December 20, 2004 -- Today Dr. Phil made an on-air statement about his Nov. 18 comment that he has seen many "cute little nurses" who are out to "seduce and marry" physicians "because that's their ticket out of having to work as a nurse." We salute Dr. Phil for expressing appreciation for nurses, including praise for their training, hard work, and judgment, and especially for his recognition of the importance of the nursing image problem. We note that he did not acknowledge the full import of his earlier comments or the reaction from thousands of nurses, nor make the apology those nurses had requested. We are also concerned that a few of his comments today--notably his remark that monitoring machines can't replace the "loving, nurturing care" of nurses--could reinforce maternal and angel stereotypes. Even so, we are encouraged by his effort, which is unusual for a popular Hollywood figure, and we look forward to the show he has promised to devote to an examination of the nursing media image problem in the near future.
About half of Dr. Phil's statement consisted of his reading of a letter than he said he had received from his two older sisters, who are nurses. The letter encourages him to make clear that he has a positive opinion of nurses as a whole. It states that in the prior show, in the context of dealing with a physician who'd had an extramarital affair with a nurse, Dr. Phil had said that he had "seen these work place romances take place lots of times." The letter notes that while such activity does occur, "nurses fight an image problem in movies, media and television," and that because of Dr. Phil's support for the profession, his sisters know he would "not want to contribute to that misperception." Dr. Phil then confirmed that he would not want anything he said to be construed as expressing a negative view of nurses, and noted that they were one of his few "heroes." He stated that the "men and women" in nursing work hard, and that they are "dedicated," devoted," "extremely well-trained," and "the backbone of the medical profession." He also noted that no matter "how much technological advance we make with machines to monitor patients, machines can't do the loving, nurturing care that a nurse can do, can't have the judgment, can't have the wisdom and can't be replaced by machines." Dr. Phil closed by stressing again the importance of "image" and "perception," assuring his sisters that he wanted to be part of the solution, not the problem, and advising viewers to "give a nurse a hug."
There is a lot to like here. First and foremost, we are very pleased that the show put so much emphasis on the importance of the nursing image, and that it acknowledged (through the sisters' letter) the image problem that nurses "fight" in the major media today. It is very unusual for Hollywood figures to acknowledge that what they do can have an impact on nursing, and we commend Dr. Phil for doing so. We also appreciate his assurance that he respects and appreciates nurses, and particularly his comments with regard to nurses' training, judgment, wisdom, hard work and central role in the health care system (we'll interpret "backbone" that way). To say that nurses are "heroes" is also good, but of course with such an abstract and overused term, much depends on the surrounding comments. Last but not least, Dr. Phil made a point of acknowledging the "men and women" in nursing, which is a helpful message as to a profession that remains over 90% female despite a well-known shortage.
We also had a few issues with Dr. Phil's statement. First, Dr. Phil has not apologized for his initial remarks, as hundreds of nurses have requested, nor has he taken full responsibility for what he really said on Nov. 18. The description of his Nov. 18 statements in the letter he read--that he had "seen these work place romances take place lots of times"--is simply inaccurate. He did not say nurses often have romances, or even adulterous romances, with physicians. He said that he'd seen many "cute, little nurses" actively seeking to "seduce" and "marry" physicians to escape "having to work as a nurse"--in effect, that many nurses are shallow golddiggers looking to escape a dead-end job. This is toxic mix of inaccurate stereotypes, and cannot be waved away with a vague phrase about "romances." In fact, Dr. Phil did not even appear to have any reason to believe that the nurse he was speaking about that day conformed to these stereotypes; he just picked the stereotypes out of the air. Again, we recognize that any effort to make amends for such remarks is a huge leap for a popular Hollywood figure, but in this case, it does present a striking contrast to how we imagine the show would treat a guest who tried to get away with such a whitewash. We suspect the show would simply go to the videotape, and force the guest to confront what he really did, which would be presented as an essential step toward real change in the person's attitudes. In a similar vein, the show left viewers with the impression that the Nov. 18 remarks merely bothered Dr. Phil's sisters, when in fact they infuriated thousands of nurses.
