In Good Health

Steve Clarke explores the latest developments in the always popular medical-drama genre.

Since the dawn of TV, medical dramas have been a lynchpin of global TV schedules. Encounters between doctors and their patients offer scriptwriters rich pickings for stories and situations that embrace the struggle between life and death. Away from the tensions and stresses of the consulting room or the operating theater, there are abundant possibilities for multiple narratives concerning the protagonists’ often complicated private lives and troubled personalities.

In common with crime scenes, the medical workplace is a gift to commissioners, producers, screenwriters and showrunners all seeking to make compulsive TV. Today, distributors’ libraries are full of medical shows as buyers seek series that have the potential to become long-running hits that can stand the test of time. These shows are thriving in most markets as the traditional and more hybrid forms—for example, Endemol Shine Group’s The Orpheus Project, which mixes medicine with the supernatural—compete for audiences. In South Korea, where ABC’s breakout hit The Good Doctor was originally created, there’s even a medical series that incorporates time travel: Live Up to Your Name.

So why is medical fiction still an essential component of broadcasters’ schedules? “These shows remain hugely popular,” says Gina Brogi, the president of global distribution at Twentieth Century Fox Television Distribution—whose portfolio includes such classic medical shows as M*A*S*H, St. Elsewhere and Chicago Hope. “I think one reason why medical drama is in such demand right now is that we live in a difficult era. They offer an escape in these scary times. There are so many negative news cycles; I think people want to watch shows that provide hope. Often, they demonstrate the good in humanity. Significantly, they deal with universal themes.”

SEEKING A DIAGNOSIS
Health care systems vary from country to country, but whether they focus on the U.K.’s National Health Service (which celebrated its 70th birthday this summer) or private insurance that funds health care in the U.S., medical dramas connect strongly to themes and topics that resonate across social classes and demographic categories.

Don McGregor, executive VP, sales liaison, at NBCUniversal International Distribution, puts it like this: “Medical dramas are one of the key genres that truly translate in all markets. I believe that everyone has either spent time in a hospital or had a loved one get sick. So no matter where you’re from, it’s something you can relate to. At the end of the day, medical dramas have themes of heroism, self-sacrifice, hope and passion. This makes them universally appealing and relevant.”

Cathy Payne, the CEO of Endemol Shine International, agrees, noting, “Everyone can relate to the storylines, which cover the whole spectrum of day-to-day life in a hospital. We are in awe of medical practitioners who deal with life-and-death situations on a daily basis while maintaining compassion and empathy for their patients. These dramas are strongly character-driven, emotive and, hopefully in most cases, life-affirming.”

LIFE AND DEATH
Robert Franke, the VP of drama at ZDF Enterprises, thinks the appeal of this schedule staple revolves around the raw material’s raw material. “All human life is there,” he says. “It might sound unduly pessimistic, but as human beings, we are people who like to learn from others’ miseries. We enjoy watching doctors struggle against the odds and seeing them make their patients well again.”

Fredrik af Malmborg, the managing director of Eccho Rights, makes a similar point. “Medical issues provide the subject matter for very good TV because they deal with highly emotional situations. Both of our medical shows, Nurses and The Clinic, are not as glossy as American medical dramas. In fact, sometimes I wonder if American hospitals really look the way they are portrayed on TV. Our shows are based more on social realism. In the Finnish version of Nurses, one of the lead characters deals in narcotics and is a drug user because she is so stressed. Another character works as a call girl to make ends meet.”

Giving principal characters an interesting backstory is one way to make a medical drama stand out in a crowded content space. It seems as if nothing is off limits in today’s über-competitive world. Thankfully, TV has moved on since the days when the lead character in a hospital series had to fit the white, alpha-male stereotype. The clean-cut Doctor Kildare was usurped long ago.

In Germany, Dr. Klein features a feisty female character who confounds expectations of what a TV medical professional should be. She suffers from dwarfism. “It’s a very brave show, very inclusive and extraordinary,” says ZDFE.drama’s Franke. Betty’s Call, meanwhile, focuses on nurses in a big-city hospital.

