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'Ailing' actors play big role training USF medical students

Tribune photo by JAY CONNER

While the work of a make-believe patient is part time, the pay rivals many professional gigs.

By RICHARD MULLINS | The Tampa Tribune

Published: July 14, 2009

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TAMPA - Can you act depressed? Can you fake symptoms of back pain, or a heart attack in progress?

If so, the University of South Florida wants to talk with you about an acting job. The USF Health medical school is hiring a new round of people to play "Standard Patients" for upcoming medical students, nurses and others to examine and practice on for training.

While the work of a make-believe patient is part time, the pay rivals many professional gigs.

For instance, actors earn about $10 per hour to have their blood pressure measured by a dozen or so medical students in a row. Other actors can earn $25 an hour for authentically faking a stroke or heart attack in the exam room. Top earners can make $35 per hour (or roughly $72,000 per year if it were full time) for submitting to actual invasive procedures, like male prostate or female pelvic exams.

Some actor patients work a few hours a day once a week; others work an eight-hour shift.

"If you can dream up an ailment, we need people who can fulfill the role of a patient suffering with it," said Dawn Schocken, director of the Center for Advanced Clinical Learning at USF Health.

Presently, the school has a roster of about 120 actors, but the school always needs more.

Schocken knows the work can appear a bit goofy from the outside – enough to spawn an entire episode of "Seinfeld," where the characters sign up to be fake patients. "It was a funny episode," she said.

But the work truly helps aspiring nurses and doctors experience the feel of a real exam situation, she said, something that can't be replicated in books or videos.

Some patients are acting students at USF. Some are senior citizens. Some are home-school students looking for science credit. Others simply have an interest in training future doctors and nurses. Typically, actors sign up for a rotating roster of exams, and the school sends out periodic e-mails asking for volunteers to fulfill those roles.

"It's a little extra walking-around money," said Richard Brooks, a patient actor who plays several characters, including one suffering a heart attack. "It's also a chance to train people who may be working on me some day."

In one recent test, a surgeon seeking a new license didn't detect the urgency of a patient's chest pains and didn't send him to the emergency room immediately.

"Yes, the patient didn't make it," Schocken said, speaking of the scenario. "That's why we have simulations."

The most complicated (and well-paid) cases involve patients who can authentically answer a myriad of questions from doctors on complicated ailments, such as all the symptoms of pancreatic cancer or schizophrenia.

Each Monday, the school practices "critical care simulations," in which students manage a patient who suffers a stroke or heart attack in the exam room and falls unconscious. Students must order the correct tests and emergency procedures in a hurry – a scenario complete with other actors serving as panicking and screaming family members in the room.

Lest anyone think the work is easy, there are psychological tolls.

More than a few patients who simulated depression – for student after student – have called the school later to say they couldn't do the work anymore. They simply began to feel depressed and worried about themselves.

On Tuesdays, the school puts doctors through the arduous process of giving patients "very bad news," Schocken said, such as telling a patient they have inoperable cancer and months to live.

That scenario can even involve using younger actors serving as children with cancer and other actors serving as horrified parents, she said. The goal is to train doctors to give such bad news and prepare them for the typical reactions of family members.

Not all the ailments are faked, however.

The school regularly employs people with physical disabilities so students can practice with authentic symptoms. And more than a few times, students have examined an actor and found a real sickness, such as an enlarged prostate or abnormal Pap smear.

"We're not licensed to give a real diagnosis," Schocken said. "So we tell the person what we've seen or felt on them and suggest they go to their primary care provider."

Reporter Richard Mullins can be reached at (813) 259-7919.

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