The Big Story: Real Medical Professionals Feel Seen and Heard in “The Pitt”
“We set out to make the most realistic and authentic medical show that’s ever been on TV. That isn’t just the procedures and terminology. It’s trying to identify what’s happening with practitioners post-COVID.”
Divide Depicted as a Chasm
By Tim Stewart
4-minute read
“The Pitt” is being hailed as a throwback to the heyday of network TV. Noah Wyle back in the ER. A pace and structure that evokes “24.” A flood of heart-stirring moments with parents, children, patients and practitioners in peril. Against that familiar framework from 1993’s “ER”, we also have elements that are all-too-current: Dr. Google, people vibrating with rage, mass shootings. Even measles.
And then a new villain appears: the hospital executive.
Gloria Underwood, whose exact role is unclear but would probably just be described as Bureaucrat Suit, comes through the emergency department every few hours to disrupt the heroism of Wyle’s Dr. Robby, pushing him on patient satisfaction, Press-Ganey scores and the need to turn beds over. In return, Dr. Robby blames her for inadequate staffing, lack of supplies, the potential sale of the hospital and her obsessive focus on the bottom line.
For a character who’s on screen for maybe 10 minutes of the show’s 15 hours, there’s a lot to unpack.
Perhaps the key to understanding the workplace dynamics lies in two contrasting speeches occurring around the season’s most tense events. In one, as an emotionally and physically exhausted staff gathers, Gloria offers a well-intentioned “thanks for being heroes” attempt at a rallying cry. It’s met with cool expressions and slumped shoulders.
In another, Dr. Robby brings everyone together and shares their stress and grief. Some cry. No one moves. The music swells. It’s devastating and cathartic, raw human connection among people who are bonded by shared experience.
The divide between white coats and dark suits has turned into a chasm.
Over the last several years we have tracked the decline of trust that both consumers and clinicians have in hospitals. Many health system leaders can point to external forces that are working hard to erode patient trust, including major insurance companies, Big Pharma, Arnold Ventures and politicians.
That may be true. But it’s incomplete.
Many physicians and nurses feel that the enemy is within the walls of their hospital, and it talks a lot like Gloria. In fact, “The Pitt” tracks with recent Jarrard research on how physicians feel about hospital executive leadership:
- Only 45% of doctors trust that their leaders are honest and transparent.
- About the same number trust that their leaders are making decisions that are good for patients.
- When asked to identify one thing their organization could do to communicate more effectively with physicians, one respondent answered, “Talk to us individually and understand what our problems are.”
Gloria tells, while Dr. Robby wants to be heard.
So, what does it mean when the most zeitgeist-grabbing hospital show in years is pointing the finger at you?
Despite what the doctors, nurses and residents of the fictitious Pittsburgh Trauma Medical Center may believe, very few healthcare administrators or executives got into this industry to obsess over patient satisfaction metrics or RVUs. Even over in our consulting neck of the woods here at Jarrard, our mission is to make healthcare better. Because we’re scared of needles and gore – and sometimes look away from intense and stunningly realistic scenes in “The Pitt” (consider yourself warned) – we use the talents we do have to positively influence this industry. Most administrators got into this to do the same.
How did we get here, and how do we get out? How do we build a real, seamless connection to the mission, from the suits to the scrubs?
- Acknowledge that the struggle is real. It starts with acknowledging that the issues clinicians are most frustrated about are real. There are genuine staffing shortages, our rage-filled times have presented greater safety issues for clinicians and the pursuit of metrics can feel at odds with the mission of healing. You won’t have the answers to all (or perhaps any) of these issues at any given moment. But it will help if everyone is facing the same reality.
- Show up when you’re not asking for anything. Every Gloria/Dr. Robby interaction is transactional. Executives need to show up even when they don’t need something – especially when they don’t need something. The people at the bedside need to feel supported, and that starts with putting faces and names to the operations side of the health system.
- Build communications as an organizational muscle. It’s clear that the chains of organizational communication are broken in “The Pitt.” Interests are misaligned and poorly communicated, creating tension and exacerbating the feeling of Us vs. Them. This might feel familiar. Communicating well is something that every leader in the organization must be expected to do, and it starts with giving them access to tools and training that can turn a gap into a strength.
- Be a teammate. When Gloria commends the team’s performance, one reason it doesn’t resonate is that she isn’t part of the team. Be visible, join huddles, develop inside jokes. Get off the bench and into the game.
It would be easy to dismiss the tension and lessons of “The Pitt” as “just a TV show.” But when the show is holding up a mirror that many clinical teams see themselves in clearly, it would be wise to take that depiction – and the fault lines it reveals – seriously.
Contributors: David Shifrin, Emme Baxter, Isaac Squyres
Image Credit: Shannon Threadgill