ALTERNATIVE MEDICINE
To a degree, the tradition of the medical procedural has been subverted, influenced perhaps by streaming services’ addiction to serialized scripted shows.

“It’s rare nowadays that we have a straight-down-the-middle exclusively procedural show,” says Fox’s Brogi. “Generally there tend to be serialized elements to all of these shows. We certainly have that with The Resident. But being able to conclude an aspect of a storyline in one episode resonates well with broadcast television audiences.”

Endemol Shine’s Payne agrees that medical procedurals are here to stay. “Historically, most medical dramas have been largely procedurals, usually with an overriding story arc featuring the main characters. Audiences want to see a resolution to the case in the same episode, combined with the ongoing storylines of the lives and loves of those working in the medical practice or hospital.”

The procedural also remains the norm in Scandinavia, Eccho Rights’ af Malmborg notes. “But there are some stories that run over many episodes, typically those concerning relationships, the affairs and divorces that happen to people who work in the hospitals.”

“People like the fact that doctors have the same human problems as everybody else,” suggests ZDFE.drama’s Franke. “In the hospital, medical staff have the power of life and death over their patients, but away from the workplace, they are prone to the same problems as the rest of us. I think audiences find that reassuring.”

Finding a point of difference is critical to launching a successful medical drama today. “The Good Karma Hospital sees a junior doctor travel to India to find herself, and she ends up in an under-resourced and overworked cottage hospital,” says Endemol Shine’s Payne. “It mixes the heartbreaking with the humorous. The Good Karma Hospital is more than just a rundown medical outpost, it’s home. Israeli medical drama The Orpheus Project sees five of the brightest medical students take part in an elite training program where they discover that life-threatening experiments are being carried out.”

TREATMENT OPTIONS
NBCU’s McGregor insists that for a medical drama to make noise, it must possess a unique point of view. “For our new show New Amsterdam, the focus is on the patients—they are the priority for our lead Dr. Max Goodwin (Ryan Eggold) and the doctors of New Amsterdam. Max is the new medical director working in one of the largest hospitals in the world and needs to be a ‘disruptor’ in order to put the patients first.” If this sounds more traditional, McGregor highlights the diversity of the cast, which includes Anupam Kher (The Big Sick).

The Australian series The Heart Guy (also known as Doctor Doctor), which is distributed by Fremantle, is set in a rural location. Most hospital shows are decidedly urban.

“We decided to set it in the country town of Whyhope, which is where all the drama takes place,” explains Ian Collie, CEO and producer at Easy Tiger, which makes the series. Whyhope is also where the central character, Doctor Hugh Knight, was raised, and he resents having to return to his quiet small town. “He was a high-flying Sydney surgeon busted for bad behavior and his playboy lifestyle,” Collie says. “Doctor Knight is put on probation by the medical tribunal and moved to his hometown.”

The Heart Guy is in its third season on Nine Network. It has been sold to the U.K. (UKTV), Germany (Sky Deutschland) and the U.S. (Acorn TV).

Jully Kim, a business analyst at Korea’s CJ ENM, echoes the importance of having “a special element” that makes a medical show distinctive. One of her company’s programs that debuted earlier this year, A Poem a Day, avoided focusing on doctors and nurses. Instead, the action centered on rehabilitation therapists. Another CJ ENM program, Live Up to Your Name, introduced time travel as a crucial part of the story. Two doctors, one from the 17th century and the other from the 21st, meet and confer to help treat each other’s patients.

CROSSING GENRES
Hybrid period medical shows are nothing new—think Dr. Quinn, Medicine Woman and Call the Midwife—and they continue to attract loyal followings. M*A*S*H, set during the Korean War, is still popular although it stopped being made in the early 1980s. At MIPCOM, Fremantle is showcasing a second season of the acclaimed German wartime drama Charité.

