Through the years, I’ve pointed new underwriters to non-traditional sources of information on healthcare professional liability, including podcasts like Dr. Death, Bad Batch, and The Drop Out but also TV shows including Botched, Dr. Pimple Popper and My Feet are Killing Me. Both the podcasts and television shows demonstrate what can go wrong and provide insights into specific specialties. A more unlikely source that has been around for many more years is Grey’s Anatomy. You may ask: Why send underwriters to a fictional TV show to learn more about healthcare professional liability underwriting? As one of the longest-running primetime shows that happens to focus on the ins and outs of a hospital, people have spent more time with the characters of Grey’s Anatomy in Seattle Grace Hospital (later Grey Sloan Memorial Hospital) than in any other hospital setting and with “McDreamy” as part of the lexicon it stands to reason that while the scenarios may often be far-fetched, more Americans (i.e. the jury pool) are more familiar with healthcare as dramatized in Grey’s Anatomy than they are with the real thing.
For many of the underwriting veterans, there hasn’t been a time in their career when Grey’s Anatomy wasn’t on television. First airing in 2005, it started its run when appointment television was still a thing and before streaming and binge-watching were possible. I remember being a new underwriter on the floor and, on Friday mornings, discussing how plausible a scenario on the award-winning drama could be in real life. Did Meredith’s fingernail “pop” the surgical glove and create a tear in the heart during cardiac surgery, or were there other factors that led to a more catastrophic outcome for the patient? What would happen if a similar claim was brought? We often found ourselves every Friday morning on the underwriting floor, rehashing how real the situation was or what would happen if a claim came in with similar facts. Fun conversations but also really unique learning opportunities for us developing underwriters.
" Carriers and defense attorneys should recognize that for much of the American population, Grey’s Anatomy may be their litmus test for how they judge real-life claims and health scenarios."
Fast forward to a mock trial I participated in in 2019, and I became far more aware that individual jurors and the population in general did not understand standards of care, what constituted actual negligence and their perceptions were largely informed more by television than anything else. How did I come to this conclusion? During that mock trial, the mock jury came back with a verdict award of “$0 to $350 million” for a claim where the ER nurse spent minutes with the patient before they were transferred, followed the physician’s orders and was not negligent. That’s a large range but demonstrates the inconsistency and unpredictability of juries.
Admittedly, the outcome was devastating, and the patient was very sympathetic, but there was no negligence whatsoever on the part of our insured. In fact, evidence supported that the standard of care had been met. So why, then, were the mock jurors awarding $350 million? Answers from the mock jurors varied: “The nurse should have stayed with the patient the whole time!” or "The nurse should have told the physician what to do!” or “Why didn’t the nurse ask more questions of the physician?!” The mock jurors did not see the nurse as following a course of treatment set by physicians, they believed the nurse should have been an intervening actor (pun intended) and affected the course of treatment for the patient. Registered nurses (RNs) and licensed practical nurses (LPNs) play a huge role in the healthcare system in our country. They, however, are not responsible nor trained to determine a course of treatment. Nor is it realistic that a nurse in the Emergency Room responsible for many patients could sit down and stay with one patient for their entire shift. But alas, as seen on TV, an episode of any medical drama only focuses on one or two patients telling their story from diagnosis to cure in an hour's episode. Somehow, this has become the reality and perception of the general public.
How do we combat this? The simple yet complicated answer is education about healthcare and insurance, as these are very intertwined.
- Healthcare facilities should strive to communicate clearly and set appropriate expectations about care and outcomes.
- Facilities should also seek to engage with patients in ways that they prefer; what works for one age group or patient type may not be as effective with a different patient population.
- Insureds should have a better understanding of the reality that healthcare workers face. The standards are incredibly high, and workers carry a significant responsibility to patients and their families – it is not an easy job and often requires long hours and sacrificing time with their own families while facing increasing threats of injury and violence. Some individual bad actors exist, but the industry should not be painted with the same brush.
- Much of the frustration and anger aimed at healthcare is due to the cost. State legislatures should also consider tort reform to help manage the cost of litigation which directly impacts the cost of insurance, which impacts the cost of healthcare for all.
In its 20-plus seasons, Grey’s Anatomy has done an excellent job discussing issues in healthcare. They have stayed relevant by tackling and portraying challenging situations within healthcare, including hospital mergers and acquisitions, an active shooter situation, nurses’ strikes, the COVID-19 pandemic, and the cost of healthcare, to name a few. But it is a dramatization of healthcare, and as a healthcare professional liability underwriter, I know that, as does any healthcare professional, dramatization is exactly that. In reality, proper patient care looks much different. Carriers and defense attorneys should recognize that for much of the American population, Grey’s Anatomy may be their litmus test for how they judge real-life claims and health scenarios. After all, it's ubiquitous enough it’s transcended networks that Gary Cole, playing Alden Parker on NCIS, when asked if he has any medical training, responds, “No, but I watch Grey’s Anatomy.” (NCIS, Season 21, Episode 8, “Heartless” aired 04/22/2024).
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