Introduction Medical drama series may contribute to unrealistic and inaccurate expectations and beliefs about care interventions and trajectories; influencing the public to assume that ‘the doctor knows best’ and patient involvement is unwarranted. Our aim was to characterize how medical drama series portray patient-clinician communication about uncertainty and patient-clinician collaboration when designing care plans.

Methods We coded fictional (in-/outpatient) encounters at U.S. healthcare facilities between patients with a serious illness (N=80) and their clinician (N=31) as portrayed in the most recent aired seasons of four medical drama series (Grey’s Anatomy, The Good Doctor, New Amsterdam, The Resident). For each identified expression of uncertainty, we coded who initiated the expression, whether uncertainty was explicitly acknowledged or left implied, and to which of 9 possible dimensions of the concept of ‘Making care fit’ each expression related. We used OPTION12 to assess clinicians’ efforts to involve patients (0–100 scale, 100 reflecting maximum behaviors).

Results Encounters had a median duration of 64 seconds (IQR 49–91). Uncertainty was expressed 25 times within 19/80 encounters (24%). Clinicians initiated most expressions of uncertainty (N=19/25, 76%), and mostly did so implicitly (N=19/25, 76%). Most expressions related to the content of patient- clinician collaboration (e.g., discussing the options available, N=13/25, 52%). Clinicians made limited efforts to involve patients (mean OPTION12=21, SD=9.7). Recurrent visits compared to first visits were associated with higher mean involvement (OR 1.4 (95%CI 1.2;1.7) p<0.001). Scores were similar across drama series and comparable with reported OPTION scores in the ‘real-life’ literature.

Discussion/Conclusion Reflecting the power of scripting, medical drama series achieved similar OPTION12 scores to those computed from complete real-life encounters, while portraying only a brief fictional interaction. These series may represent both a useful educational resource but also a missed opportunity to adequately convey uncertainty and model patient-clinician collaborations in making care fit.