Hollywood just doesn't make movie doctors like they used to
■ A review of films shows that doctors are not often depicted in a favorable light.
By Damon Adams — Posted Jan. 24, 2005
In the good old days of the silver screen, this was the movie face of a physician: a dreamy Elvis Presley working as a family physician in a free clinic in New York City. As Dr. John Carpenter in the 1969 film "Change of Habit," the King tends to the medical needs in a rough part of the city and jams with community youths until duty calls.
Much like Elvis in his later years of flab-packed jumpsuits, the movie image of physicians has gone to pot. It has come to this: In 1997's "Critical Care," one physician asks another why a comatose patient with a poor prognosis needs a procedure. The response: "It's called revenue! He's got catastrophic health insurance."
Movies nowadays often cast physicians in a less attractive light than earlier films that showed them as more compassionate and idealistic, says Wisconsin pediatrician Glenn Flores, MD. Dr. Flores has rented and watched about 150 films spanning 80 years to gauge how physicians are depicted in films. In an article in the December 2004 Archives of Disease in Childhood, Dr. Flores says money and materialism are common themes in movies about doctors. Movie physicians base treatment decisions on a patient's ability to pay, and they are hampered by inefficient bureaucracies and health care systems.
"In the early decades, you see movie doctors often placing more lofty aspirations and altruism over materialism. Now you see more doctors as egotistical and uncaring," said Dr. Flores, associate professor of pediatrics at the Medical College of Wisconsin and director of its Center for the Advancement of Underserved Children.
Dr. Flores' article in Archives is his second review of physicians in cinema. His first study of 131 films was published in the July 2002 Journal of the National Medical Association. He found that physicians were negatively portrayed in 44% of movies, and that positive portrayals had declined since the 1960s. Film doctors were depicted as greedy, egotistical, uncaring and unethical, especially in more recent movies.
New villains of the screen
For his follow-up study in Archives, Dr. Flores reviewed more than a dozen additional films and explored key themes and humor in movies with doctors. Materialism and love of money continued to be prominent in recent movies. Money was often shown as the primary motivation for becoming a physician. In fact, characters were often shocked when doctors didn't appear wealthy, as in "Playing God," when an FBI agent belittles a surgeon for living in squalor.
Dr. Flores said movie doctors face the frustrations and follies of dealing with inefficient bureaucracies and health care systems that hinder patient care. In "Article 99," a physician explains to an intern why open-heart surgery is being done on a patient admitted for prostate surgery: "Here's the problem: this patient needs open-heart surgery. The administration of this hospital will only authorize a prostate procedure. Now what good is fixing his prostate if he has a heart attack every time he tries to use it?"
In films "John Q" and "As Good As It Gets," hospitals and health plans are shown as hurting health care.
"The new villain is the hospital administrator and the insurance company," said Lester D. Friedman, PhD, a senior lecturer in the medical humanities and bioethics program at Northwestern University in Chicago.
Dr. Flores said physicians should be concerned about how they are portrayed in movies because such depictions could affect patient expectations and the doctor-patient relationship. Well-known psychologist Joyce Brothers, PhD, agrees that movie images leave an impression on viewers.
"If [physicians] are shown as uncaring, the more likely they'll be viewed as uncaring when [patients] see them," Dr. Brothers said.
Glen Gabbard, MD, a psychiatrist who co-wrote the book, Psychiatry and the Cinema, said some patients ask if he will hypnotize them and make them recall their childhoods like doctors do in movies.
"One patient said, 'Can you hug me the way Judd Hirsch hugged Timothy Hutton?' (in "Ordinary People"). I said, 'In therapy, we use words,' " said Dr. Gabbard, professor of psychiatry at Baylor College of Medicine in Houston.
Dr. Flores and other physicians use movies as a teaching tool to train medical students. Dr. Flores said there are ample positive images of insightful and engaging portraits of physicians, such as Ingrid Bergman's psychiatrist character in "Spellbound" and Robin Williams' portrayal of the lead character in "Patch Adams."
Educator Hershey Bell, MD, recommends renting "Dr. Zhivago."
"It was one of the few movies that showed the human side of the doctor," said Dr. Bell, clinical professor of family medicine and associate dean for faculty development and evaluation at Lake Erie College of Osteopathic Medicine in Pennsylvania.