When the popular TV hospital drama Grey’s Anatomy featured a story line about a patient diagnosed with a rare genetic condition called von Hippel-Lindau disease (VHL), Joyce Graff paid close attention. The Executive Director of the VHL Family Alliance watched as the surgeon onscreen discovers a large cyst on the patient’s pancreas, described as being “in danger of rupturing”. Joyce described the scene:

“The TV surgeon removes a significant portion of the pancreas. But pancreatic cysts in VHL are almost never dangerous, and are not sufficient to warrant operating on the pancreas, which is the last organ you want to touch. Dr. Steven Libutti, one of the world’s experts in VHL in the pancreas, says he has NEVER seen a VHL associated pancreatic cyst in danger of rupturing, and described this scene as pure fiction.”

The potential inaccuracy of medical information presented on widely-watched hospital dramas (about 20 million viewers watch Grey’s Anatomy every week, for example) is a concern to Joyce – and should be to all of us.  But how much educational impact does a weekly visit to the fictional hospitals of Grey’s Anatomy or House or E.R. actually have on the average viewer?  And couldn’t we take advantage of our favourite TV docs to help raise awareness of serious real-life health issues?

The Kaiser Family Foundation (a private non-profit foundation focusing on major health care issues, research and communications) decided to evaluate this educational impact. They conducted research on viewers during the Foundation’s participation with the producers of Grey’s Anatomy for an episode that aired on May 1, 2008.

In this episode, a young couple comes into the hospital’s clinic for a pregnancy test. They are seen by Dr. Izzie Stevens, one of the lead characters on the weekly show. Izzie gives the couple what she assumes is the good news that they’re pregnant, and is surprised when they become distraught. She learns that the mother-to-be has had HIV since the age of 19, and because the couple don’t want their child to be born with HIV, they demand an abortion.

After researching the issue, Izzie returns to explain to the couple that, if the mother receives the proper treatment, her chances of transmitting the HIV virus are substantially reduced. The mother becomes angry, but Izzie returns yet again, to make sure she is clear with the woman about her chances of having a healthy baby. Izzie says:

“I wasn’t saying there’s some chance your baby might not be sick. I’m saying there is a 98% chance your baby will be born perfectly healthy. Ninety-eight percent!”

Later, the mother confirms: “A 98% chance?” and Izzie repeats: “A 98% chance!”

In order to measure whether this episode had an effect on viewers’ awareness of this issue, the Kaiser Family Foundation conducted three surveys among regular viewers of Grey’s Anatomy:

1. a pre-show survey conducted one week prior to the target episode
2. a post-show survey, conducted during the week after the target episode aired
3. a follow-up survey conducted six weeks later

Each survey used a separate sample of respondents, and tested viewers’ knowledge and attitudes about HIV-positive women giving birth.

The results were significant. Viewers’ knowledge about mother-to-child HIV transmission rates rose substantially after the Grey’s Anatomy episode aired, and the new information was still retained by many viewers six weeks later.

For example, the proportion of viewers who were aware that, with the proper treatment, there is more than a 90% chance of an HIV-positive woman having a healthy baby increased by 46 percentage points after the episode aired (from 15% to 61%).

This increase includes 17% of respondents in the post-show survey who volunteered the specific response that a woman has a 98% chance of having a healthy baby – the same statistic that was repeated several times on the show.

Six weeks after the episode aired, the proportion who gave the correct response had dropped to 45%, but was still substantially higher (by 30 percentage points) than it had been prior to the show.

I happen to be a heart attack survivor who has been absolutely gobsmacked to learn that heart disease is the #1 killer of North American women. For example, heart disease:

• kills more women than men each year
• kills six times more women than breast cancer does
• kills more women every year than all forms of cancer combined.

Yet when the American Heart Association asked physicians in 2005 if they were aware that more women than men die from heart disease each year, the response was shocking. Only 8% of family physicians knew this fact, but (here’s the real shocker!) only 17% of cardiologists were aware of it.  Cardiologists!  This is their business. It is all they do. Yet barely 17% of those surveyed could correctly identify this reality.

My own suggestion for Grey’s Anatomy: let’s show Dr. Izzie Stevens sending home a woman in mid-heart attack, misdiagnosed with indigestion (or anxiety or menopause or gall bladder problems or any of the common misdiagnoses that send many of us home from the E.R), and then let the rest of the episode help to educate Izzie and her 20 million viewers (including all those doctors watching, too) about how women actually present with heart attack symptoms, and how cardiac diagnostic tests designed and researched on men may not be as accurate in identifying women’s heart disease.

See also: How Does It Really Feel To Have A Heart Attack? Women Survivors Tell Their Stories published on my other site, Heart Sisters. 

Read the entire Kaiser Foundation report about this Grey’s Anatomy project.  Visit the VHL Family Alliance website, or Joyce Graff’s review of the Grey’s Anatomy episode on VHL.

♥  NEWS UPDATE:  February 16, 2012:  Grey’s Anatomy did feature a story line this week about a pregnant intern who suffered a heart attack due to Spontaneous Coronary Artery Dissection. Watch the episode here (for U.S. residents only, for some strange reason).

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This post was also featured in Grand Rounds on May 24, 2011

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