Primary care physicians are negatively portrayed in the media

Does it really make sense for a neurosurgeon to be quoted in a news story about a new treatment for diabetes or prevention of obesity? Some news reporters think so, leaving primary care physicians frustrated at the media’s lack of understanding about the wide range of expertise they practice on a daily basis. In both news and entertainment media, seeking out and representing primary care expertise seems to be the last priority. These popular misconceptions now challenge family physicians to become role models and a source of information to the media, general public and especially to patients in need of primary care.

Recognized as small town heroes and role models, family physicians have carried the lion’s share of responsibility in their communities because of their comprehensive range of expertise. From treating broken bones to delivering babies, entire communities admire them for a strong work ethic and their inspirational effect on society. However, despite the positive impact of family physicians nationwide, many individuals form their strongest impressions of primary care through entertainment media.

The media influences public views and behavior with the help of popular public figures in various fields of specialty. One example is CNN’s selection of Sanjay Gupta, M.D., assistant professor of neurosurgery at Emory University School of Medicine, a medical correspondent who discusses straightforward primary care and public health topics, but rarely on topics of neurosurgery. Another example is cardiothoracic surgeon and host of the popular Dr. Oz show, Mehmet Cengiz Oz, M.D., who discusses many primary care topics, such as migraines, cancer screening, exercise and nutrition, but not cardiothoracic surgery. By choosing subspecialist’s to discuss these topics, rather than their specialty, the news media indirectly suggests that a specialist is better qualified to speak on primary care, instead of an actual primary care physician!

While media gives weight to the importance of specialists such as neurosurgeons and cardiothoracic surgeons, primary care physicians are negatively portrayed. A good example was the television series Becker, where the lead character, Dr. John Becker, a primary care physician played by actor Ted Danson, was described as “a twice-divorced cynical doctor who is always annoyed by his patients, co-workers and friends. He is in trouble with the IRS and believes all dwarfs are bad luck!”

As a result many of us in primary care were happy to see the end of this show in 2004.

Previous generations grew up admiring the general internist on Dr. Kildare, while the TV show Marcus Welby, M.D. focused on a family physician. In contrast, note the surplus of pathologists in the trilogy of CSI, NCIS and Cold Case series shows. The main character on House is an infectious disease specialist, while Scrubs and Grey’s Anatomy residents train in general surgery.

Changing the perception and role of family physicians in mainstream media requires a multi-tiered approach. One suggestion to remedy this issue is by using entertainment-education, the incorporation of informative messages into entertaining media. For example, an interested coalition of family physicians could partner with an organization such as PCI-Media Impact, a leader in entertainment-education programming, to encourage collaboration between primary care associations and media professionals such as scriptwriters and television show producers.

By approaching the issue this way, we can create believable, likable characters for prime time television that highlight the importance of family physicians and emphasize their important role in preventing disease and maintaining the health of their patients. This will lead to more equitable representation of family physicians and develop or adapt characters in popular TV programming to increase attraction to the field of primary care.

Michael O’Connor of University of Washington School of Medicine made an interesting discovery on how medical media hype can affect medical students.  In his article, “The Role of the Television Drama ‘ER’ in Medical Student Life,” published in JAMA (1998), O’Connor concluded that “medical students reactions to televised medical dramas like ‘ER’ suggest that they may incorporate the attitudes and beliefs of physicians on television much the same way they acquire the qualities and behaviors of physicians through their experiences in patient care.”

When the media influences the medical community to this extent, family physicians must become proactive in speaking up. Specialists like Dr. Gupta and Dr. Oz have made great strides in this direction. It’s time for family physicians to take their cues and rise up to become leaders who can positively impact the thoughts and actions of the public and their colleagues in the medical community with the help and cooperation of the media.

Trishul Reddy is Chief Resident, Department of Family Medicine, East Tennessee State University.

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  • http://pulse.yahoo.com/_2LRZNHDZS6DU45WQ567LPQ7CMI ninguem

    Marcus Welby portrayed primary care  so unrealistically, I have to wonder if it made things worse by creating unrealistic expectations.

  • scrubsfan

    Could not agree with this article more. General practitioners are totally undervalued by the general public since they are seen as “the people that couldn’t make it into neuro/cardio/etc” and thus perceived as less smart. The media does not understand that PCPs are the backbone of medicine and are probably more valuable than the neurosurgeon that only a small percent of the population will ever see. The media needs to stop glorifying these types of specialists. It’s a shame that this, along with the cost of medical education, is pushing people away from specializing in family medicine.

    BTW, on Scrubs, only Turk is a surgeon. JD, Elliot and Dr. Cox are all internal medicine docs. (Just to because Scrubs is one of my favorite shows.)

    • http://www.facebook.com/profile.php?id=891415436 Trishul Tunga Reddy

      Absolutely, people often think primary care fields are less challenging than a specialized fields. I believe this misconception is due to glorification of specialized fields in popular media. We must motivate pre-medical & medical students to take an interest in Family Medicine. One of many ways is via Media Advocacy and Entertainment education. This will give rise to a fresh point of view, confidence, and intellectual inquisitiveness of young doctors-to-be, which are essential for advancement of Primary Care field.

