Demand is high for pretend patients

WASHINGTON — Ted Bell knew his portrayal of a depressed, elderly patient was convincing when the medical student who was examining him broke down in tears. Her instructors had to call a timeout because his flat monotone and unkempt appearance reminded her too much of her father, who had similar symptoms.

Sad personas are part of Bell’s new career. He plays the part of a patient. It’s a big change for the retired civil engineer who spent more than three decades managing construction projects for the Army Corps of Engineers. Emotion was hardly part of the job description.

“That sort of thing was somewhat stifled in a conservative bureaucracy,” he said. “I found it quite rewarding to be able to cut loose.”

Bell, 62, of Greenbelt, Md., is one of hundreds of Washington-area residents whose day jobs are to realistically portray patients in medical cases. They are poked and prodded. They occasionally take off their clothes. Some even undergo breast and pelvic exams.

They come under the direction of medical school clinical directors, who act as casting directors, stage managers and dialect coaches rolled into one. With six major medical schools in the region annually training tens of thousands of students seeking to be doctors, nurses, pharmacists, social workers and other health-care professionals, demand for “patients” is high. Directors compete for those most likely to be convincing, take direction and show up on time.

The formal title is “standardized patient,” or SP for short.

Many are actors, but actors don’t always make the best patients, clinical directors said. Improv is not allowed. People trained to portray a particular type of patient must work from the same facts and deliver responses in the same way to the students examining them.

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