Is House MD an accurate representation of a clinical setting?

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House reminds me greatly of 3rd year rotations. House is like the main attending while the other doctors are like the med students, interviewing them first, figuring out labs, following the main attending around a lot and making diagnosis where the attending says they are wrong 100% of the time.

But it's different because med students never get the assessment and plan part correct and can't do surgery while the doctors do get the diagnosis right sometimes and can do surgery...because they are actually doctors(obvious I know, don't kill me D: )
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bleargh said:
that explains it.. what would radiologists know about what hospitals are like :laugh:

a joke -

an MD and wife are aboard a plane. the captain says over the intercom "if there is a doctor on board, please identify yourself to assist with a medical emergency." the wife turns to her husband and says "you're a doctor, you should go help them." man turns and says "no honey, i'm a radiologist."
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The better version involves the same deal, but the radiologist begrudgingly goes up there and hunches over the guy. He fumbles around for a bit. Checks his pulse, looks at his fingers, does doctorly looking things. Then the attendant runs up pulling another guy saying, "Doctor, we have another doctor to help you out!". The radiologist looks up and says to the other doctor, "Oh thank god, I'm just a radiologist. Without a CT, I'm kind of worthless." and the other doctor replies, "Oh $!#$, I'm a radiologist too...."

Best told by my dad, a radiologist. He admittedly would find something else to do when people coded in the department. Keep in mind, he still was ACLS certified and even did a lot of interventional procedures and clinical stuff. He just felt like the patient had the best shot by him NOT being in there.
 
Lol wtf @ ER being realistic. That show is so far from reality, it's ridiculous!!!! (I worked in an ER for 4 years - I think I'd have some idea)

Scrubs is a far more accurate portrayal of the day-to-day in a hospital.
 
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startswithb said:
I just wish they'd get a decent female doctor. Actually, an amazing, brilliant, kick ass and take names doctor. 13 was lame and Cameron was whiney and wore those stupid vests.
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How dare you knock Olivia Wilde. For Tron's sake.
 
gettheleadout said:
I-Aint-Even-Mad.jpg
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lol :laugh::laugh:
 
4 $pecilist attending$ $alarie$ + lab and dx tests= One hell of a broke patient. House's department would be a financial black hole for the hospital.

-Generally nurses spend way more time with patients then the doctors.
-The attending I have shadowed have never done their own lab tests.
-The Free clinic is more representative of a non-urgent track in a ER or urgent care.
-Oncologists generally can't drop their patient load on a dime to work on one sick patient for a week.

TV is TV. If anything I hope it is more like general hospital.:smuggrin:
 
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I think most doctors have more than one patient per week. An entire team of doctors treating one patient per week is unique to the Princeton‑Plainsboro Teaching Hospital.
 
xPersephone said:
I think most doctors have more than one patient per week. An entire team of doctors treating one patient per week is unique to the Princeton‑Plainsboro Teaching Hospital.
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Who says it is only one patient in a week? You see how they spend 42 minutes over the course of several days... you don't see how they spend the other 71 hours and 18 minutes.
 
LizzyM said:
Who says it is only one patient in a week? You see how they spend 42 minutes over the course of several days... you don't see how they spend the other 71 hours and 18 minutes.
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Well, they pretty much come out and say it when the hospital got taken over by that billionaire - how the department was a big financial liability since they only treated an average of one patient per week.

I think it's completely realistic that five doctors are assigned to your case, and only your case. They think about you all day, every day until you're cured, and even think about you at night when they're home. They care so much, they will frequently break into your home and violate all sorts of legal and ethical concerns to cure you despite your own stupidity.

That's what happens in every hospital.
 
LizzyM said:
Who says it is only one patient in a week? You see how they spend 42 minutes over the course of several days... you don't see how they spend the other 71 hours and 18 minutes.
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They say that House averages one patient a week in several different episodes. It's mostly said by people trying to get the hospital to fire him.

The premise of House is 'what if Sherlock Holmes was interested in medicine rather than crime?' Just like Holmes would get consulted by Scotland Yard once a week when they couldn't figure something out on their won, House is a doctor who only gets consulted when no one else in the hospial can figure something out. In both stories, that doesn't happen very often, maybe once a week on average.

