A Medical College of Wisconsin physician reviews movies with one thing in mind - how doctors are portrayed. Glenn Flores, M.D., brings his expertise as a pediatrician to his avocation reviewing movies from the past and present. His findings are published as the lead article in the December issue of Archives of the Disease of Children. His current review of a dozen movies builds on an earlier published study reviewing 131 films. Dr. Flores is an associate professor of pediatrics at the Medical College and, director of the Center for the Advancement of Underserved Children at the Medical College and Children's Hospital of Wisconsin, a major teaching affiliate of the College.

He found that in older movies physicians are portrayed as wise and dedicated healers, while in current films, most are avaricious and incompetent.

One theme Dr. Flores sees frequently in movies about doctors is money and materialism. ?Money is often portrayed as the prime motivation for becoming a doctor and choosing a medical specialty in the movies,? says Dr. Flores.

Movie doctors, he points out, sometimes base treatment decisions on the patients' ability to pay and are shown as bound by the strictures of insurance bureaucrats. And the foibles of both doctors and patients, he says, consistently provide a treasure-trove of humor.

His concern is that because of negative portrayals of doctors, patients' expectations and the doctor-patient relationship may be adversely affected. He also feels that films about doctors can serve the medical profession as useful gauges of public opinion and a valuable tool in training doctors.

A second theme is bureaucracy and healthcare systems. ?Movie doctors frequently face the frustrations and follies of having to confront inefficient bureaucracies and healthcare systems that hinder patient care,? he says.

A third theme is humor, both intentional and unintentional. He cites episodes that make doctors laugh, even if the average viewer misses the humor, such as a doctor diagnosing severe edema of the abdomen and liver without ever touching the patient's abdomen, or a doctor using a light microscope to see a virus. In one movie, a doctor developed a cure for a virus in one evening's work.

Since he is a pediatrician, he also looked at how his specialty is treated in movies. The conclusion: they are mostly absent. Only two percent of doctors in the movies he reviewed are pediatricians, all in movies from the 1940s.

His study includes an annotated ?Top Ten? list of doctor movies which he considers the best, most humorous and most useful in medical education.

This work builds on research he did two years ago when he reviewed 131 films in which one or more characters were doctors. His paper, published in the Journal of the National Medical Association in July 2002, details his major findings:

-- Compassion and idealism were common in older films but have become scarcer in newer movies.

-- Positive images of doctors have declined since the 1960s, while negative images have increased.

-- Doctors are often portrayed as greedy, egotistical, uncaring and unethical, especially in recent films.

-- A recurrent theme is the ?mad scientist?, the doctor-researcher who experiments on patients and values science over his patients' welfare.

-- Doctor movies continue to fascinate because they can be humorous, thought-provoking and informative of the public's perception of doctors,? he says. ?And they never cease to entertain. Movie doctors can provide insightful and realistic portraits of the challenges, rewards and excitement of being a doctor."

?Top Ten? list of doctor movies which he considers the best, most humorous and most useful in medical education:

Best
1.Red Beard (1965)
2.The Hospital (1971)
3.Article 99 (1991)
4.State of Emergency (1993)
5.Miss Evers' Boys (1997)
6.The Elephant Man (1980)
7.Panic in the Streets (1950)
8.Spellbound (1945)
9.Death and the Maiden (1994)
10.Guess Who's Coming to Dinner (1967)

Most Humorous
1.M*A*S*H (1970)
2.Body Parts (1991)
3.High Anxiety (1977)
4.The Patriot (1999) 5.What About Bob (1991)
6.Carry on Doctor (1968)
7.Doctor at Sea (1956)
8.What's New Pussycat (1965)
9.Torture Ship (1939)
10.Malice (1993)

Most Useful in Medical Education
1.The Doctor (1991)
2.Arrowsmith (1932)
3.The Citadel (1938)
4.Not As a Stranger (1955)
5.Pressure Point (1962)
6.Whose Life is It Anyway (1981)
7.Miss Evers' Boys (1997)
8.The Interns (1962)
9.Critical Care (1997)
10.And the Band Play On (1993)

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