Love Matt Czuchry, but The Resident Needs Help

As you all know, I’ve been taking my own jabs at The Resident which you can read here and here. Today, our resident radiology expert Shannon Redmon offers her insight of some of the show’s inaccuracies.

Welcome back, Shannon!

As a huge fan of Matt Czuchry since his Gilmore Girl days, I must say that his new show, The Resident, is quite entertaining. Too bad several episodes include inaccurate medical information.

For example, two MRI scenes have aired on this series and both are misrepresented as to what happens in a real hospital.

In the first scene, Drs. Conrad and Pravesh are viewing an exam in the MRI control room. No one else is around. No technologists, radiologists or even patients. The reason this is out of character is because most surgeons view the images from their workstations or with a radiologist in their office, not in the technologist control room.

Digital radiographic photos can be accessed from computers all over the hospital. All doctors need is their login and the patient’s name to access any record in the system. Why would both surgeons trek all the way to the MRI room to look at the images? They can pull them up right from where they are sitting and in the operating room before surgery.

The second MRI scene shows Nic, the well-rounded nurse, marching into the MRI room to confront a billing lady who convinced a doctor to order an MRI on a patient with a penile implant – a metallic based penile implant according to the dialogue in the scene. When nurse Nic enters, the patient is already in the machine. She stops the exam because the patient has a metal penile implant which could be “ripped out” by the powerful magnet.

If this patient were going to have any issues from the MRI, then the damage would already be done. MRI magnets are always activated. The patient with a metal implant would not even be allowed in the room. MRI technologists have strict vetting procedures in place to conduct on all patients. These policies keep at-risk patients from harm and are emblazoned into the brains of all technologists. They would have been the ones to prevent the test from being completed, not the nurse from an outside department. This scene makes the MRI tech seem inept.

Also, where does the billing consultant get so much authority? If any employee confronted physicians and nurses the way she did, she’d be tossed out on her head. No surgeon is going to stand there and let a consultant from billing tell them what to order or how to treat their patients. This woman strongly encourages all staff to upcode patient exams for more money. Without proper documentation or a legitimate reason, upcoding is illegal and hospitals can be highly fined for healthcare fraud in violation of the False Claims Act.

Although I cringe when I see such inaccurate scenes, I will continue to watch for two reasons. Because I love Matt Czuchry and … I love Matt Czuchry!
********************************************************************************************
Shannon Moore Redmon writes romantic suspense stories, to entertain and share the gospel truth of Jesus Christ. Her stories dive into the healthcare environment where Shannon holds over twenty years of experience as a Registered Diagnostic Medical Sonographer. Her extensive work experience includes Radiology, Obstetrics/Gynecology and Vascular Surgery.

As the former Education Manager for GE Healthcare, she developed her medical professional network across the country. Today, Shannon teaches ultrasound at Asheville-Buncombe Technical Community College and utilizes many resources to provide accurate healthcare research for authors requesting her services.

She is a member of the ACFW and Blue Ridge Mountain Writer’s Group. Shannon is represented by Tamela Hancock Murray of the Steve Laube Agency. She lives and drinks too much coffee in North Carolina with her husband, two boys and her white foo-foo dog, Sophie.

A Real Doctor’s Thoughts on The Resident

As you know, last week I did a couple of posts on Fox’s new television show The Resident. You can find Part I and Part II by clicking the links. Shortly after this post, I came across a You Tube video by Dr. Zubin Damania who runs a series of entertaining and informative videos on healthcare under the name ZDoggMD.

I’ve found Zubin’s videos fun. Some are satirical in nature, but others tackle very serious healthcare issues. Zubin does for the general public what I try to do for writers. As a note, some of his videos do have some salty language.

So, it was with interest that I viewed his thoughts (serious ones) on The Resident to see if we agreed on the same things. I was somewhat shocked in some of the things he thought were spot on as far as medicine goes and I must say I’m relieved we’ve worked at different hospitals. To be fair, I’ve never worked on a surgical floor or in the OR so my expertise is not in that area. You can view his thoughts in the posted video.

One thing he found more truthful than I did was the cover-up of the doctor who shouldn’t be performing surgery anymore. That something like that wasn’t as blatant as it appeared on television, but was much more subtle— but does happen.

It was interesting to see the differing opinions between a physician and a nurse. The lead female character— I think is a resident because she wears a long, white lab coat. Nurses typically don’t wear this unless they are nurse practitioners. He thinks this same character is a nurse who seemingly works in every unit of the hospital. What’s clear is it’s not clear what her job is. This is also one of my major complaints about medical shows in general— they don’t realistically show the true nature of the job.

I appreciate ZDoggMD— particularly his support of nursing. It has not gone unnoticed by me. Keep up the good fight, my friend!

Fox’s The Resident: Everything Stereotypically Bad About Hospitals (Part 2/2)

Today, I’m continuing my review of Fox’s new medical drama The Resident and all that is bad about it. You can find Part I here.

Let’s continue our list.

THE RESIDENT: L-R: Manish Dayal, Emily VanCamp, Shaunette RenŽe Wilson, Matt Czuchry, Valerie Cruz and Bruce Greenwood in THE RESIDENT premiering midseason on FOX. ©2017 Fox Broadcasting Co. Cr: Justin Stephens/FOX

Bargaining with IV drug users for drugs. In one scene, the younger protege is seen bargaining with an IV drug user so that she’ll give into his demands and it becomes a bartering of sorts like buying food in an open market. Hands down, the physician should decide what his bottom line is and not waiver from it.

Effective CPR is “until the ribs crack”.  Effective CPR is just the amount of compression depth it takes to generate a pulse that can be felt. It is a risk factor that the patient’s ribs can break, but it is not the clinical guideline we shoot for.