There are other parallels to. The names, obviously: Holmes becomes House, Watson becomes Wilson. Also some of the Character's habits: Holmes's opium addiction became Houses Vicodin addiction and Watson's gambling became Wilson's philandering.
 
Perrotfish said:
They say that House averages one patient a week in several different episodes. It's mostly said by people trying to get the hospital to fire him.

The premise of House is 'what if Sherlock Holmes was interested in medicine rather than crime?' Just like Holmes would get consulted by Scotland Yard once a week when they couldn't figure something out on their won, House is a doctor who only gets consulted when no one else in the hospial can figure something out. In both stories, that doesn't happen very often, maybe once a week on average.

There are other parallels to. The names, obviously: Holmes becomes House, Watson becomes Wilson. Also some of the Character's habits: Holmes's opium addiction became Houses Vicodin addiction and Watson's gambling became Wilson's philandering.
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Fascinating... I missed that.

Many of the early episodes were based on very old stories of the Epidemiologic Investigation Service (EIS) of the CDC. Of course, the CDC will come into your house, and other places you frequent, to look for "clues" to your illness and will send a team to deal with just one patient (or a group in an "outbreak"). See Eleven Blue Men and other Narratives of Medical Detection by Berton Roueche. It was written decades ago but may be of interest.

Although taking care of one in-patient, House also spends time barely tolerating the patients in the clinic. ;)
 
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apumic said:
I think you could learn a lot more by actually walking into one of those big, brick buildings MDs, RNs, LPNs, techs, etc. work in... what're they called again...?! Oh yeah -- HOSPITALS! Yeah, walk into one of those and look around. You just might learn something. I thought most premeds did this early on in their premed days but by the existence of this thread, I am CLEARLY mistaken. :rolleyes:
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Dude, I practically live at the hospital, yo! I live, breathe, and **** ER. :)
 
LizzyM said:
The episodes of ER in the early 90s were so good that some med schools used them for teaching purposes.
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When I was in paramedic and nursing school, DVDs for the first seasons of ER were just coming out. I really feel like ER was great reinforcement with clinicals and book work.....or maybe I just like watching Dr. Green. He's kind of nerdy hot. :)
 
While all the details of medical care aren't accurate, some of the early scrubs episodes really portray the spirit of residency as some residents I've talked to have told me.

Namely:

1. The feeling way out of your league initially despite four years and several hundred k of debt

2. The "getting the hang of" all the basic procedures etc. way faster then you'd think so they become second nature

3. A combination of being terrified by screw ups and boredome from repeating the same thing over and over.

4. The lack of social life defects that come from hospital hours

5. The fact that more often then not the resident is holding fat flaps, lifting the leg during a surgery, and occasionally getting to close, as opposed to "other hospital shows" where you do brain surgery from day 1.
 
DoctwoB said:
While all the details of medical care aren't accurate, some of the early scrubs episodes really portray the spirit of residency as some residents I've talked to have told me.

Namely:

1. The feeling way out of your league initially despite four years and several hundred k of debt

2. The "getting the hang of" all the basic procedures etc. way faster then you'd think so they become second nature

3. A combination of being terrified by screw ups and boredome from repeating the same thing over and over.

4. The lack of social life defects that come from hospital hours

5. The fact that more often then not the resident is holding fat flaps, lifting the leg during a surgery, and occasionally getting to close, as opposed to "other hospital shows" where you do brain surgery from day 1.
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There's nothing quite like assisting in spreading the divide or holding up a hospital bed rail. :)
 
Compass said:
Whatever you do, do not cite Trauma as your go-to guide for emergency medicine. EMTs are not performing cardiac surgery IN THE FIELD.
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You mean the helicopter isn't going to land next to my house with the pilot acting as an EMT?

Also, there isn't an MCI every week?
 
StudyShy said:
When I was in paramedic and nursing school, DVDs for the first seasons of ER were just coming out. I really feel like ER was great reinforcement with clinicals and book work.....or maybe I just like watching Dr. Green. He's kind of nerdy hot. :)
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CSB SDN style time.

