Grey's Anatomy Question

Cafe Society
1

OK, my wife watches this show and by extension so do I. But one thing’s always bugged me about the set-up and I’m hoping someone in the US might be able to fill me in.

The hospital where the show’s set seems to be entirely staffed by surgeons (and the odd nurse, and an anaesthetist or two). Is this a common set-up in US hospitals? Are there no hospital doctors who aren’t also surgeons? Does surgeon mean something different in US hospitals than it does in UK ones? Is this just a ridiculous TV show with a ridiculous set-up? Is surgery just more sexy?

It just really confuses me as to why a hospital which has an emergency department and seems to accept walk-in patients (ie. is not just dealing with surgical referrals) has no general medical staff who aren’t surgery specialists.

Please help fight my ignorance.

OB

2

It’s for TV purposes. Reality is not a concern.

There’s a lot of fudging things in the show concerning it’s size, staffing, etc.

It is supposed to be a nationally ranked teaching hospital. But, the main exterior building shown is a small 3-story VA rehab facility. The elevator numbers, though, go up to 5. There is only one small surgery floor for all departments. And only two ORs shown in the early years. With OR numbers going up to like 12 shown on the OR schedule board.

This wouldn’t even be a top hospital in Seattle, let alone the nation.

At the beginning, the ER and its residents were treated as a different group. That went away so that there could be more “action” for the surgical residents.

For a while there was even a clinic for walk-ins that was manned by the surgical staff for some reason.

Occasionally, other departments have a person or two show up. Psych had a resident that showed up a few times. Some interaction with neonatal including one resident that was shown a whopping 2 times, etc.

I’m not sure if anyone ever labeled “General Medicine”/“Medical” has ever been shown. (At least Scrubs maintained the distinction.)

Once in a while, the CoS calls people together to make a big announcement. Usually this is from a set of stair to a lobby full of people (surgeons and nurses). Can’t be more than 30 people at a time. Once, it was to surgeons in an OR. Something like ~20 people. A few times, there’s a big meeting in an auditorium, so theoretically 50+ people but I doubt that many are shown.

If you’re paying attention to anesthesiologists, watch carefully in Season 1, one of them later turns up as …

Joe the bartender

The problem started with the pilot. They said that there were 6 women among 20 surgical interns. 3 were regulars. But at least 5 other women are shown during the episode.

Counting, consistency, are not an issue on TV. (E.g., the recent return of you-know-who episode mentioned the “last 7 years”, when it’s only 6 within the show.)

3

There’s a trope for that.

4

The hospital does have a separate dermatology wing which resembles a large day spa and where all of the doctors are relaxed and friendly, in contrast to the rest of the hospital.

5

Also, most US surgeons leave hospitals by finding another job, and moving their practice. It’s fairly uncommon for them to get hit by a bus, or die in a plane crash, or get shot by a grieving spouse.

6

What about helicopters? Is “squished by a helicopter” on the list?

7

Dr. Daisy Pepman!

There is no mocking in Derm.

I wouldn’t call it a “wing”. It’s just a space at the top of the OR floor stairs, to the left of the OR galleries. Which should be the fourth floor, if they were consistent. The Psych ward is on the fifth floor. Newborns on the second floor as are the most commonly used patient rooms.

Strangely, when in the ER they want to send someone to surgery, they refer to “taking them down” to surgery. Despite surgery being two floors higher.

The doctors also don’t know the difference between a CAT scanner and an MRI. Scary.

8

Another question: in real life, are there hospitals where damned near every resident is engaged in some sort of cutting-edge research? Wouldn’t that be activity you would associate with a university-connected facility? What percentage of MDs actually publish? I’ve never even met an MD who engages in original research, but admittedly my sample is biased.

9

Seattle Grace (I know, but I don’t care), is a teaching hospital. Most, but not all are affiliated with a Med School/University. (If they are, they definitely are going to have researchers.) So it is something of a rarity but not implausible to have a very high percentage of researchers. The myth that Seattle Grace is a nationally ranked program would imply a strong research program to boost their status and draw better residents and attendings.

Note that writing up case histories for publication isn’t really research in many cases. Many of the doctors on GA haven’t done much more than that.

10

Don’t get me started.
Instead of rotating through services like most residents do, these residents serve at the whim of their attendings, who commandeer them for months at a time.
There is one orthopedist in the entire hospital who happened to be made chief resident of general surgery even though they are entirely different specialties.
Nobody ever has office hours.
Nobody ever goes into practice-they are either hired by the hospital or die.

That said, at least they keep to the notion that these are surgeons and rarely show them doing non-surgical medicine.

11

They do show them going thru rotations in the early years. 4 weeks was frequently mentioned. Only occasionally, like when Alex ticked off Addison was a rotation extended. Cristina was always gaming it to stay in cardio. But during the merger-layoffs arc, they had her rapidly going thru a bunch of specialties to try and find a protector-mentor.

The position of chief resident was for all surgery, not general surgery. (But in a real hospital of respectable size, each department would fully manage their own affairs.)

It has been mentioned that Derrick has office hours, at least.

Alex has just gone into private practice. Ditto the whole spin-off of Addison into a show called … Private Practice! If you look carefully of the clipping announcing Burke winning the Harper Avery, it indicates he was working for a pharma company at that time. (The writers were really mad at Washington.)

As for non-surgical work: The complaint (already mentioned in this thread) is that they do waaaay too much non-surgical stuff.

