Starring William Fichtner, John Hannah, Aunjanue Ellis, Michaela Conlin, Jane Lynch, Leslie Stefanson, Robert Joy
Executive Producers: Gary Tieche, Marc Platt, René Echevarria
"MDs" transplanted the basic premise of "M*A*S*H"--two renegade surgeons thwarting a monstrous system to save lives--to a rundown, HMO-dominated San Francisco hospital. The operation failed. Despite populist anti-HMO antics and likeable lead actors William Fichtner and John Hannah, the writing was so one-dimensional and the depiction of health care so unpersuasive that the show lasted only eight episodes. The chance to explore the real problems with managed care was wasted. The series also ignored the nursing that is central to the work of hospitals. Physicians provided all important care, including the patient advocacy and support that nurses would actually do, and nurses did not even have the marginal roles seen in other Hollywood shows. But "MDs" did create one remarkable thing: Nurse "Doctor" Poole, the show's lone major nurse character.
Nurse "Doctor" Poole (Jane Lynch) was the Frankenstein monster of fictional nurses, combining some of the worst parts of Nurse Ratched from "One Flew Over the Cuckoo's Nest" and Margaret Houlihan from "M*A*S*H." Poole was a nurse with a Ph.D. in management who held an administration position that entailed acting as a heartless, cost-cutting enforcer for the HMO that controlled the hospital. With no apparent bedside or nurse management duties, she spent her time scheming with an HMO ally to deny patients care, while the physicians spent much of their time foiling her evil plans. Like Ratched, she used her training to control patients and actually prevent them from improving. Like Houlihan, she was obsessed with enforcing the rules of her system and frustrated by subversive surgeons who wouldn't play along. She even had a pathetic affair with her married HMO cohort, as Houlihan did with Frank Burns. The big difference is that Houlihan was fiercely committed to giving her patients excellent nursing care. Of course, Poole was just one character, and in real life some nurse administrators do serve the managed care agenda. But without even a minor counterexample, Poole was the entire vision of nursing that "MDs" viewers took away.
The crowning touch was Poole's "Doctor" label, which the show itself put in quotes. This label mocked the idea that a nurse could have a doctorate in a health-related field, when in fact many thousands do, including in the field of nursing. (A nurse who thinks she's a "doctor!" The gall!) The label also implied that if a nurse had a doctorate, she would use it to pinch pennies and deny patients needed care. To suggest that nurses are obsessed with money but physicians are not might have been too black-is-white even for an Orwell character. But the notion that nurses--the biggest professional victims of managed care, most of whom fight burnout every day to protect their patients from it--are the main collaborators with that system is truly mind-boggling.
Review by Harry Jacobs Summers
Nursing Editor: Sandy Summers, MSN, MPH, RN
Reviewed February 8, 2003
The views expressed herein do not necessarily reflect those of the Board Members or Advisory Panel of The Truth About Nursing.