An environment of “no questions asked” is dictated. The senior resident gives his junior resident this mantra: “Do what I want you to do. No questions asked.” Again, this type of environment is intolerable in the hospital setting and should never be dictated . . . like ever. A questioning environment has been shown to increase patient safety and smart hospitals are encouraging this very thing. Most hospitals also have a mechanism in place to go above the bedside medical team if family concerns are not being addressed.

A surgical resident get first dibs on the new, bright, shiny, robotic surgical wonder. Need I say more?

The attending surgeon pretends to do a surgery. Remember the new shiny surgery robot? Remember the attending from Part I that has obvious hand tremors and should not be doing surgery? Did I mention this attending surgeon is an ego maniac (he even leaves positive medical reviews for himself)? Well, since no one has ratted out this well . . . rat . . . it must be him that first uses the machine. However, physically, he can’t do it. So he sets up a ruse where it appears he’s doing the surgery where in reality his uber smart, highly capable resident is. I cannot tell you how ethically bad this is on so many levels.

There are several issues that surround a lengthy medical code in the ER. The IV drug user that bargains for drugs in the beginning codes related to a heart infection. She is coded for nearly 30 minutes— the junior resident keeps it going for that long because of his emotional connection to the patient. Of course, just as he decides to call it, the patient gets her pulse back.

The senior resident is mad at him because he’s just revived a “vegetable”. Honestly, it is the senior resident’s job to watch their underlings. There would have eventually been an attending doctor overseeing this code. So, the person least responsible for the length of this code is the junior resident. Everyone higher up on the totem pull has the ability to stop the code.

Hospitals keep vegetative people alive for money. This is so patently false it’s laughable, but is probably more believable for the general public because many think hospitals will do anything to meet their bottom line.

I’ve been in nursing twenty-five years this May. I first started in adult ICU nursing and in that unit in Kansas there was avid discussion of clinical pathways to put people on to withdraw unnecessary (futile) care. In fact, I would say I’ve seen the opposite— at times a push to take people off of life support sooner then may be warranted from both the family and/or medical providers.

A resident taking it into their own hands to discontinue life support. Because the patient has no hope for life and he sees that the family is in no hurry to stop life support, the resident decides to turn off the machines. Fortunately, he is caught by a fellow resident and quickly turns back on the life support and the patient suffers no ill effects. Again, highly unethical. How about . . . having some hard conversations with the family about the viability of their daughter and helping them come to this decision? I know this is painted in the episode as a merciful thing for this doctor to do, but it would have been murder if he succeeded. He does not have permission to discontinue life support and cannot do so on his own accord. Period.

Also, there is no reason to be dumping a bucket of ice cold water onto a patient’s face . . . like ever.

I guess I should be thankful to The Resident for giving me all this blog material. It’s the only thing good about the show.

Tell me what you think of The Resident? If you’ve seen an episode, will you keep watching?

 

Fox’s The Resident: Everything Stereotypically Bad About Hospitals (Part 1/2)

Seems like this television season there have been quite a few new medical dramas hitting the airwaves. I’ve done a four part series on The Good Doctor (Part 1, Part 2Part 3, and Part 4) and 9-1-1. Newest onto the small screen is Fox’s The Resident.

It will make you hate hospitals and everything about them.

There are a few that say to me, “Why try and correct all this misinformation? Most people know it’s not factual.” It might actually surprise you how many people view what they see on television as real and true. The recent demise of crock pots everywhere after an episode This Is Us led the company to release a statement about their safety.

The Resident highlights every horrible hospital stereotype . . . literally on the planet. This is pretty amazing for a show to do in one hour.  The show centers around two residents: the senior resident Dr. Conrad Hawkins and a new bright and shiny resident, Dr. Devon Pravesh. One big problem . . . it’s not even clear what type of residents they are.

Hawkins is the gunslinger. The medical doctor who knows everything under the sun and bucks corruption (and common sense) at every possible turn. He is brash, arrogant, and needs a few classes in mentoring and bedside manner. Well, not just him, but really the entire cast of doctors from the senior attending with tremors who shouldn’t be doing surgery anymore to the wicked smart surgical resident who, in a room full of people (and on the fly by no less) states to a family that the result of their loved ones surgery was “Prescott’s dead.”

Sweet.

I don’t even like this show a little bit. As it stands now, I personally find nothing redeeming about it. Not only medically, but socially as well.

Here is just a short list to get us started on what’s wrong with The Resident.

An open appendectomy. Appendectomies are mostly done laparoscopically. In this patient, it’s even commented that it hasn’t ruptured so it should be the easiest of all appendectomies. However, this patient has a heinously large incision and the attending physician (the one with the horrible hand tremors) nicks an artery and the patient dies.

A short surgical code. It is true that surgeons don’t like deaths to occur in the actual OR. Considering that, the surgical code (compared to a medical code later) is laughingly short. Like big shrugs around the room after a few minutes— golly gee, our patient is dead.  Not sure how we treat hemorrhage.

The cover-up. I can’t say with one-hundred percent certainty that no bad medical outcome is hidden, but I will say that the climate is definitely supporting the truth coming out in the hospital setting. In this television episode, it’s plainly clear that this attending surgeon has a reputation for bad outcomes and the staff has been covering this up for a while. After the patient dies, they develop “the story” to cover up the surgeon’s negligence. Hands down, this puts too many careers at risk and most people aren’t willing to take that chance. This is beyond “playing along”. Most hospitals have corporate compliance hotlines where concerns can be left anonymously. Honestly, it would increase the tension of this television show to have someone trying to expose him.

Next post, we’ll continue our discussion on the medical inaccuracies of The Resident.