12

In the GA world:

  • Surgical resident generally staff the ER, doing the intake, evaluation and treatment. They are not called for consultation when needed like other ED’s. They also staff the free clinic when needed. Unless it’s been retconned, the free clinic is also administered by Dr. Bailey, a surgeon.
  • The Chief Of Surgery is somehow also the Chief Of Staff of the hospital, making overall management and staffing decisions - even overseeing the merger with another hospital (where was the board during that time?)
  • Cutting edge and non-surgery related research is performed by surgeons. ie. Dr. Bailey’s experimental immune system treatment using deactivated HIV. Can’t see how that’s surgery related at ALL, unless you count an injection as surgery. Where were the internal medicine specialists? A patient is near death due to a non-surgical issue, and you don’t even call for a consult outside your specialty? Call Dr. House!

There are COUNTLESS examples like this. While they try to keep some of the medicine cutting edge by ripping from the headlines (fecal transplants for instance), they certain don’t try to make the medical setting accurate in any way. Kinda like watching “Grimm” and complaining about the police-procedural mistakes. While they each have their own setting, they’re not written to be accurate medical or cop shows (GA leaning heavily toward the drama, Grimm more toward the supernatural/lore genre).

If you want a somewhat more realistic hospital depiction, try “ER”, created by an actual M.D. You just have to understand that the hospital in ER, as well as the hospital in Greys Anatomy, are both built on cursed Native American burial grounds. That’s the only way to explain the falling helicopters, crashing planes, shootings, explosions, …

13

Bailey gave up control of the free clinic to Izzie in the finale to (strike shortened) Season 4. The clinic then started fading out of the show after that. (But it did feature an appearance of Mrs. Wolowitz in Season 5.) The last episode that I recall set in it was S06E10 when Izzie returned with her high school teacher. Izzie had been fired by that time and no mention was made of who ran the clinic at that point.

There are 3 hospital sites in Grey’s Anatomy: The KOMO-TV building in Seattle used for aerial shots. The Sepulveda VA rehab building in the LA area used for exterior and some interior shots. (Only rarely used in recent seasons except for stock footage.) And the ABC studio set. All 3 must be on cursed burial grounds to explain the horrors the staff, their family and friends have endured on the show.

14

Could it have been more laughable? “My mother was a surgeon at Seattle Grace at one time…that’s why I wanted to work here…”

15

Yes, completely absurd.

First of all, they’re selling us the asinine concept that Ellis Grey had the affair with Richard, and carried the love child to term right under the nose of her lover AND her husband, in full view of a hospital crammed with nosy doctors. Like nobody would have noticed! Laughable.

Then, she’s apparently not aware that the Grey of Grey Sloan is Ellis Grey’s ex-husband’s daughter by someone else, Lexie, no relation to her whatsoever.

And, either she failed to mention that Meredith Grey is her half-sister or hasn’t yet realized it. In which case she’d be too dumb to dress herself, let alone head a cardiology department. In her mid 30s, no less, probably a few years younger than Meredith. Ridiculous.

And the only older black guy working at the entire hospital, an lifer and that has been there last 30 years, her mom is white, she’s biracial and she isn’t even slightly aware that Richard might be her dad? Durrr.

16

i agree 100%. She’d done just enough research to know her birth-mom’s name, and where she worked - but didn’t dig deep enough to find out her daughter’s name??? or even realize that it was emblazoned on the hospital.

As soon as I saw Weber walk up to her sitting on the bench I totally expected her to blurt out “I’m your daughter!”. She did, just in a differently clichéd way…

Speaking of reused clichés, my roommate was worried they were going to kill Christina off right as she was leaving, so they wouldn’t have to explain why she never comes back. I retorted that that would just be mean, but then remembered that’s exactly what they did with George :smack:

17

I still maintain that an orthopedist would never be chief resident of surgery. They are different specialties and do not share any training after medical school. For clarification, there are some subspecialties of surgery for which you do your 5-6 years of general surgery and then additional years of specialty training, such as cardiothoracic, vascular, plastics and pediatric surgery. But nowadays, even most surgical subspecialties such as neurosurgery and urology have dedicated training programs where you do at most one or two general years of surgery before going into your specialty. In addition, there are surgical specialties that have entirely separate training tracks such as Ob/Gyn, and orthopedics. Having an orthopedic resident be chief resident for surgery is equivalent to having a dermatologist be chief resident for psychiatry. The training is completely separate; orthopedics don’t even do a preliminary general surgery year.

As far as realistic medical training shows, I only include the pilot of ER since after that the doctors mostly lost their specialties and the ER doctors started doing procedures that they would never do in the ER, like endoscopies. If you want the most realistic show you have to give it to St. Elsewhere. They got most of it right. What is fascinating to me is that all of the really crazy things that I thought were too farfetched when I first saw it pretty much happened during my training.

-Resident “loses” patient when patient wanders off and spends the day trying to find him/her to avoid the wrath of the attending? Been there, done that, finally found her in church (don’t ask).

-Bitchy nurse ends up dating a resident and nobody but he can stand her? As far as I know they’re still married.

-Resident passes out during rounds? Happened in CCU and we never let him forget it.

What I am waiting for just once is for one show to acknowledge that there is a difference between a cardiologist and a cardiothoracic surgeon and an oncologist and a tumor surgeon. Not many people realize that when you have heart surgery the surgeon sees you for follow-up once or twice then dismisses you back to your cardiologist and usually never sees you again.

18

Who are we talking about? I didn’t watch the earlier seasons, so the only Chiefs I remember are Webber and Hunt, and I don’t think Webber’s ortho and Hunt’s a trauma surgeon.

19

Chief Resident of the surgery program, not Chief of Surgery. I’m blanking in her name- married George, now lesbian, with the pediatrician who lost her leg…

20

Callie Torres.