Grey’s Anatomy gave a big boost to the careers of its main cast, even though many of them were already known actors, as is the case of Patrick Dempsey, though he wasn’t the only actor interested in the role of Derek Shepherd – here are the actors who could have played this beloved character. Created by Shonda Rhimes, Grey’s Anatomy premiered on ABC in 2005 and started as a mid-season replacement, but it was so well-received by critics and viewers that it has lived on for over 10 seasons. Grey’s Anatomy shows no signs of stopping soon, even if some of its most popular characters are now gone.

Grey’s Anatomy follows the basic premise of medical dramas and focuses on the lives of surgical interns, residents, and attendings as they juggle their professional and personal lives, which often end up overlapping and creating a lot of conflict and drama. Grey’s Anatomy is led by Meredith Grey (Ellen Pompeo), who viewers have seen go from an intern at Seattle Grace Hospital to head of general surgery, while also following her personal life quite closely. Meredith married Derek Shepherd (Patrick Dempsey), best known as “McDreamy”, and while they went through a lot of ups and downs, they were a fan-favorite couple. Derek died in season 11 but returned in a dream sequence in season 17 as Meredith fights COVID-19.

Related: How Grey's Anatomy Teased Derek Shepherd's Death 6 Seasons Early

Derek Shepherd became a favorite among Grey’s Anatomy fans and Patrick Dempsey became a widely-known name, but even though Shonda Rhimes has shared she knew he was her “McDreamy” the moment she saw him, there were other actors interested in and considered to play the role. Here are the actors who almost played Derek Shepherd in Grey’s Anatomy.

Grey’s Anatomy: Rob Lowe Could Have Played Derek Shepherd

Owen looking to his right in 911 Lone Star

Although Patrick Dempsey was not a newcomer when he joined Grey’s Anatomy, having appeared in movies like Scream 3 and Sweet Home Alabama, there was a bigger name than him in consideration to play Derek Shepherd: Rob Lowe. However, he turned down the offer in favor of starring in another medical drama, this one from CBS, titled Dr. Vegas, which sadly, only lasted 10 episodes. Lowe’s big break came with his first movie role in Francis Ford Coppola’s The Outsiders in 1983, after which he became an icon of the decade, appearing in movies like St. Elmo’s Fire and Wayne’s World, and later on in the drama TV series The West Wing. The failure of Dr. Vegas wasn’t the end of Lowe’s career, who later appeared in movies like Behind the Candelabra and TV shows like Brothers & Sisters and Parks & Recreation. His most recent credits include the rom-com Holiday in the Wild and the drama TV series 9-1-1: Lone Star.

An actor who auditioned to play Derek Shepherd is Isaiah Washington, but he was turned down. However, he was called back after Paul Adelstein, who had been cast as Dr. Preston Burke, dropped out, and so he was given that role. Washington left Grey’s Anatomy in season 3 after an incident with co-star T.R. Knight, and unlike other Grey’s Anatomy characters, he hasn’t returned, though he has been mentioned a couple of times. After his time in Grey’s Anatomy came to an end (and before his return in season 17), Patrick Dempsey appeared in the movie Bridget Jone’s Baby and served as producer in The Art of Racing in the Rain, and is also set to return in the Enchanted sequel, Disenchanted – in the meantime, he plays the lead role in the drama TV series Devils. Grey’s Anatomy would have been very different without Patrick Dempsey, and it’s up to viewers’ imagination if Rob Lowe would have made a better McDreamy or not.

Next: Grey's Anatomy: All 3 Spin-offs Explained (& How They Connect)