, but I play one on TV
Alex Folkl, Medical Student, 01:14PM May 23, 2011
University of Vermont College of Medicine, Burlington, VT

For as long as I've been in medical school, my father has been asking me when I'll become a famous TV doctor. Although I figure I probably never will -- as a result of lack of motivation, lack of opportunity, and, let's be honest, lack of talent -- I do sometimes find myself thinking about those who have chosen the "famous TV doctor" route -- Dr. Oz, Dr. Phil, Dr. Drew, and so on -- as well as the doctor dramas -- Grey's, House, and so on -- because these people, and these shows, noticeably affect how I'm percieved and how I percieve myself. Additionally, in a variety of subtle ways, they affect my interactions with patients.

Take Dr. Oz, for example. I'm not singling him out because I think he's done anything particularly egregious. In fact, it's the opposite: A lot of his material focuses on preventative health, and this week, he's even devoting a show to childhood obesity, in which he's asking the ethically-delicate, but important question, of whether having an obese child is a form of child abuse (my opinion: It depends, and I'm not going to comment further in this post, but may come back to this topic in a future post). Overall, Dr. Oz seems to do a good job. The reason I'm singling him out is because on some occasions he seems to do a better job than people's real-life doctors. I've been with patients on several occasions who've said that they finally cut down on their fast food intake because "Dr. Oz said to." Well, that's great that Dr. Oz is having an impact, but I happen to know that their own doctor's been saying that for years. Why did it take a celebrity to get the message across? For someone like me, who's headed into primary care, I'm not sure whether to be frustrated by the knowledge that I might beat my head against the wall for years with a patient, only to have a flashy TV show do the work for me -- or to be thankful, because that TV show is one more piece of the combined arsenal we use to keep people healthy. I'm also not sure that I shouldn't re-consider my father's advice to become a famous TV doctor if I really want to reach people.

On the other end of the spectrum, there are famous TV doctors who gain the public eye by commenting publically on others' misfortunes. This happens all the time, but right now I'm thinking specifically about a celebrity who was recently in the American media for having a bit of a public meltdown, which involved insta-catchphrases like "winning," "tiger blood," and an ill-fated "Violent Torpedo of Truth" comedy tour. In the wake of his many off-canter television appearances, news outlets across the country had medical experts weigh in on a possible diagnosis. The only problem? None of them was his doctor. While it may be tempting to grab a little bit of the spotlight by publically voicing an opinion on such a high-profile story, isn't that just a little... unethical? Is it appropriate for doctors to give a diagnosis without seeing all (or any, which is more likely the case in most instances) of the evidence? And in so doing, are they stigmatizing the actor in question (okay, I'll just get on with it -- it's Charlie Sheen), or however many millions of people may be living in relative obscurity with whatever diagnosis they've given him? Does commenting without all the facts in this way do our profession a disservice?

Finally, there are the TV shows. What can I say? They're entertaining, for sure. I used to watch House religiously until I figured out that, basically, if the diagnosis is offered up anytime in the first 45 minutes of the show, it's not the diagnosis. But they definitely misrepresent the way medicine is practiced. For example, according to House, we're all to be multi-specialists capable of diagnosing the most esoteric diseases in extremely short order. And according to Grey's Anatomy, a hospital is basically someplace where a little bit of medicine goes on, in between steamy bouts of illicit, um, conjugal visitis. Thanks to Grey's, I've had to reassure my wife that no, in fact, call rooms are generally used for sleeping, and nothing more. On a more serious note, I get the feeling that patients sometimes have unrealistic expectations of the diagnositic process because of what they see on these shows, and that can negatively impact the patient/physician releationship.

What are your thoughts? I'm worried that while we're seeing an explosion of relatively good medical programming -- Dr. Oz, Dr. Phil, The Doctors, and so on -- we're also seeing an explosion of programming that is less positive for the profession -- Celebrity Rehab, the recent opining on the Charlie Sheen debacle, TV shows that over-dramatize the medical process.

On the whole, is the medical profession's involvement and representation in popular media a good thing, or a bad thing? How has it affected your interactions with patients?

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