Flores Glenn
Division of General Pediatrics, Boston University School of Medicine, Massachusetts, USA.
J Natl Med Assoc. 2002 Jul;94(7):635-58.
Cinematic depictions of physicians potentially can affect public expectations and the patient-physician relationship, but little attention has been devoted to portrayals of physicians in movies. The objective of the study was the analysis of cinematic depictions of physicians to determine common demographic attributes of movie physicians, major themes, and whether portrayals have changed over time. All movies released on videotape with physicians as main characters and readily available to the public were viewed in their entirety. Data were collected on physician characteristics, diagnoses, and medical accuracy, and dialogue concerning physicians was transcribed. The results showed that in the 131 films, movie physicians were significantly more likely to be male (p < 0.00001), White (p < 0.00001), and < 40 years of age (p < 0.009). The proportion of women and minority film physicians has declined steadily in recent decades. Movie physicians are most commonly surgeons (33%), psychiatrists (26%), and family practitioners (18%). Physicians were portrayed negatively in 44% of movies, and since the 1960s positive portrayals declined while negative portrayals increased. Physicians frequently are depicted as greedy, egotistical, uncaring, and unethical, especially in recent films. Medical inaccuracies occurred in 27% of films. Compassion and idealism were common in early physician movies but are increasingly scarce in recent decades. A recurrent theme is the "mad scientist," the physician-researcher that values research more than patients' welfare. Portrayals of physicians as egotistical and materialistic have increased, whereas sexism and racism have waned. Movies from the past two decades have explored critical issues surrounding medical ethics and managed care. We conclude that negative cinematic portrayals of physicians are on the rise, which may adversely affect patient expectations and the patient-physician relationship. Nevertheless, films about physicians can serve as useful gauges of public opinion about the medical profession, as tools for medical education, and as instruments of positive social change in efforts to reform managed care.
电影对医生的描绘可能会影响公众期望以及医患关系，但电影中对医生的刻画却很少受到关注。本研究的目的是分析电影对医生的描绘，以确定电影中医生的常见人口统计学特征、主要主题，以及这些描绘是否随时间发生了变化。所有以医生为主角且公众易于获取的录像带发行电影都被完整观看。收集了有关医生特征、诊断和医学准确性的数据，并转录了与医生相关的对话。结果显示，在131部电影中，电影里的医生显著更可能为男性（p < 0.00001）、白人（p < 0.00001）且年龄小于40岁（p < 0.009）。近几十年来，女性和少数族裔电影医生的比例稳步下降。电影中的医生最常见的是外科医生（33%）、精神科医生（26%）和家庭医生（18%）。在44%的电影中，医生被负面描绘，自20世纪60年代以来，正面描绘减少而负面描绘增加。医生经常被描绘成贪婪、自负、冷漠和不道德的，尤其是在近期电影中。27%的电影存在医学不准确之处。同情和理想主义在早期医生电影中很常见，但近几十年来越来越少见。一个反复出现的主题是“疯狂科学家”，即重视研究甚于患者福祉的医生 - 研究人员。将医生描绘为自负和物质主义的情况有所增加，而性别歧视和种族主义则有所减少。过去二十年里的电影探讨了围绕医学伦理和管理式医疗的关键问题。我们得出结论，电影对医生的负面描绘正在增加，这可能会对患者期望和医患关系产生不利影响。然而，关于医生的电影可以作为公众对医学职业看法的有用衡量标准、医学教育工具，以及在改革管理式医疗的努力中推动积极社会变革的手段。
