It may be obvious to those working in hospitals—and especially in emergency medicine—that a TV medical drama isn’t quite reality. But for patients who are regular viewers of the long-running “Grey’s Anatomy,” the show could have a real-life impact on how satisfied they are with their care.

In a study published in The BMJ’s Trauma Surgery & Acute Care Open journal, researchers at Dignity Health’s St. Joseph’s Hospital and Medical Center in Phoenix watched parts of 269 episodes of “Grey’s Anatomy,” skipping over the personal drama and focusing on how it portrayed 290 fictional trauma patients. They then compared those results to more than 4,800 real-life patients in the 2012 National Trauma Databank (NTBD).

Researchers even tried to match the geographical patient population by examining admissions to university-affiliated teaching hospitals with more than 400 beds in the Western U.S.—similar to those served by the show’s fictional Seattle Grace Hospital.

Unsurprisingly, significant differences existed between the TV and real patients. For example, many more of the TV patients died (22 percent versus 7 percent among the NTBD sample). While the study authors admitted it was hard to gauge how long some of the TV patients were in the fictional hospital, half of those patients who survived severe injuries made rapid recoveries and were discharged within a week, compared to 20 percent of the real-life patients.

This split between extremes in terms of outcomes—patients either dying or making quick recoveries—carried over to long-term care. Only 6 percent of surviving patients on “Grey’s Anatomy” were transferred to inpatient care. Among the real-life patients, 22 percent were discharged to a facility other than their home, making their road to recovery a much longer one than their fictional counterparts.

“Although realism is an integral element to the success of a television drama set in a contemporary workplace, be it a hospital or police department, the requirements for dramatic effect demand a focus on the exceptional rather than the mundane,” general surgery resident Rosemarie Serrone, MD, and her coauthors wrote.

None of the differences should be surprising, the authors wrote, for simple reasons like the need for plotlines to be wrapped up within an hour-long episode. The problem arises if patients don’t make the separation between TV and reality.

Previous research has shown that regular viewers of “Grey’s Anatomy” and other medical drama believe the storylines are realistic and have overly optimistic expectations about outcomes after cardiopulmonary resuscitation (CPR). The study authors said in an age where patient satisfaction scores count for so much in terms of quality improvement and reimbursement, having patients come in such a skewed perception of trauma care can have a real impact.

“Divergence of patient expectations from reality may, in fact, contribute to lower levels of satisfaction,” Serrone and coauthors wrote. “In the present study, we have demonstrated how the representation of trauma patients on television dramas differs from reality, particularly with respect to recovery after injury. It follows that patient’s expectations after injury may be distorted by this unrealistic depiction of injury on television.”