Fox's new medical drama The Resident was taken to task on Twitter upon its premiere last week for its completely unrealistic portrayal of what goes on in American healthcare and the January 29 episode, "Comrades in Arms," was no different as it portrayed medical personnel ordering unnecessary tests to drive up costs and the hospital administration refusing to treat a dying illegal immigrant.
Doctors on Twitter were completely horrified with this new episode, with one saying, "When you have many, many ACTUAL doctors telling you that your fictional depiction of our chosen profession (one that greatly relies on the trust and participation of our patients) is way off-base and indeed potentially harmful, please take it seriously," another offered: "Watching @ResidentFOX which may be the worst ever 'doctor show.' Money in medicine is a problem, but this show is unrealistic, offensive and potentially harmful to the public’s perception of US medicine,"and still another said, "Seeing people tweeting about how this show is 'so true' or that all the top doctors are 'crooked and money hungry' or that they’re terrified of getting sick and needing to go to hospital is very upsetting."
This week, the plot centered around the doctors of Chastain Hospital in the midst of a new initiative called "CUTE" which stands for Code Up To Excellence.
Barb: Now, to simplify, doctors and nurses at Chastain need to charge more per procedure.
For example: Ear infection. Typically billed to insurance as service code one at about... Yeah?
Nicolette: $200.
Barb: But what if that ear infection took a trip to the brain? That's now a code four. Serious. Costly. We can bill in the thousands. Illness is unpredictable, so billing must be proactive. Right? It's called upcoding. Think... CUTE. Code. Up. To. Excellence.
Upcoding is illegal, so I highly doubt hospitals are bringing in consultants to teach their employees to do it. That's a lot of legal exposure.
If this didn't make American medicine look evil enough, they then brought in an illegal immigration twist to drive it home.
Louisa Rodriguez, an employee at Chastain, collapses on the job but, before they can run the tests they need and determine a course of treatment, Barb, the upcoding consultant, looks into her immigration status and goes to the hospital administration, telling them, "Ms. Rodriguez is an uninsured, undocumented immigrant. She has no family in this country. She was brought here from El Salvador as a child." It sounds like she might not just be an illegal immigrant, but a DREAMer as well. How timely!
Despite being told Lousia will die if she doesn't get surgery right away, Barb says, "No more tests, no more treatment on our dime. This hospital isn't a charity."
There are a lot of problems with all this, but the main one is that it is illegal. This "consultant" is a walking lawsuit waiting to happen. As one medical resident tweeted, this is a direct violation of EMTALA, which requires that hospitals treat patients in need, regardless of ability to pay.
Of course, The Resident's rule-breaking hero Conrad Hawkins (Matt Czuchry) figures out a way to help Louisa and gets her ready for surgery, but the evil hospital has one more trick up its sleeve to avoid treating her - calling ICE.
Conrad: How can I help you, gentlemen?
ICE Agent: Sir, you need to move aside.
Conrad: I will, if you tell me what's going on.
Devon: Hospitals are sensitive areas, along with schools and churches. And sensitive areas cannot be accessed by immigration officials without arrest warrants or under investigation of an imminent national security threat. ICE policy letter, October 24, 2011.
ICE Agent: You're interfering with the actions of authorized federal agents.
Conrad: You're gonna regret this.
ICE Agent: I doubt that.
Devon: Well then, you better drag us both out of here.
Nicolette: Conrad.
Claire: Stop. Step aside or you will both be fired.
Nicolette: It's okay. Let them pass.
Nicolette: Surgery's underway. Sterile environment. You cannot enter under any circumstance. No one can.
So, Louisa was haphazardly rushed into surgery to stay away from the ICE agents that the hospital called on their own patient. In reality, hospitals do sometimes call immigration on patients, but the government rarely responds, because they would become financially responsible for the patient's medical care. Instead, the hospital has to pay for it. It is estimated that American hospitals pay nearly $30 billion per year in healthcare for illegal immigrants. Money which, of course, either comes out of budget cuts as the administration is threatening at Chastain Hospital, or the cost is passed on to those who have insurance.
The Resident wants viewers to think that American healthcare is run by heartless doctors who care about profit over people, but that couldn't be further from the truth. Our healthcare system isn't perfect, but its certainly better than most alternatives.
This doctor challenged the writer/executive producer on Twitter before being blocked, "I watched your horrible excuse for a medical drama (the plot beyond the medicine is also quite unwatchable). It represented nothing I know medicine to be. Come spend a day watching me take care of dying children. See what medicine is. I gave you an hour of my life, you owe us."
