Operating On Accuracy

It's a Thursday morning on the set of "ER" and actress Alex Kingston (Dr. Elizabeth Corday) is tripping over her lines. "I need 30 'migs' per kilo of methylprednisolone," she says, rushing to a gunshot victim. "Entry wound left mid-, sterno... cleido... uh... I'll never get that," she says, smiling at Jon Fong, an osteopath and one of "ER's" on-set medical advisers. "Dr. Jon" sounds it out: "Sterno-cleido-mas-toid." Soon, everyone, including Noah Wyle (Dr. John Carter) and director Richard Thorpe, begins chanting together: "Sterno-cleido-mas-toid. Sterno-cleido-mas-toid." Thorpe even kicks into a jig to pound the jargon into Kingston's head. Finally, she gets it--and Thorpe shouts the magic words: "Cut. Let's print."

"ER," one of television's most successful dramas ever--despite, or perhaps because of, its excruciating medical accuracy--has long been the envy of Hollywood. This week, as the show kicks off its ninth season, two new medical dramas will fill prime-time slots on CBS and ABC. Like "ER," "Presidio Med" and "MDs" have added doctors to their production staffs as gatekeepers of truth in a fictional world. At the same time, the shows have become targets of health organizations, which have become increasingly aware that medical drama is an ideal conduit for public-health education.

Studies suggest that viewers take medical info they see on TV seriously. The Kaiser Family Foundation found that half of "ER's" regular viewers--which number more than 20 million--say they gained new knowledge about health issues from the show. After one scene on human papilloma virus, awareness of the sexually transmitted disease jumped from 24 to 47 percent. In May, Robert Blendon, a Harvard public-health researcher, surveyed responses to "ER's" season finale, about a smallpox scare. He was pleased to find that the number of viewers who learned that smallpox vaccine can prevent the disease--even after exposure--rose 18 percent. "If we had an attack," says Blendon, "that would be the biggest public-health message" to relay.

Those kinds of numbers have prompted groups like the Centers for Disease Control and, most recently, the American Association of Health Plans (managed care's trade group), to knock on Hollywood's door. In July, the AAHP hired the William Morris Agency to improve its image. High on the list: a meeting with the writers of "MDs," which pits do-good doctors against number-crunching execs in a San Francisco hospital. The danger is that special-interest groups will present one-sided information that makes it on air. But the AAHP says it's building bridges, not pushing agendas. And others, like Kaiser and the CDC, which has its own Hollywood unit, agree. "Our goal is to get accurate health information out," says the CDC's Vicki Beck. "We don't control content."

For the creative side, the priority, by far, is making the characters compelling. "Medicine," says "ER's" supervising producer, Dr. Joe Sachs, "is the wallpaper." Still, being accurate and timely bolsters the drama and relevance of storylines. That's where medical types like Sachs, who also has a film degree, come in. At a recent writers' meeting, he was joined by medical supervisor Dr. Mark Morocco, a former actor, who stumbled in still wearing scrubs after an all-night shift at a real ER at UCLA. Starbucks lattes and popcorn helped keep him awake, as did the medical nitpicking he and Sachs did on that week's script. (Should a negligent parent "shake" or "whack" a kid?) Morocco revels in TV's power: "Imagine how many patients we'd have to see to reach the number of people we get on a bad night on 'ER'."

The new shows have their own docs onboard. Two of "MDs' " writers are, in fact, M.D.s. "We want to be as accurate as possible," says executive producer Marc Platt. And "Presidio Med" (produced by a team from "ER"), set in a San Francisco clinic, also has two physicians writing. One, Lisa Zwerling, says she debated working in TV until a mentor said: "This is the public-health opportunity of a lifetime."

In the end, what really matters to Hollywood is ratings. That means having viewers like Marcy Jaslow, 15, who was treated by Morocco at UCLA for an eye allergy. "You work for 'ER'?" she shrieked when told about his day job. "Oh my God, I love that show!" Just what the doctor ordered.