In certain markets like the U.K., unscripted medical shows have long proved their value to commissioners and schedulers. Jimmy’s, one of the first docusoaps, ran successfully from 1987 to 1997 on ITV. It was filmed at a busy hospital in Leeds, one of the biggest cities in northern England. More recently, fixed-rigs shows such as 24 Hours in A&E and One Born Every Minute, filmed in a maternity unit, have been successful for Channel 4. Have unscripted hospital shows had an impact on medical drama?

“We’ve endeavored to make the events portrayed in our medical dramas grounded in reality,” says NBCU’s McGregor. “The writers on our current shows Chicago Med and New Amsterdam work to make the cases and storylines feel authentic.”

Endemol Shine’s Payne agrees that medical dramas have gotten more realistic recently, partly due to the success of their unscripted cousins. “When you watch these unscripted shows, it sometimes feels like you are watching a TV drama unfold. The reality of the emergency situation is something that you would rather believe could only happen in a TV drama.”

Eccho Rights’ af Malmborg adds, “When you make unscripted shows set in a hospital it’s important not to make them look too glossy. The medical world is full of stories that are larger than life, so making a documentary in that environment can be very powerful. There is a lot of good material that doesn’t have to be too fictionalized.”

REAL INSPIRATION
Fox’s Brogi says that screenwriters and showrunners are inspired by unscripted hospital series. “The idea that real life informs the storylines of scripted shows is a concept that resonates with creatives. On 9-1-1 all the storylines—the medical stories, the emergency stories—are inspired by real 911 calls.”

Unscripted medical series are, of course, cheaper to produce than medical drama. Generally, however, in an era when drama budgets are ballooning, the genre remains inexpensive—another reason why it continues to be ubiquitous.

“Medical dramas are relatively cost-efficient to produce,” af Malmborg points out. Consequently, co-productions are rare. “Medical dramas are commonly financed by their domestic market, and they will often have a local feel,” says Payne. Obviously, the very best of U.S. medical shows travel all over the world. Consider the international success of Grey’s Anatomy, Chicago Hope, ER and autism-themed The Good Doctor, a big seller for Sony Pictures Television with around 200 territories acquiring the series. Yet, the importance of medical drama reflecting local concerns is a priority, especially in Europe.

“This is crucial in Scandinavia,” says af Malmborg. “Although there are lots of things to watch on Netflix and other streaming services, drama that provides audiences with local settings and themes is something that broadcast TV does better than the SVOD providers. Shows like Nurses adapt very easily to different local markets in Scandinavia and elsewhere. Local drama is gaining ground and becoming more important, and medical drama can fill that need.”

BACK TO BASICS
Ultimately, the basis of a hit medical drama is great characters and good storytelling. Fox’s Brogi cites The Resident as a good example. Despite mixed reviews, the program was renewed for a second season in May. “It’s connected with audiences wherever we launch it. 9-1-1 is another medical drama that is performing extraordinarily well for us.”

While high-end, serialized crime drama like Scandinavia’s The Bridge has been formatted successfully internationally, adaptations of this kind are less common in medical drama—but they do occur. As already noted, Good Doctor originated in South Korea, where it won awards following its 2013 debut on KBS2. The Orpheus Project was created in Israel and has been adapted in the Netherlands. Doktor Martin is the German version of the British series Doc Martin, which has also been adapted in several other markets.

So is medical drama faithfully reflecting modern society in all its diversity and complexity? “There is less stereotyping these days, but I think we still have some work to do,” says Fox’s Brogi. “I haven’t done a study, but I, for one, would like to see more female doctors and female medical professionals as lead characters.”

Finally, is the prognosis for medical shows good, or is the genre facing a terminal diagnosis? All distributors agree that medical drama looks sure to remain in rude health. “Like crime drama, medical drama will always be popular on TV,” states ZDFE.drama’s Franke. “The genre appeals to the subconscious and our basic human urges, and it is very atavistic.”

Pictured: ZDF Enterprises’ Betty’s Call.