Intelligent, humorous, and insightful post from Rev Reddy on the surprisingly accurate portrayal of the hospital ecosystem in the beloved TV sitcom Scrubs…
It ended 4 years ago but my favorite TV show of all time is Scrubs.
Without question. Out of all the sitcoms, mockumentaries, 1 hour dramas, reality shows, and HBO the past decade, Scrubs just stood out to me as having it all. At the end of the day, it made you laugh, it made you think about relationships, and it made you feel good. It just resonated.
There’s no doubt Scrubs thrived on rampant slapstick, absurd humor (say Family Guy for a comparison). But the irony of it is that despite the copious amount of cutaway comedy, out of any “medical TV show,” Scrubs most accurately and holistically depicted how a hospital is run in real life.
Let’s compare –
- House-like cases definitely don’t happen on the reg like that in any hospital…
- There were just too many hospital crashes and hostage takers in ER…
- Grey’s Anatomy and Nip/Tuck – just no…
These shows were still highly intriguing in their own right. But in the plot lines and drama they served up they misrepresented some of the core elements of how healthcare works.
Scrubs managed to explore actual scenarios, challenges and dilemmas doctors, nurses, and hospital administrators still face today, all while being highly entertaining along the way.
For example –
- As in reality, patients were actually old at Sacred Heart. The average age of a hospital patient is 55+. Several stories on Scrubs focused on elderly patients and ethical dilemmas such as DNRs, euthanasia, and the nature of end-of-life-care. When JD (i.e., Zach Braff) misinterprets an elderly patient’s statement, “Well… I’ve lived a good life,” to discontinue the aggressive treatment and just make her “as comfortable as possible,” he learns to never assume and always listen to a patient choosing to fight back at all costs rather than make the most of days to come.
- Insurance shouldn’t but can make it difficult for physicians to do their job. In multiple episodes, JD and crew treat uninsured patients “around the system,” using fake patient names and switching rooms, because they know Kelso, the Chief of Medicine, would grill them for not turfing the patients out if they were stable. In reality, the best interest for the bottom-line of the hospital can often conflict with doctors treating each patient equally, insurance or not. This is perhaps the biggest on-going challenge hospital administrators face. In one episode, when JD and crew don’t treat Kelso’s uninsured friend out of fear of being caught, he asks, “Why didn’t you do what you always do and go behind my back?”
- Doctors are bound by the Hippocratic Oath. The essence of the Hippocratic Oath is to ensure that a doctor will always do what’s in the best interest of the patient and that they will never disclose information about the patient without their consent. JD’s commitment to this oath is tested when he finds out his crush’s boyfriend has an STD from sleeping around but can’t tell her because of the oath. Luckily, she finds out herself and JD gets the girl (even if only for a little while).
- The progression from intern to attending is a wild one. Every season JD, Elliott and Turk climb a rung on the ladder. From the conversations I’ve had with young doctors who’ve watched the show, Scrubs is so good because it explores the nature of this hierarchy so well, whether it’s the mentor/mentee relationship between teaching attending and intern, vis-à-vis JD’s endless need of approval from Dr. Cox, or the insecurities interns face just starting out, paging their attendings constantly for approval on basic medical decisions.
These are just a few examples in detail but there are many more that make Scrubs such a healthcare-relevant show: pharma reps and the ethics of highly priced drugs, hospitals using fear tactics to sell unnecessary investigations (i.e., full-body MRIs), surgeons avoiding complex procedures to avoid risk of poor outcomes, the perception of surgeons as “jocks” and medical doctors as “geeks,” how easy hospital-acquired infections can spread, the need for doctors to constantly keep up with the latest medical knowledge, the importance of bedside manner, the under-appreciation of nurses… the list could go on.
These real-life issues so pertinent to understanding the nuances of healthcare delivery are all explored in Scrubs.
Though it ended 4 years ago, I think anyone interested in healthcare or looking for a fun way to learn about it, should watch this show.
It’s funny, smart and relevant. You can’t ask for much more.
You can see more of Rev’s thoughts on healthcare and entrepreneurship at his blog Healthcare Conversation for our Generation