Medics in the mediaBMJ 2011; 342 doi: https://doi.org/10.1136/bmj.d1461 (Published 09 March 2011) Cite this as: BMJ 2011;342:d1461
Could you handle the spotlight? Neil Chanchlani considers the issues that doctors wanting to write or broadcast should consider
Doctors are everywhere—writing weekly columns, advising scriptwriters, reporting international news, and even appearing on primetime television shows. A new specialty has emerged in the past two decades: media medicine.
Companies such as Media Medics and the Association of Broadcasting Doctors have employed hundreds of hospital specialists and general practitioners to consult on all aspects of medicine for production companies.
The number of doctors appearing in front of the camera has surged. They use their medical qualifications when reporting medical news or giving health advice.
But these medics don’t have the glory without the worry. They are bound to the same rules and regulations as other doctors, such as maintaining confidentiality, and they’re also bound to extensive copyright laws and, perhaps most vaguely, not bringing the medical profession into disrepute.
In the United Kingdom the General Medical Council sets out a code of conduct for doctors and medical students to uphold. Most of the guidelines are based on clinical situations and thus are unlikely to be problematic for such television doctors.
Rise of medical dramas
Over the past decade you may have noticed an increasing number of medical dramas on television. In the 1960s media theory scholars, such as Marshall McLuhan, predicted that medical dramas would be on the rise because the viewer would be able to imagine being in that scenario—doing the operations that the actors were doing.
McLuhan, author of Understanding Media: The Extensions of Man, said, “Television, in fostering a passion for depth involvement in every aspect of experience, creates an obsession with bodily welfare.” And his prediction was right.
US television programmes such as Scrubs, Emergency Room (ER), and Grey’s Anatomy are shown worldwide and have been translated into many languages. And the phenomenon is international: Spain has Hospital Central, Israel has BeTipul, India has Dill Mill Gaye, and New Zealand has Shortland Street.
Advisers: a vital role
Expert advisers have a vital role in medical drama. They make us believe that what we see on television is possible, helping to draw us into the story.
David Shore is creator of House MD, a US television show in which the eponymous doctor is the head of a team of “diagnosticians,” solving baffling medical cases. But the medicine is just a means to an end. “There’s a reason we’re telling the medical stories,” he says. “You want that emotion. You want that interesting and touching payoff.”
So while being factually correct and having to take out the medical jargon, yet still keep the storyline interesting, people like David Foster, a medical adviser to House MD, have to incorporate how they will expect the audience to feel—and write accordingly.
Dr Foster says that the show rarely runs out of good material, often taking cases from the New England Journal of Medicine or stumbling across interesting case reports on the internet.
“The story of House’s leg, the infarction that left him with a limp and constant pain, is ‘adapted from a story’ that first appeared in the New York Times Magazine’s Diagnosis column, which deals with dilemmas faced by real life doctors,” he says.
What drives one to consider a career as a medical adviser is enthusiasm. Dr Foster adds: “Writing and medicine are both passions I enjoy, and they fuel one another. I hope I will never have to choose exactly one or the other.”
Leaving medicine behind
Shibby Robati is a 28 year old former trainee surgeon who appeared on the BBC’s The Apprentice. The reality television show focuses on rewarding the best contestant with a one year apprenticeship position with the entrepreneur and businessman Alan Sugar. While he was practising medicine Dr Robati ran a recruitment agency for doctors, nurses, and midwives in Guildford. His business savvy personality got him on to the show, but he was not acting as a doctor while he was on screen.
When it became known that he was a doctor, some of the medical community expressed concern. Internet forum users thought that Dr Robati might make doctors “as a name” look bad.
Dr Robati behaved entirely properly throughout the show. But because he was never involved in any medical situation or with patients, he would have had to have done something very bad or even criminal to get into trouble with the professional regulators.
Medical student Yvette “Sunshine” Martyn went on Channel 4’s Big Brother reality show in 2009. Previous series had seen many contestants strip nude, behave inappropriately, and break down because of emotional anxiety and frustration.
Many medics were worried when Sunshine was selected for Big Brother. Before the series started, tabloid readers, including readers of the Daily Mail and Sun, commented that “she was ruining the medical profession’s reputation” and that “she was too immature to be a doctor.” Others said that “she’s going to get eaten alive when she qualifies [in medicine].” Sunshine’s online blog explains that even the show’s psychiatrist warned her that “she’d never be able to be a doctor, that patients wouldn’t trust her, and that they would specifically ask her to leave.”
Before going on Big Brother, Sunshine says, “I called the General Medical Council anonymously for advice about what to do. They were supportive and told me that going on the show would not be a disciplinary issue.”
Sunshine behaved impeccably on the show. “People and patients who recognise me on the streets and wards often say, ‘Good on you.’” She has gone back to her final year with her reputation in excellent shape and is one close step away from being a qualified doctor.
Booklets such as A Guide for Doctors Handling the Media, released by the Medical Protection Society, and Social Media and the Medical Profession, authored by the Australian Medical Association Council of Doctors-in-Training, can provide basic advice on what a doctor is permitted to do when dealing with the media.
For example, regarding Facebook, the Australian Medical Association recommends: “Employers and colleagues may access online material and activities about their current medical staff or trainees, with potentially career damaging outcomes . . . so, when using social networking sites, think before making offensive comments or jokes and sharing information about unprofessional activities.” The UK Medical Protection Society suggests that general practices nominate one or two staff members to be the first point of call for all media inquiries to ensure a consistent approach in handling an inquiry. “If you anticipate that you may receive some media attention concerning a patient you have treated, you should make sure that you brief your team properly so that they know what they can and can’t say.”
The Medical Protection Society and the Medical Defence Union encourage doctors to call their helplines for advice before saying or doing anything that might damage their image or reputation as a doctor.
Jacqui Phillips, the union’s medicolegal adviser, says that doctors working within media medicine should get professional insurance or indemnity in place from the publishers or broadcasters that they are working with. “This is in case a libel action is brought, or allegations are made about breach of copyright, for example,” she says.
Another layer of complexity is added when doctors publicly give real life medical advice—for example, on a chat show or in a newspaper column.
Dr Phillips says, “When giving medical advice, we recommend that doctors provide general advice and that it is made clear by the publication that the information provided should not be used as a substitute for patients seeking help from their own GP.”
Luisa Dillner, an employee of the BMJ Publishing Group and a health columnist for the Guardian, agrees. “It is important to get a disclaimer in, because readers may apply general information to themselves. You should also be clear what you are happy to comment on—I wouldn’t write about a celebrity’s personal health problem, for example. Then you also might want to ask to see the headline the editor is giving your column to make sure it reflects what you’ve said and isn’t sensationalist. I’ve always loved writing for newspapers—it is a real privilege but also a real responsibility.”
Australian Medical Association. Social media and the medical profession: A guide to online professionalism for medical practitioners and medical students. http://ama.com.au/node/6231
Medical Protection Society. A guide for doctors on handling the media. www.medicalprotection.org/uk/a-guide-for-doctors-on-handling-the-media
Competing interests: None declared.
From Student BMJ.