There was an episode of ER where one of the attendings intubated with a lighted stylet and about a week later, independent of the episode, a thread popped up in the EM forum about it.

http://forums.studentdoctor.net/showthread.php?t=167455&highlight
 
StudyShy said:
When I was in paramedic and nursing school, DVDs for the first seasons of ER were just coming out. I really feel like ER was great reinforcement with clinicals and book work.....or maybe I just like watching Dr. Green. He's kind of nerdy hot. :)
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DVDs?? Back in the 1990s it was possible to write to Warners Bros. on letterhead, list which episodes you needed for class, and have them send the cassettes with the stipulation that they be returned when the class was over. :cool:
 
LizzyM said:
DVDs?? Back in the 1990s it was possible to write to Warners Bros. on letterhead, list which episodes you needed for class, and have them send the cassettes with the stipulation that they be returned when the class was over. :cool:
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In the 90s, I actually didn't like ER. I was still in middle and high school and wasn't much into it. All the medical terms seemed so confusing to me. I would have been amazed then to learn that one day I would be running my own code.

I started medic school around the same time 9/11 happened as just a fun thing to do. I ended up loving my clinical time in the ER so when the ER seasons started coming out on DVD, I bought them up whenever they would come out with a new year!

That is totally awesome that they would send cassettes. I had no idea. I wish I would have watched ER when they actually aired. I guess you never do know the path that life will take you.
 
"Love's Labor Lost" episode from the first season of ER is a classic regarding medical mistakes, communications, etc. Granted, it would be very unlikely for everything to go badly in a single case but juxtaposition that episode with any clinical-pathological conference involving maternal mortality (NEJM published one just around the time of that episode) and you can see how it can happen.
 
LizzyM said:
"Love's Labor Lost" episode from the first season of ER is a classic regarding medical mistakes, communications, etc. Granted, it would be very unlikely for everything to go badly in a single case but juxtaposition that episode with any clinical-pathological conference involving maternal mortality (NEJM published one just around the time of that episode) and you can see how it can happen.
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I remember that episode. It was particularily haunting and a good reminder that life is tenuous and never guaranteed. It is easy to make mistakes especially when a person is placed under so many stressors related to work and home. Obstetrics is the area that I'm going for, and I brace myself for the day when I will invariably loose a baby...and my goodness I hope that I never loose a mother to anything preventable.
 
LizzyM said:
"Love's Labor Lost" episode from the first season of ER is a classic regarding medical mistakes, communications, etc. Granted, it would be very unlikely for everything to go badly in a single case but juxtaposition that episode with any clinical-pathological conference involving maternal mortality (NEJM published one just around the time of that episode) and you can see how it can happen.
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Sounds like the rabies case from Scrubs (Episode "My Lunch") where 3 patients die following transplants of a patient infected with rabies.
 
Siggy said:
Sounds like the rabies case from Scrubs (Episode "My Lunch") where 3 patients die following transplants of a patient infected with rabies.
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Yikes. That sounds like a nightmare.
 
StudyShy said:
Yikes. That sounds like a nightmare.
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Albeit creative licensing with it being 3 patients at the same hospital, it is based on a true story regarding 3 patients receiving diseased organs.

Edit:

That's the other thing. While a lot of the episodes of some medical drama shows seems far fetched, a lot of them are based on real (albeit exceedingly rare or unique) cases. Perfect example, the always hilarious, "My Musical" episode of scrubs. Bonus points for people who recognize the guest star from that episode*.


*Hint: It's the source for the "Internet is for porn" meme.
 
I'm watching it now. 13 is under anesthesia. House and Foreman are doing a procedure with a catheter to irradiate (right word?) a tumor in her brain. Neither of them are qualified as far as I know (neurointerventional radiology procedure?), and there is no anesthesiologist present. Gotta love it.
 
Siggy said:
Albeit creative licensing with it being 3 patients at the same hospital, it is based on a true story regarding 3 patients receiving diseased organs.

Edit:

That's the other thing. While a lot of the episodes of some medical drama shows seems far fetched, a lot of them are based on real (albeit exceedingly rare or unique) cases. Perfect example, the always hilarious, "My Musical" episode of scrubs. Bonus points for people who recognize the guest star from that episode*.


