\n\t\t\t\t\t\n\t\t\t\t\t\t![\"The](\"images/content/paris.jpg\")
\n\t\t\t\t\t\t\n\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\tIn 1968, two researchers named McCombs and Shaw studied how the Presidential election was unfolding in Chapel Hill, North Carolina—and what, if any effect the media was having on it. They discovered that, unlike the hypodermic model would predict, the news media weren’t very good at telling people what to think. Everyone had their own opinion on the issues and it wasn’t heavily influenced by the media.\n\t\t\t\t\t
\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\tBut people did appear take their cues from the news media when it came to what issues they thought were important in the election. The more the news media covered a particular issue, the more often citizens said it was important.\n\t\t\t\t\t
\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\tThe simplest definition of agenda setting theory is that “The news media don’t tell us what to think. But they do tell us what to think about.” The theory primarily addresses the effect of the news media on public discourse, but if news lineups have an effect on what people think is relevant on a day to day basis, it’s also possible that what gets included in (or left out of) television entertainment influences what we think about.\n\t\t\t\t\t
\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\tFor instance, take a look at the proportions in which professions are represented on primetime TV:\n\t\t\t\t\t\t\n\t\t\t\t\t\t![\"Chart](\"images/content/tvoccupations.jpg\")
\n\t\t\t\t\t
\n\t\t\t\t\t\tSource: Science & Engineering Indicators—2002, NSF\n\t\t\t\t\t
\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\tHealthcare professions are overrepresented. At the same time, until recently physicians made up the bulk of healthcare professionals in television entertainment. Only in the last decade or so have medical technicians and other professionals in the healthcare sytem made their appearance in primetime.\n\t\t\t\t\t
\n\t\n\t\t\t\t\t\n\t\t\t\t\t\tAgenda setting theory might lead us to hypothesize that television entertainment raises the visibility and importance of physicians in the public’s eyes, though it’s essential to note that little empirical evidence has been collected on the matter.\n\t\t\t\t\t
\n\t\t\t\t\n\t\t\t\t![\"Framing](\"images/content/framinggreys.jpg\")
\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\tIt’s a bit disingenuous to call framing a single theory. There are actually numerous theories of framing from different academic disciplines—psychology, sociology, linguistics, etc.—and scholars have made multiple attempts to integrate them in different ways. Nonetheless, there are a few common themes that we can pull from the fray.\n\t\t\t\t\t
\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\tOne of the reasons that framing has been discussed so often in so many different contexts is that it’s an incredibly useful idea. To start with, consider actual framing in the sense of framing a window or a picture. When you decide where a window goes, or how to place a small frame over a big picture, you’re basically making a decision about what parts of the whole vista or image you’d like people to be able to see, and what parts you’d like left out. But framing isn’t limited to images. When you tell a story, you don’t include things that aren’t relevant to the plot—what you had for breakfast, the color of your socks, and so forth. Some things you might leave out on purpose, and others you simply omit because they’re uninteresting.\n\t\t\t\t\t
\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\tThe crux of the matter, though, is that what’s relevant or interesting can be very different depending on the context and the person doing the telling. For instance, as we saw earlier this semester, some people frame the issue of climate change in terms of job growth (or loss), while others look at in terms of environmental impact. And, of course, the same people may frame the same issue differently when it suits their interests. (If framing interests you enough that you want to continue looking at it after this course, you should know that there are some problems with looking at framing as just a matter of designing messages—but these are outside the scope of the present discussion.)\n\t\t\t\t\t
\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\tSo what does all this have to do with medical dramas? In the same way you decide to leave things in and out of the stories you tell, details about the world of medicine are selectively included, excluded, and manipulated by writers constructing TV plots. There’s nothing sinister about this. It makes for a good story, after all. But consider that in watching television, we’re more likely to see ethical dilemmas from the point of view of doctors than patients. We’ll gloss over some arguably important realities, such as the fact that the blood disease diagnosed in the show is exceedingly rare, that surgeons generally don’t perform procedures outside their subspecialty, that first-year medical residents don’t necessarily assist in complicated operating room procedures, or that most hospitals aren’t teaching hospitals at all. Those things, after all, don’t advance the plot.\n\t\t\t\t\t
\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\tAs essential as all these things might be to the narrative we’re watching, they may also convey unrealistic images of the healthcare system to their audiences. Watching the real thing probably wouldn’t be nearly as exciting, though.\n\t\t\t\t\t
\n\t\t\t\t\n\t\t\t\t![\"Cultivation](\"images/content/tvfarm.jpg\")
\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\tJoe Turow, one of the leading scholars researching the influence of television portrayals of healthcare, uses cultivation theory to make his case for TV doctors’ influence on real-life healthcare. In fact, he contends that entertainment images of medicine may be more influential than non-fictional accounts of healthcare from the
news media:\n\t\t\t\t\t
\n\t\t\t\t\t\t\t“Policy makers, academic observers, and journalists ... have long accepted the idea that journalism has a key role in the public’s understanding of health care. ... [They] treat the vivid health-care rhetoric as weapons in a hot debate, yet they virtually ignore the relation of that rhetoric to popular images of medicine in television entertainment.” (Turow, 1996, p. 1240)\n\t\t\t\t\t\t
\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\tCultivation theory grew out of the work of George Gerbner, beginning in the 1960s. He suggested that television viewing is the source of much of our shared experience today. People from very different backgrounds across the country may not have much in common, but they probably watch the same TV shows.\n\t\t\t\t\t
