The Pitt: A Lifeline for Emergency Medicine Providers

Reshaping Expectations and Elevating Emergency Care

Sarah Spelsberg, MD, FAWM, FEWM
IFHS Clinic/Mayo Clinic

Who thought a TV show could have this profound a cultural impact?

As an emergency medicine senior resident physician and former physician assistant, I have witnessed firsthand the tumultuous environment of the emergency department (ED)—an arena defined by urgency, unpredictability, and, often, administrative frustration. For years, television shows like House and Grey’s Anatomy have created unrealistic expectations among patients. This changed how patients treated us. House fostered the idea that a team of elite diagnosticians could uncover obscure ailments within hours after breaking into your home and discovering a rare mold, while Grey’s Anatomy romanticized hospital drama with broom closet rendezvous that, frankly, are impossible when you're neck-deep in critical medicine, trauma and – lest we forget - charting. These portrayals have shaped misconceptions about what happens in an ED and in a hospital, making it difficult for patients to appreciate the stark reality of medical practice and creating impossible to achieve expectations. And then came The Pitt, a well-researched window into our world—a clear, unfiltered lens through which the public can finally see the chaos, grit, and resilience that define emergency care providers.

The Pitt: A Voice for Emergency Medicine Providers

For the first time, The Pitt has made us feel seen. It has brought attention to the relentless challenges we face every day—challenges often compounded by systemic barriers. Hospital leadership may attribute delays and overcrowding to a supposed lack of staff resilience, but the truth is far more complex and nefarious. It's not that we lack resilience - it's that we're exploited - navigating a labyrinth of boarding admitted patients in the ED, short staffing, and specialists who take their time responding to consults. We are the dump everyone worries about but constantly ignores. These delays and barriers to care not only frustrate patients but also place undue stress on ED providers. It is tantamount to abuse.

For years, emergency medicine professionals have been the unsung heroes of healthcare, working at the crossroads of life and death, all while absorbing the ire of hospital staff and patients alike. The Pitt has given us a voice—a way to highlight the systemic flaws that often leave us bearing the brunt of blame for issues far beyond our control. For the first time, the chaos and complexity of the ED are on full display, and it feels like someone finally understands the battles we fight daily.

Improving Patient Satisfaction by Managing Expectations

One of the most profound contributions of The Pitt to emergency medicine has been its ability to reshape patient expectations. By portraying a realistic view of the ED's trials and triumphs, the show has helped patients grasp the logistical and emotional challenges of emergency care. It has dismantled the fantastical notions perpetuated by other medical dramas, offering a sobering yet empathetic perspective on what emergency providers endure.

Patients are beginning to understand that their long waits are not the result of indifference but of overwhelming demand, staffing shortages, and systemic bottlenecks. They are finally beginning to understand what little control we have over these systemwide failures. The Pitt has encouraged transparency, fostering conversations that manage patient expectations and prevent misunderstandings. As a result, patient satisfaction scores are improving—not because the wait times have vanished (the system has yet to answer the call to correct boarding and staffing) but because patients now see the humanity and efforts behind every decision in the ED.

Decreasing Escalation and Violence Against Providers

Another crucial impact of The Pitt has been its potential role in reducing escalation and violence against healthcare providers. Emergency departments are often pressure cookers, where stress, fear, and frustration can boil over into aggression against emergency medicine providers. We have all been kicked, punched, spit on, groped, etc by people who are angry or psychologically dissociated from reality. Patients and their families, overwhelmed by the chaos, may lash out at ED staff who are already stretched thin.

By offering an honest portrayal of our work, The Pitt has humanized emergency medicine providers. Viewers see our exhaustion, our dedication, and the stark realities we face. They witness the barriers imposed by bureaucracy and systemic inefficiencies—the long waits caused not by our negligence but by factors beyond our control. They witness the (at times) awkward administrative morale initiatives in the form of pizza and candy when what we really need is safe staffing and a hospital that can accommodate the boarding crisis. This transparency has fostered empathy, reducing the likelihood of verbal or physical confrontations in the ED. The show is changing the narrative, allowing patients to appreciate the complexity of emergency care and see us not as faceless neglectful providers but as people doing our best under extraordinary circumstances.

Finding Resilience Beyond the ED

Still, the weight of the ED is heavy, and there are moments when I need to step away to recalibrate. For me, that often means venturing to the farthest reaches of the planet, engaging in wilderness medicine assignments where the focus is purely on patients and solutions, without the layers of bureaucracy. Coordinating multidisciplinary medevacs in remote jungles or flying past erupting volcanoes—tasks that would seem daunting or dangerous in the civilized ED—feel liberating in comparison to explaining a 14-hour wait caused by upstairs floor nurses refusing to admit patients boarding in the ED.

These wilderness experiences ground me, reminding me of why I entered medicine in the first place: to heal, to act, and to make a tangible difference. To ameliorate your suffering – even if just a little. Yet even in the wildest corners of the earth, I carry the lessons of the ED with me—the resilience, the adaptability, and the unyielding commitment to patient care in spite of the barriers we face.

The Pitt: A Beacon of Change

The Pitt has not solved all our problems; the systemic barriers in healthcare remain daunting. But it has given us hope. It has held up a mirror to our struggles, reshaped patient expectations, and fostered empathy in ways I never thought possible. It is a tribute to the resilience of emergency medicine providers and a call to action for systemic change.

In a world where healthcare providers are stretched to their limits, The Pitt is more than just a television show—it is a lifeline. It reminds us that the work we do matters, that we are seen, and that, even amid the chaos, against the barriers to care, there is hope for a better future. When everyone understands the problem – maybe then we can evolve.

Because I would love to simply say to you:

Hi there. I am Dr. Spelsberg. What brings you into the ED today? How can we help?

Instead of:

I am so sorry for your wait…I promise we are doing our best…Yes, I understand that you are very angry…I would be too…I agree the wait time is unacceptable…throwing your coffee on the nurse is not going to solve this for any of us…yes I would be happy to go find you a supervisor to assist you in lodging your complaint…but first…what is the emergency that brought you to the ED today? We would really like to help…

We should both understand that in the time I spend apologizing – I could have seen and cared for you and another patient.

It seems like some of you finally see us. Thank you. Now, please help us.

End boarding in the ED. Demand safe staffing. Let us simply do what we were born to do – take care of you at your most vulnerable.