Good Doc, Bad Doc

Everything About Fiction You Never Wanted to Know.

Not all the conflict in a medical drama is between the doctors and the diseases; sometimes it's among the doctors. One of the most common recurring fights is over money. This works kind of like a Good Cop, Bad Cop setup, only with doctors. One doctor (the Good one) says that healing people should be the first, last and only focus of a doctor. This Doc is a jaded expert physician as often as he's a young idealist. The other doctor (the Bad one, often a senior or higher-promoted one) insists that making money is an important part of the medical profession. Bad doc often comes in two flavors:

  1. A pragmatist whose mantra is, "We can't help anyone if the hospital goes bankrupt."
  2. An honest-to-goodness heartless greedy bastard who sees patients as walking (or rolling or comatose. Whatever) piggy banks in need of a good MRI-hammer or two.

Usually, Good Doc will view/describe Bad Doc as Type 2 regardless of which he really is, while Bad Doc will usually insist he's Type 1 despite any evidence to the contrary.

Common sources of head-butting between Good Doc and Bad Doc are:

  • Handling of uninsured patients: Good Doc will treat them anyway and take the loss, Bad Doc will say, "Get them stable and send them off to the state hospital."
  • Distribution of transplant organs or slots in medical trials: Good Doc will usually try to steer them to poor, unconnected patients, while Bad Doc will give them to wealthy patients who could potentially afford alternative, but less pleasant/effective, treatments. Bad Doc will often justify this by detailing exactly what program their endowment will be funding.
  • Buying new hospital equipment: Good Doc thinks they need the best they can afford, Bad Doc will opt for a cheaper version.
Examples of Good Doc, Bad Doc include:

Anime and Manga

  • Black Jack, though he charges exorbitant amounts of money for his services, sincerely fights for the lives of his patients; he has a Dr. Kevorkian-esque rival who is presented sympathetically (as in, he also wants to end unnecessary suffering), but who vehemently disagrees with Blackjack.
    • Say Hello To Black Jack, another medical manga (which doesn't really have much to do with Blackjack at all, actually) is almost entirely focused on this trope, chronicling the travails of an idealistic young doctor facing various challenges from the medical establishment. What's interesting is their variation on the Type-1 Bad Doc. Rather than directly bringing up money at all when lecturing him, the antagonistic hospital administrator tells him that jumping through too many hoops for the sake of individual patients is wasteful and small-minded. The real goal of the hospital should be funding its medical research programs to benefit all of mankind in the long run, rather than worrying too much about specific individuals. This basically turns the whole dynamic on its head, from idealistic humanitarianism vs. pragmatic capitalism to two different pie-in-the-sky idealists arguing over individualism vs/ collectivism.
  • Monster, where being a "good doc" backfires in epic proportions.

Film

Live-Action TV

  • Doctor Cox (Good Doc) and and Doctor Kelso (Bad Doc) on Scrubs fought regularly, often trying to draw J.D. to support their point of view. Played with in that although he was the Bad Doc (in more ways than one), Kelso's point of view isn't always entirely the wrong one, being Type 1 as much as Type 2.
    • The chief of medicine that temporarily replaced Kelso was a Type 2 through and through. However, she does chew the others out for ousting her out a job after she went through the trouble of relocating, when they ought to know that she'll simply be replaced by someone exactly like her, and they've therefore accomplished nothing. This is partly what spurs Dr. Cox into taking the offer for the chief's job.
  • Though House doesn't seem to care as much about his patients as he does solving the puzzle, he still hates to lose anybody under his care; he runs into a number of obstructive bureaucrat types (Vogler being one) who only cares about the hospital's reputation. Cuddy, as dean of medicine, has to balance these objectives.
  • In the JAG episode "Each of us Angels", the characters are put aboard a hospital ship off Iwo Jima in an alternate-plot. Alter-Sarah is a straightforward good doctor(or nurse rather) while Alter-Bud is a bad doctor of the first type(he and the head nurse are fierce about discipline and triage and of course they need to be considering how many casualties are coming).

Video Games

  • Trauma Center has Derek Styles (good doctor) and a number of rivals, including "death doctor" Tyler.