*Hint: It's the source for the "Internet is for porn" meme.
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That was a really good episode. Also, I love Avenue Q <3
 
StudyShy said:
I would have to agree. You can learn a lot from watching an episode of ER.
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The first season of ER was relatively accurate, particularly to the extent it followed John Carter's rise from med student to intern. After that Michael Crichton's influence disappeared and the show began being written by soap opera writers. Grey's anatomy was realistic for the first 10 seconds of the first episode when Meredith's alarm clock went off at 4am, but ceased to be accurate since. Scrubs hits on real topics but in a very unrealistic way, and for the most part is not what hospital life is like. They create caricatures of what folks in the various specialties are like which are amusing, but you won't see anyone like this in the hospital in reality.
House started out as lauded by the medical profession because of its strong use of the differential diagnosis. To the extent House used to write out every possible diagnoses on a marker board and then the team tries to figure out tests that will eliminate 1 or more of these diagnoses (with whatever's left at the end, however unlikely, being the actual diagnosis - a Sherlock Holmes-eque exercise). But in the last few years the show has lost its focus. It was never realistic in the sense that no single doctors do everything those doctors on House's team do (they do their own labwork, surgery, radiology, etc.).
St Elsewhere (available on Hulu) actually does a better job of dealing with some of the ethical hospital issues, if you are looking for accuracy. The main character, (Morrison?) is a Caribbean med school grad at a run down community hospital in boston. Worth a watch if you thrive on the medical shows.
 
Law2Doc said:
The first season of ER was relatively accurate, particularly to the extent it followed John Carter's rise from med student to intern. After that Michael Crichton's influence disappeared and the show began being written by soap opera writers. Grey's anatomy was realistic for the first 10 seconds of the first episode when Meredith's alarm clock went off at 4am, but ceased to be accurate since. Scrubs hits on real topics but in a very unrealistic way, and for the most part is not what hospital life is like. They create caricatures of what folks in the various specialties are like which are amusing, but you won't see anyone like this in the hospital in reality.
House started out as lauded by the medical profession because of its strong use of the differential diagnosis. To the extent House used to write out every possible diagnoses on a marker board and then the team tries to figure out tests that will eliminate 1 or more of these diagnoses (with whatever's left at the end, however unlikely, being the actual diagnosis - a Sherlock Holmes-eque exercise). But in the last few years the show has lost its focus. It was never realistic in the sense that no single doctors do everything those doctors on House's team do (they do their own labwork, surgery, radiology, etc.).
St Elsewhere (available on Hulu) actually does a better job of dealing with some of the ethical hospital issues, if you are looking for accuracy. The main character, (Morrison?) is a Caribbean med school grad at a run down community hospital in boston. Worth a watch if you thrive on the medical shows.
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I haven't made it beyond the 10th or so season of ER, but I can see how things were drifting from its original accurateness. :)
 
Law2Doc said:
The first season of ER was relatively accurate, particularly to the extent it followed John Carter's rise from med student to intern. After that Michael Crichton's influence disappeared and the show began being written by soap opera writers. Grey's anatomy was realistic for the first 10 seconds of the first episode when Meredith's alarm clock went off at 4am, but ceased to be accurate since. Scrubs hits on real topics but in a very unrealistic way, and for the most part is not what hospital life is like. They create caricatures of what folks in the various specialties are like which are amusing, but you won't see anyone like this in the hospital in reality.
House started out as lauded by the medical profession because of its strong use of the differential diagnosis. To the extent House used to write out every possible diagnoses on a marker board and then the team tries to figure out tests that will eliminate 1 or more of these diagnoses (with whatever's left at the end, however unlikely, being the actual diagnosis - a Sherlock Holmes-eque exercise). But in the last few years the show has lost its focus. It was never realistic in the sense that no single doctors do everything those doctors on House's team do (they do their own labwork, surgery, radiology, etc.).
St Elsewhere (available on Hulu) actually does a better job of dealing with some of the ethical hospital issues, if you are looking for accuracy. The main character, (Morrison?) is a Caribbean med school grad at a run down community hospital in boston. Worth a watch if you thrive on the medical shows.
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Wow. I just watched the first episode of St. Elsewhere, and I see what you mean. If the rest of the episodes are similar, then my list will look like this:

#1) Code Blue, & Trauma: Life in the ER

#2) St. Elsewhere

#3) ER (1st half)

#4) Scrubs

I can't believe that I never watched St. Elsewhere before; especially considering some of the big names in the cast: Denzel Washington, William Daniels, Howie Mandel, Ed Begley, Jr, etc.!! Thanks for the great contribution, Law2Doc!!:thumbup:
 
Wait!!! House isn't a realistic interpretation of what a dr does? Oh boy..... back to the career aspirations drawing board.....
 
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