Grey’s Anatomy vs ER. (Breast Cancer Storyline – busted!)

We have come across so many different types of communication strategies in our science communication course. This article touches on one strategy that I’m sure we all can relate to quite easily – entertainment-education.

Entertainment-education (E-E) is a communication strategy that has been popular among international health promotion program planners since the 1950s.

They have been integrated into dramatic serial TV programs, and other forms of entertainment. This stretches out in countries as diverse as Mexico, Turkey, India, South Africa, and Columbia. They target health issues such as HIV/AIDS prevention, reproductive health, family planning, domestic violence, and the list goes on.

E-E has the potential to cost-effectively reach millions of people with health messages. There are a couple of reasons why I think and agree that it really is so effective:

  1. Drama serials attract large audiences, as people are able to relate to things in the shows – e.g. characters, emotions, scenarios, gender, race etc. Well, “life” basically.
  2. Once they get drawn or hooked to a drama serial, the program may subtly touch on different health issues every other episode while maintaining an intriguing storyline, which will keep viewers in suspense and coming back for more.
  3. Viewers chat and discuss about it with their friends or fellow viewers, and may even introduce the show to others.
  4. A lot of people are visual learners and watching shows can be considered observational learning. This can lead to attainment of new knowledge, impacts on attitudes and behaviours.
  5. Drama serials visually portray future consequences of a certain topic. In other words, it “fast-forwards” time to show the impacts of present-day decisions.

If one drama serial can be so powerful, what do you think the impact would be if two drama serials exercised a coordinated campaign in the same period?

Image Image

(Photo credits to and

Everybody would have heard of the two very famous and popular medical dramas namely, Grey’s Anatomy (cheer if you love this!) and ER (cheer if you think this show is old!). In 2005, both dramas focused on the breast cancer risk that confronts women who test positive for the gene mutation (BRCA1). The two stories featured female patients who were struggling with the difficult decision of choosing to undergo preventive surgery (prophylactic mastectomy) to reduce her risk of developing cancer, since they were already tested positive for the BRCA1 test. (Scientific research shows that preventive surgery does reduce the risk by about 90%.)

The two dramas had similar storylines and similar health messages, however, after a study was done to evaluate the impact of both, it showed that the storylines had influenced different variables (knowledge, attitudes, behavioural intentions and behavioural change).


As much as I think that drama serials and shows are really effective in communicating science and creating awareness of health issues, I also feel that it can be very dangerous if viewers were to make life decisions based on them.

People tend to put themselves in the actors/actresses shoes and follow the decisions they make. But in doing that, they will also be expecting the ideal scenario, which they are now familiar with, to also happen in real life. (We know that it probably won’t happen that way. I mean, how can romance, relationships, family support, friendship, medical outcomes all turn out exactly 100% like in a drama?)

 With that said, is entertainment-education really more effective than dangerous? What do you think?




Heather et al. (2008) Entertainment-Education in a Media-Saturated Environment: Examining the Impact of Single and Multiple Exposures to Breast Cancer Storylines on Two Popular Medical Dramas. Journal of Health Communication: International Perspectives, 13(8): 808-823.

By Jessica Ho

7 comments on “Grey’s Anatomy vs ER. (Breast Cancer Storyline – busted!)

  1. I love Grey’s Anatomy! Just wanted to put that out there!

    Whether we like it or not it is a fact that these programmes capture the attention of millions of viewers. People look up to some (not all) of the characters in their favourite shows and aspire to be like them. Dangerous as this may be, I think screenplay writers need to use this phenomenon for good rather than bad. If you could potentially save lives by encouraging positive health behaviour wouldn’t you want to do it? I know I would…

    To answer your question, I would say that EE is more effective than dangerous. I think society is much more knowledgable about lots of things than they were before. Last week I heard an elderly gentleman refer to the Discovery Channel as travelling with his eyes from his living room.

    • Thanks for your comment Diana! How awesome that is, to think of watching documentaries as travelling with your eyes! I agree with you that people look up to characters in shows and aspire to be like them – because sometimes I do too!

      I think EE can be so dangerous because it is so effective! Mindsets can change just from watching television – it’s almost like brainwashing! So screenplay writers really do have to make sure that what they portray on the screens is not only interesting/intriguing, but also beneficial (in some sense) to viewers. Last but not least, (actually quite importantly), they have to keep in check that the information or facts that are on screen, are accurate and updated.

  2. Yes i think EE is more effective than dangerous, and how the issue is portrayed is vital. A friend of mine pointed out to me that the Hong Kong tv series (that can be very engaging and addictive) use storylines meant to convey a message about certain social issues. They have had series revolving around the lives of police officers, setting in hospitals, flight crew, schools and family issues. Apparently they try to be as close to reality as possible to provide the public with a window into the lives of some high-risk or glamorous jobs, and in the process introduce the laws and ethics so that people will be aware of it. I’m not sure how scientific they are but apparently they try to convey updated technical information. And it seems to have the desired effect.
    There is a huge viewership in drama series all over the world, tapping into various issues unique to their cultures, telling their stories and helping viewers learn about current issues. Not just American drama, but even Philippino, Brazilian, Japanese, Spanish, British, Indonesian, Korean, and the list goes on. Very much a behaviour changing medium and very influential in educating the masses, including those from disadvantaged backgrounds.

  3. Thanks for your comment Nosrat! Yes I agree! As I was typing the reply to Diana’s comment above, I was just thinking to myself that Korean drama series are equally addictive and attract a huge viewership! Now I know that HongKong tv series are also equally influential!

  4. I also think E-E is more effective than dangerous, although I know what you mean- this media industry do have a lot of control over many people, and these people may not question what they hear. They might just willingly accept it. Us as scientists probably question everything more than the lay public.

    I think the dangerous part comes into play when certain ‘popular characters’ might be doing something reckless or dangerous. This could translate to the audience as ‘if they can do it then so can I!’. For example smoking as a ‘cool’ thing to do because that hot guy on that cool show on TV does it.

    I completely agree when you say this ‘power’ or ‘influence’ should be used for good not evil… but if it is, then I hope the shows stay interesting!

  5. I love Grey’s Anatomy too! In my opinion, I think that EE is more effective than dangerous, as it is able to reach out to a wider audience and allow the viewer to know more about a topic that is brought up. I like how a different topic is highlighted with each episode on Grey’s anatomy, and how the show creates a good plot to generate the interest of viewers.

    I agree with you and zoe that EE can be dangerous if the popular characters does something reckless or dangerous, as the audience might look to some of these characters as role models and follow suit. Apart from that, I believe that these EE shows were created with good intentions to draw attention for health promotion.

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