The other major concern we had was with part of Dr. Phil's descriptions of nursing. Of course, all were ostensibly positive, but in many cases the messages people send when praising nurses reinforce stereotypes that are not helpful. Normally we might hesitate over Dr. Phil's descriptions of nurses as "devoted" and "dedicated," since those are key elements of the angel image. But because his earlier remarks clearly questioned nurses' commitment to nursing, we prefer to take the new descriptions as responses to that issue. However, Dr. Phil's statement that nurses can't be replaced by monitoring machines because machines can't provide the "loving, nurturing care" of a nurse reflects unfortunate maternal stereotypes, and perhaps a misunderstanding of nursing. Monitoring machines are an important tool that nurses use to assess their patients, so that they can plan and implement appropriate interventions. The nurses, not the machines, provide this care, including highly technical physical interventions. To contrast high tech care with nurses' "loving" and "nurturing" is to suggest that machines save lives, while nurses hold hands.
More broadly, most of Dr. Phil's descriptions of nursing are consistent with a vision of nursing as a physically demanding support vocation that is focused on providing comfort and emotional care. We wish the show could have included some reference to the fact that nurses' highly skilled care saves lives--as research has shown--and that nursing care is central to the prevention of and recovery from disease. And nurses' emotional care is itself the product of special training and experience; it is not something any "loving" mother could do. Would anyone have said that physicians can't be replaced by high tech surgical tools because they're still needed to provide "love" and "nurturing?" It almost seems like Dr. Phil knew he was going off track here, as he quickly added comments about nurses' "judgment" and "wisdom." Likewise, it might have been nice if there had been some recognition that nursing is an exciting, autonomous profession on the cutting edge of health care research and clinical practice, not least through the efforts of the nation's 200,000 advanced practice nurses, most of whom have graduate degrees.
However, on the whole, we salute Dr. Phil's expression of appreciation for nursing, and his efforts to respond to concerns about his depiction of it--efforts, we stress again, that are very unusual in Hollywood. And we look forward to the show Dr. Phil promised to devote to the nursing media image problem to which he himself pointed in today's broadcast.
Feel free to send your comments to Dr. Phil at DrPhil.com@DrPhil.com
McGRAW: Now, we've been talking about psychics today, and we've been talking about image and the image of psychics. And I've been careful to say that I don't mean to color Char in any way with...
Ms. MARGOLIS: Thank you.
McGRAW: ...the unethical brush that others. And you changed how you referred to yourself because of image.
Ms. MARGOLIS: Right.
McGRAW: And image is something all of us--lawyers, doctors, psychologists, nurses--everybody follows and has to manage. I got an interesting letter that I wanted to read to you. It's "Dear Dr. Phil, since I have heard you many times comment about your respect and admiration for those in the nursing profession, I wanted to address something you said to a recent guest. You were dealing with the wife of a physician in the aftermath of his having an affair with a member of the nursing staff at a local facility. You said that across many years, you had seen these work place romances take place lots of times.
"While we certainly know that such activity takes place, nurses fight an image problem in movies, media and television, and because of your support of our profession, I know you would not want to contribute to that misperception. I know you were speaking only to those people about their specific situation, and you're certainty not charged with managing our challenges as nurse professionals, but as a nurse, we very much want your continued support to be evident. I hope you will make clear that you don't have a negative opinion of the profession as a whole. Thank you for reading our letter, and don't forget that, together, we can still beat you up if you don't do right." This is signed, "Dina and Donna, your two older sisters" and, parentheses, "professional nurses."
And so I wanted to respond to your letter, because Christmas is coming up and I don't want to get beat up by my sisters. You're right. I don't have a negative opinion of nurses at all and would not want anything that I said to be construed that way. I think the men and women that are in nursing work hard, they're dedicated, they're devoted, and they're extremely well-trained. And they are the backbone of the medical profession. I've said many, many times, I have very few heroes in this society. It's a short list, and it's made up of teachers, who we don't pay enough money; nurses, who--I don't care how much technological advance we make with machines to monitor patients, machines can't do the loving, nurturing care that a nurse can do, can't have the judgment, can't have the wisdom and can't be replaced by machines; and, thirdly, single parents who really struggle to do it right. That's on my--that's on my list, and we've done shows about all of those things, and we'll be doing that in the future. Image is important. Perception is important.
And, sisters, I want to be part of the solution, not the problem. So don't beat me up at Christmas.
And give a nurse a hug. They are the absolute backbone of the medical profession. We'll be right back.
See the original offensive remarks by Dr. Phil (November 18, 2004)
His initial response (November 30, 2004)
His on air response we discuss above (December 20, 2004)
A later attempt to make amends (still inadequate) (July 14, 2005)