I should preface this review that I found The Pitt riveting television. I’ve always liked Noah Wyle as an actor and ER was always a favorite show of mine. This review will have some minor spoilers for the show so if you have not watched it – go watch it! Then come back and see whether the same things struck you as they struck me. The Pitt has a couple of problems, and they not only take me out of the show when they occur, they also perpetuate the myths that surround human and veterinary medicine (my world).

Administration is the Bad Guy

The character of Gloria Underwood, played by Michael Hyatt, who is credited as the Chief Medical Officer but acts as more of a non-medical Hospital Administrator, is portrayed, except for one scene (more on that later) as the bad guy throughout. This is not because they do anything particularly bad, but because they care about how long patients have been waiting and how they are treated by the doctors and nurses. The show treats this push back against the tyranny of customer service as a noble endeavor, as our hero character championing medicine over business.

The big problem with this mindset that can often be found in both human medicine and veterinary medicine is that “my time (the doctor) is more important than your time (the patient). There will always be wait times in medicine, but that does not mean they are a badge of honor that shows how much more important the medicine is from treating patients respectfully. Patients who leave because they won’t or can’t have an extended wait time are punished with worse outcomes. If we want what’s best for our patients we have to care about wait times.

The Pitt then seemingly redeems its portrayal of Gloria by showing just how good she is at her job. When the staff are informed of a mass casualty event, Gloria shows that she is three steps ahead of our hero Robbie, played by Noah Wyle, in having emergency supplies of all kinds already on the way. It’s a great moment and the disconnect between the doctors and nurses as they realize that this person who they consider the enemy is just someone who sees the wood for the trees.

…And then they go and spoil it by having Robbie curse Gloria out and call her a micromanager because she questions their use of unscreened blood from team members in patients.

The fact that Robbie is shown on multiple occasions to be struggling with his own mental health, and that while often right, he prefers to use his own intuition rather than facts or rules is shown as an honorable sacrifice. I hope that in season two we get to see Robbie be wrong because to do otherwise is disingenuous to the professions involved.

Likewise; Dr. Gregory House, from TV’s House, is a great and fun character to watch but nobody wants him as their doctor. When you are purporting to show a hyper realistic medical drama, falling into using these well-worn tropes does the show and its audience a disservice.

Poor Doctors

I have the upmost respect for human doctors and nurses, just as I do for veterinarians and veterinary nurses. I believe they all deserve to be paid well. However, The Pitt plays fast and loose with the socioeconomic realities of the ER and human medicine as a whole.

Dr. Michael “Robby” Robinavitch  is a Senior Attending Physician and probably earns in the region of $361,072 per annum.

 All of the other doctors of The Pitt are residents who are likely to be earning $75,000 per annum although it seems this could increase to almost $100,000. The medical students shown in the show would not be paid.

Robbie is unlikely to walk to work, or take the train, as is implied by his backpack as he walks through the park late at night, after his shift, where he can share a beer with other members of his team. Many of his team will have to use public transportation because they won’t be able to afford not to. Robbie will drive his BMW, which is parked in the hospital parking garage, he may even have his own parking spot, to his home in the suburbs.

Just when you think I might be being unfair about Robbie, I should mention that Pittsburg’s cost of living is about 2% below the national average.

If Gloria is a Hospital Administrator, her salary would be in the range of $223,561

If the job title of chief medical officer is correct we are looking at a salary of $462,913

By making Robbie seem like just one of the team rather than a member of senior leadership it frames Gloria, and therefore by example all Hospital Administrators / Chief Medical Officers, as only interested in money – rather than the health of the hospital and the team as a whole. Whereas in truth, Robbie is much closer or even exceeds Gloria in compensation than to the doctors and students he works side by side with. By framing him as “one of the boys” and therefore the hero it paints Gloria as the villain.

When Robbie complains about the lack of nurses and Gloria points out that there is a national nursing shortage. His response is to say “pay them a living wage and they will be lining up to work here.”

The average wage for a registered nurse in Pittsburgh is $82,458.

As Gloria points out “other hospitals are managing” but Robbie dismisses this and  because he is our hero we are encouraged to dismiss this too – rather than see it as a failure of his management of the ER. I’m all in favor of paying nurses more, just as I am in favor of paying veterinary nurses more, but dismissing $82,000 as less than a living wage is ridiculous and manipulative.

You can do so much better “The Pitt.” These are real issues the divide the treatment of patients and the management of hospitals both in the human world and the veterinary world.

Buying into lazy tropes does not help.