      BTW, correction noted. Thank you. :-)

  • http://www.facebook.com/profile.php?id=27200744 Jordan Storhaug

    Although Scrubs had some of them becoming general surgeons. The main and most of the characters were training to essentially be hospitalists. 

  • http://www.facebook.com/profile.php?id=100003790666407 James Lincoln

    No brainer! The critical gap of primary care physicians can be decreased if the younger generations can see the right role models in primary care field on mainstream media.

  • http://www.facebook.com/profile.php?id=891415436 Trishul Tunga Reddy

    It’s time for Primary Care Physicians to step up. Let’s make ourselves available to our local press by, say, writing to local newspapers and suggesting that if they ever need an expert on primary care issues such as diabetes and migraine, we’d be happy to do an interview. We can have a positive impact on the thoughts and actions of the public (and our colleagues in the medical community). We simply need to reach out to members of the media and speak up.

  • sFord48

    I don’t watch medical shows…most of my experience with primary care has been personal.

    I find it interesting that the article uses broken bones and babies to show the value of primary care…when I though I broke my hand, my PCP didn’t have time to see me and I went to a retail clinic. Most FPs don’t deliver babies…or work in hospitals.

    • http://www.facebook.com/profile.php?id=891415436 Trishul Tunga Reddy

      It depends where you are from. In cities, yes many deliveries are done by OB/GYN docs, however, in rural area’s almost 100% of the deliveries are done by Family Physicians.
      One survey in 2007 showed in Minnesota, Family physicians perform cesareans at 39.2% of the rural hospitals offering cesarean deliveries. Same goes for Hospital work, most FP’s in traditional practices do see their own patients in the hospital.

  • http://twitter.com/SeattleMamaDoc WendySueSwanson MD

    I’m a primary care doctor who is working to do just what you’d like. I have just taken a job with KING5 (NBC here in Seattle) to do health reporting segments weekly, I author a pediatric/parenting blog, I share insight and observations on Twitter and I am present on multiple social networks. I share experiences and observations working in primary care and what I’m learning about improving care in this health care environment. My true love is the medical home and I’m working hard to learn how to do provide that home better and share what we’re all learning along the way.
    Thanks for this post!

    • http://www.kevinmd.com kevinmd

      Congrats Wendy. Along with Mike Sevilla, you’re another who has bridged the gap between social media and mainstream television.

      It’s critical that physicians have a greater voice in mainstream media. For many, including myself writing for USA Today and CNN, a social media presence opens the door to mainstream media opportunities.

      Kevin

      • http://briarcroft.wordpress.com/ Emily Gibson

        Great news, Wendy Sue! You will be a real asset on KING5 and to the community with your clarion voice of reason in medicine. Emily

        • http://twitter.com/SeattleMamaDoc WendySueSwanson MD

          Thank you. I expect to learn a ton.

          • http://www.facebook.com/profile.php?id=891415436 Trishul Tunga Reddy

            Congratulations Wendy Sue!! It’s refreshing to see Primary Care Physicians in mainstream media as role models. Thank you.

            Trishul

  • SidewaysShrink

    Related question: as a psychiatrist in Seattle, the major insurance companies just cut my rates by 15% and said it was because Medicare decided to decrease funding to specialists and increase payments to primary care. Are any of you seeing this increase in private insurance company reimbursement or from Medicare? As the lowest paid of all “specialists”, I just want to ensure that the cut to my income is going to primary care providers and not into insurance companies pockets. I value my family practice and internal medicine colleagues greatly. You deserve it.

  • http://www.facebook.com/Theonidas Theo Hensley

    Great article Trishul! I would love to see more local primary care physicians become involved in all forms of media outreach! I lose breath every week trying to caution friends and family about the “advice” they got recently on Dr. so and so’s TV show. It would be great to have Family Physicians doing weekly segments on the local news to promote health. It could be called “An apple a day… keeps ME away!” :-D

  • http://twitter.com/WindyCityMed Michael Mank

    Great piece. Not only do primary care physicians need to become more involved with social media, but they also need to become bigger players in health care policy and reform. Tackling care and influence from both ends can aide in implementing meaningful change.

  • http://www.facebook.com/amarsh07 Amanda Marsh

    As a writer, I can definitely see how family physicians could feel neglected when it comes to having their expertise heard and respected within the media. Yes, us writers are at fault for not calling upon sources that fit with a specific topic, however, if we don’t know these sources exist, we cannot call upon them. Reporters have strange schedules and strict deadlines, so if we don’t hear from Dr. so-and-so by 4 p.m., we’ve got to go with someone else so we can get the story out of our hands and onto the editors.

    Just as Trishul said, family physicians do need to let the media know they are there and ready to be interviewed! Reach out and make contact with writers, we’re friendly and VERY talkative people!

  • http://twitter.com/anniebradford Annie Bradford

    Great article! Our country’s PCPs are undervalued in many ways – your piece highlighted one that I hadn’t yet considered.