Houston Medical: Of cameras and criticism

Hospitals continue to open their doors to television producers, and some risk managers say the latest reality show is exploiting patients’ most private moments with the hospital’s blessing.

Cameras have become much more common in health care facilities in recent years, with many allowing producers access to emergency departments and other areas as they make reality television programming for entertainment purposes. The practice came to a head in 2000 when Johns Hopkins Hospital in Baltimore allowed camera crews unprecedented access to create a six-hour, prime-time, ABC News miniseries that garnered substantial publicity. The miniseries was widely hailed for its in-depth look at the inner workings of a hospital, but some risk managers criticized the hospital for jeopardizing patient confidentiality and privacy.

The latest entrant in the hospital-as-entertainment category is Memorial Hermann Hospital in Houston. A respected teaching hospital, Memorial Hermann allowed ABC access to patients and staff in a wide range of situations, including a number of intimate moments of grief.

The general media characterized the program as great entertainment, with TV critic Monica Collins writing in the June 18 Boston Herald that "Houston Medical’ shows us how it is inside a real hospital, where a tiny, fragile baby dies while a mother weeps and wails. This is not happy stuff. We wonder why the subjects have allowed their most private moments to be shown on TV. But they have, and it’s unrelievedly dramatic."

Officials at Memorial Hermann declined numerous requests from Healthcare Risk Management for interviews or information about how the hospital protected the rights of its patients and staff. With the previous program, Johns Hopkins officials told HRM that all patients shown on camera gave consent, though some patients were taped in emergency situations and then consent was obtained afterward. That raised questions among some risk managers, who questioned whether distraught patients and family members could truly give informed consent. Critics also questioned whether the hospitals participating in these programs are sending the wrong signal to staff, after years of trying to ensure confidentiality and the privacy rights of patients.

The Memorial Hermann program is another example of "turning health care into entertainment," says Sandy Mahon, vice president for risk management and quality assessment with Program Beta, the risk pool for hospital districts in California, based in Alamo. Mahon coordinates risk management activities for 77 hospitals, and says she would discourage any of her hospitals from allowing media access for entertainment purposes. She didn’t think much of the Johns Hopkins program and didn’t like what she saw in the new Memorial Hermann show either. "I don’t know what’s in it for them. We’re not in the entertainment business. We’re in health care."

In the first episode of "Houston Medical," a young couple was shown with their premature twins. The episode followed them through the stress of watching one child die, at one point focusing on the mother as she wailed at the baby’s bedside, "Why is this happening to me and my baby? It’s something I did! Please take me instead!" In the week leading up to the show, that clip of the mother screaming also was shown over and over again in prime time as a promotion.

As with the Johns Hopkins program, Mahon questions whether patients and family members understand that their most private moments of grief will be used that way, and whether they feel compelled to consent.

"These people are in very vulnerable situations, and then they have people come up and say how much they’d like it if you would cooperate with the film crew," she says. "We have to ask if they feel the need to cooperate so that the level of care is appropriate, whether there will be any retaliation if they don’t cooperate and be the good patient, the good parent. People’s minds are reeling in these situations, and they don’t want to do anything that might upset the people responsible for saving their baby."

Like other critics, Mahon points out there is a major difference between programs intended as entertainment and programs that serve a legitimate educational purpose, such as those that educate people about diabetes care or spinal injury rehabilitation. But she says "Houston Medical" and similar shows provide only a minimal amount of useful information, and the main purpose of the program is entertainment.

"Memorial Hermann is a respected hospital, and I truly don’t have a clue why they would want to go down that road," she says. "It’s a People magazine version of health care, with profiles of the beautiful blonde doctor and the buff microsurgeon out jogging with no shirt."