\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\tAs such, while any particular media message appearing on television won’t have much of an effect on audiences (as the hypodermic model might suggest), if television images are consistent over time, years upon years of television viewing might ultimately, a little bit at a time, change the way our entire culture sees the world. This idea of tiny, incremental effects accumulating over time is sometimes called the “drip, drip, drip” notion of media influence. Gerbner and colleagues also suggested that such effects would be more pronounced in viewers who watched lots of television.\n\t\t\t\t\t
\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\tSo, once again, how does this apply to doctor shows? Remember that according to cultivation theory, for those tiny effects on the way we see the world to accumulate and become a notable change, media images have to be consistent over time. In the “Healthcare on Television” section of this site, we learned that many of the genre conventions of “doctor dramas” have been around for a long time. If the cultivation hypothesis is correct, no doubt they’ve had many effects on what sort of people we think our healthcare providers are, as well as our understanding of what it is they do, the type of place they work in, and what we should expect from them.\n\t\t\t\t\t
\n\t\t\t\t\t\n\t\t\t\t![\"Media](\"images/content/scrubsdependency.jpg\" "\\"Media")
\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t“Media dependency” is a measure—first proposed by Ball-Rokeach and DeFleur—of the extent to which people need the media to complete their personal objectives (i.e., to manage their stock portfolios, for example, or their fantasy baseball teams). One of the more interesting hypotheses surrounding media dependency is the notion that mass media images will generally have less influence on people who have personal experience with the thing being portrayed. \n\t\t\t\t\t
\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\tShapiro and Chock decided to expand on this idea in a 2004 study. They showed participants in the U.S. synopses of soap opera plots and asked them to rate how realistic they thought each was. In one experimental condition, subjects were told that the story occurred in Brazil, and in the other they were told that it occurred in the U.S. Subjects tended to rate the same stories as more realistic when they were told that the plot occurred in Brazil.\n\t\t\t\t\t
\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\tSo what’s the upshot of all this? And—as usual—what does it have to do with medical dramas? The point of the above experiment (or one point, anyhow) was to show that in situations where people are more reliant on the media for their information, they are in turn more likely to see fictitious media portrayals as realistic. People in the study were unlikely to have been to Brazil, or have had a great deal of experience with the country and its culture. Apparently because of this they tended to put more trust in the realism of the events portrayed in the soap opera scenario.\n\t\t\t\t\t
\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\tSimilarly, general audiences are unlikely to have a great deal of experience with hospitals and emergency rooms. It’s true that they’ve probably been to them and know people—both doctors and patients—who’ve spent time in those places. But compared to many other environments portrayed on television, like schools or apartment buildings, audiences probably don’t have a lot of experience with medical settings. Moreover, most viewers are very unlikely to have had much experience with the “behind-the-scenes” aspects of healthcare around which doctor dramas revolve. It would stand to reason then, that audiences would see primetime portrayals of healthcare as more realistic than television shows depicting environments, people, and events with which they’re much
more familiar.\n\t\t\t\t\t
\n\t\t\t\t\t\tMuch of the information on this site comes from the work of Joseph Turow—in particular, his book Playing Doctor and two articles in The Lancet. The citation information is below:\n\t\t\t\t\t
\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\tTurow, J. (1989). Playing doctor: Television, storytelling and medical power (p. 315). New York: Oxford University Press.\n\t\t\t\t\t
\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\tTurow, J. (1996). Television entertainment and the US health-care debate. Lancet, 347, 1240-1243.\n\t\t\t\t\t
\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\tTurow, J. (2004). “The answers are always in the body”: forensic pathology in US crime programmes. Lancet, 364, 54-55.\n\t\t\t\t\t
\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\tOther useful sources include:\n\t\t\t\t\t
\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\tMcCombs, M. E., & Shaw, D. L. (1972). The Agenda-Setting Function of Mass Media. The Public Opinion Quarterly, 36(2), 176-187.\n\t\t\t\t\t
\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\tLowery, S. A., & De Fleur, M. L. (1983). Developing frameworks for studying mass communication. In Milestones in mass communication research: Media effects (Vol. 2). New York: Longman.\n\t\t\t\t\t
\n\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\tMorgan, M., & Shanahan, J. (1997). Two decades of cultivation research: An appraisal and meta-analysis. Communication Yearbook, 20, 1-45.\n\t\t\t\t\t
\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\tScheufele, D. (2000). Agenda-setting, priming, and framing revisited: Another look at cognitive effects of political communication. Mass Communication and Society, 3(2/3), 297-316.\n\t\t\t\t\t
\n\n\t\t\t\t\t\n\t\t\t\t\t\tShapiro, M. A., & Chock, T. M. (2004). Media dependency and perceived reality of fiction and news. Journal of Broadcasting and Electronic Media, 675, 675-695.\n\t\t\t\t\t
\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\tLastly, I’ve had the benefit of several years’ worth of discussions with Communication Department faculty and other graduate students. If I’ve said something here that interests you, that you don’t see cited anywhere, or about which you have a question, don’t hesitate to ask and I will try to point you in the direction of the best sources I can find.\n\t\t\t\t\t
\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\tThe photograph titled, They Want To Give Us Life in Pills, on the “Theories & Concepts” page is CC-licensed by Flickr user confused vision.\n\t\t\t\t\t
\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\tThe image accompanying the text on cultivation theory is a painting by Jeremy Baum titled TV Farm 2. Prints and more information on the artist are available via the painting’s Flickr page.\n\t\t\t\t\t
\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\tThe color scheme for this site is based on a palette by dammar.\n\t\t\t\t\t
\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\tAll copyrighted material, including images and video clips, displayed on this site is fair use.\n\t\t\t\t\t\n\t\t\t\t\t
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