This week, The Resident premiered on FOX. If you missed it, you should find a way to stream it.
It’s not just trashy, fun TV (although it definitely is that). The show also manages to skewer one of our pet peeve figures in healthcare — the overhyped surgeon.
The Resident wastes no time in introducing us to its major villain, Dr. Randolph Bell.
Dr. Bell is a medical grandee, the most eminent surgeon at the fictional Chastain Park Memorial Hospital in Atlanta.
You might’ve seen the type in your city. You can catch him smiling from bus ads, hosting huge fundraisers; maybe, as is the case with Dr. Bell, his face is even plastered on the side of the building.
Dr. Bell plays this role at Chastain Park, and it’s evident from the onset that he’s as profitable as he is popular. Patients flock to him, and leave breathless reviews online.
They love him for his bedside manner, for his people-pleasing service, and for his…handsomeness. “McDreamy is real!” gushes one patient.
But those who work with Dr. Bell know something none of the patients do — the Doctor’s complication rates.
We learn pretty quickly that Dr. Bell doesn’t quite live up to his hype. In fact, in the show’s opening scene, he botches an appendectomy (a very routine procedure) by nicking an artery, leaving the patient dead on the table.
The hospital’s staff has seen enough of these kinds of mistakes to give Dr. Bell his open-secret nickname: HODAD. That’s an insider acronym, for Hands of Death and Destruction. The title was coined by Dr. Martin Makary, in his memoir, Unaccountable: What Hospitals Won’t Tell You and How Transparency Can Revolutionize Health Care. It’s a must-read for anyone who wants to know what hospital staff talks about when there aren’t any patients in the room.
Who Tightens the Bolt?
This contrast between Dr. Bell’s reputation and his results highlights one of surgery’s enduring issues. If we can’t see the results of surgeries, how can we find the best performers?
In the show, it’s hammered home by Nic, a nurse explaining to a resident where the disparity comes from.
Your car has a rattle so you take it in to a mechanic, and this guy’s kind, polite, eager to help. For two days he runs every test in the book, tells you the fix’ll cost you a thousand bucks. You max out your credit card, and on your drive home, guess what? You hear the same rattle.
Or you can take your same car with the same rattle to a different mechanic. This guy’s rude, dismissive, arrogant — but, he tightens a bolt, fixes the rattle, charges you five bucks. Problem solved.
We shouldn’t stretch the metaphor too far. Courtesy and competence aren’t mutually exclusive, and patients have every right to expect both from their doctors.
But Nic’s speech points to the underlying problem: in most situations, patients have no way to tell who tightens the bolt, and who’s just eager to please.
Bleeding into Reality
Now, being a show on FOX, The Resident naturally heats up the drama with menacing schemes and prurient side-stories that probably don’t happen in real hospitals.
But the problem of reputation vs reality is strictly non-fiction. Last year, for instance, the Seattle Times featured a scandalous story about a revered and highly productive surgeon in Seattle who, nonetheless, made numerous decisions that “led to significant patient harm and death.”
While the situation doesn’t quite compare to Dr. HODAD, the real-life physician certainly didn’t measure up to the prestige afforded him by his hospital or perceived reputation. Cases like that are the whole reason we developed the MPIRICA Quality Score.
Patients need an easy, intuitive way to see past the hype of figures like Dr. Bell, and find the providers who will give them the results that they want. Because at the end of the day, it’s not a surgeon’s handsomeness that matters to us — it’s his (or her) hands.
We’re thrilled to see how The Resident brings public attention to this conflict, and we’ll definitely be watching to see how they explore it.
Watch the trailer from YouTube below, and if you’re interested in seeing the reality behind the “Dr. Bells” in your area, we invite you to give our data a look.