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Grey's Anatomy: 10 Rules The Doctors At Seattle Grace Are Forced To Follow (And 10 They Always Break)

Grey’s Anatomy is one of the longest-lasting, successful medical dramas in TV history. However, its portrayal of medical practices and hospital etiquette sometimes leave much to be desired. There are also, surprisingly, instances in which many of the characters successfully follow traditional rules and guidelines of hospital practice, but other times, they don’t. Many things that occur in virtually every episode would be enough to get a doctor dismissed in the real world, although the dreamy soap opera landscape of Grey’s Anatomy doesn’t quite fit in with the real world, so things are a little more lenient.

The steamy relationships of the characters often open themselves up to at-work relations that violate almost all hospital (and common sense) protocols. At the same time, there are plenty of instances where, given this context, the abilities of the show’s medical staff to follow ethical guidelines are surprisingly sufficient. But, the mixed bag of these elements often leads viewers to wonder what the doctors actually should or shouldn’t be doing in any particular situation. Due to this, we’ve compiled a list of 10 Rules The Doctors At Seattle Grace Are Forced To Follow (And 10 They Always Break):

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20 Follow: Never Promise a Patient Or Their Family That They Will Live 

Early on, George O’Malley actually broke this rule, but that was one of the things that helped cement it. The patient was getting a routine heart procedure and O’Malley promised them that they would make it, but unfortunately, they didn’t. For this, he was reasonably chewed out, and since that time, the rule was largely followed.

This is one thing that is incredibly important for a doctor, as a no matter how a situation seems at first glance, there’s never really any clear indication of where it’s going to go or what’s going to happen. At one point, though, Miranda Bailey also broke this rule and promised a kid that he would live when she probably shouldn’t have. Luckily, he did.

19 Break: Friends and Family Are Not Patients

Thatcher Grey Grey's Anatomy

This one is incredibly common, as they end up being each others’ patients all the time. Miranda Bailey even jokingly pointed out that only one of her interns did not wind up being her patient at some time or another, meaning they were the only one she had not operated on.

Obviously, this wouldn’t fly in an actual work environment as it represents a huge conflict of interest. As another example, Dr. Derek Shepard operated on Izzie Stevens, who was also roommates with his wife and in her internship class, by taking out her brain tumor. There are several other examples of this happening throughout the show’s run as well. It’s one that the doctors tend to break fairly often.

18 Follow: Do Not Argue With Colleagues In Front of Patients 

Brooke Smith in Grey's Anatomy

This entry’s almost surprising, considering that it tends to fly in the face of typical narrative television in which any scene is an excuse for exposition and character conflict. The doctors at Seattle Grace tend to be surprisingly reserved when it comes to keeping their drama at bay until after speaking to their patients.

Not that they don’t argue right outside of patients’ rooms, of course – where one could naturally assume the patients could still hear them – but they do get credit for a degree of professionalism in this instance. There are always arguments going on between the medical staff, but the more often those occur outside of patients’ earshot, the better.

17 Break: Do Not Get Involved With Your Boss 

In the very first episode, Meredith Grey wakes up a stranger she met in a bar, who she later finds out is her new boss, Dr. Derek Shepard. Then, she tells him that they can’t do that and that it’s inappropriate, but kisses him in an elevator moments later.

This is one of the broken rules that drives the show. It’s almost a rule for the show that this rule be broken. For example, there are countless examples of this happening throughout the series: Jo and Alex, Cristina and Owen, Ben Warren was married to Miranda Bailey when he was a resident and she was Chief of Surgery, and the list goes on and on. Naturally, this is something that would never fly in the actual field.

16 Follow: Scrubbing In 

Lexie Grey and Cristina Yang sing Like A Virgin in Grey's Anatomy

Before surgeons can enter an operating room, it’s imperative for the health of the patient (and everyone in the room) for them to thoroughly scrub their hands and follow procedures in order to prevent contamination. However, some real life policies are not followed, such as no jewelry in the operating room, but that’s more than likely due to people on set being unaware that that was a real-life rule.

While this is a fairly basic rule, it’s something that the doctors on the show almost never miss and follow consistently. At one point, Bailey was investigated for potentially not following these procedures, but it turned out to be a manufacturing error in the gloves.

15 Break: Do Not Have Romantic Relationships With Your Co-Workers 

This happens even more than relationships with bosses, because anyone who’s seen the show knows that these characters can rarely keep their hands off one another. After Meredith found out that Derek had been married to Addison all along, she went to the bar with O’Malley and they woke up together the next morning; Alex and Izzie wound up getting married, then divorced a matter of weeks later; April and Jackson were on-again-off again for years, dating other co-workers along the way, and eventually remaining friends even after they had a child together.

Almost all of the core characters have shared a bed at one point or another. Even after fifteen years, this is a habit that the characters continually fall into despite their mildest efforts.

14 Follow: Don’t Operate If Not In the Right State of Mind 

This is one rule that would obviously get anyone dismissed in the real world and probably prevent them from working at another hospital, but thankfully, the doctors of Grey’s Anatomy have tended to avoid this for the most part.

However, many of the characters have struggled with various habits. Richard is recovering at this point in the show, and although he relapsed, he never operated in this state. Amelia, on Grey’s Anatomy, has never operated in this condition as well, but she was introduced on the spinoff, Private Practice, where she actually did operate under those conditions and had her medical privileges revoked.

13 Break: Don’t Tell Patients About Your Personal Life 

To their credit, when patients ask about their personal lives, the doctors try to work around it, but they don’t try that hard, and it’s almost never successful. This past season, after explaining her past relationships in detail, Meredith wound up hiring one of her patients, a matchmaker, to try and find her a date. That obviously crosses multiple lines of professional discretion.

April discussed her crisis of faith with a patient who was a Rabbi, after losing her son, Samuel, due to an illness at birth. While it is natural that real-world doctors let personal details slip on occasion, it’s hard to imagine it happening with the consistency of the staff on this show.

12 Follow: Don’t Use the Success of Your Parents/Grandparents to Further Your Career 

Richard Webber and Ellis Grey in Grey's Anatomy

Two Grey’s Anatomy doctors came from families with established and well-known medical careers. Meredith Grey was the daughter of Ellis Grey, a pioneer surgeon who discovered the famous “Grey Method” to treat gallbladders. This discovery earned Ellis the prestigious Harper-Avery award and, despite the favor that this legacy could have won her in the competitive world of surgery, Meredith hardly ever mentions her mother’s accomplishments, especially not to her bosses.

Moreover, Jackson Avery is the grandson of Harper Avery, creator of the Harper Avery award. After Mercy West merges with Seattle Grace, Jackson barely says his last name to his new coworkers, but when the secret is out, he does everything he can to downplay it.

11 Break: Don’t Get Together At Work 

If there was one rule people only vaguely familiar with Grey’s Anatomy would guess, it’s this. The doctors on this show are frequently connecting at work, usually in the on-call rooms or in the elevator. Sometimes, even stopping the elevator if need be.

It goes without saying that in a real hospital environment, this would never, ever be acceptable. The amount that it happens on the show is almost surprising when considering that there are people's lives in their hands and any time spent with colleagues in the workplace could be better spent, well, working.

10 Follow: Wear Gloves, Scrubs, and Other Proper Attire 

Christina Ricci Greys Anatomy

On one level, it could be considered the bar is so low for the characters of Grey’s Anatomy that the notion of simply wearing the proper clothing to work could be congratulated. But, this is genuinely an important safety concern and if they failed to follow this rule, there would be obvious problems.

Failure to wear gloves while performing procedures could risk contamination and spread of infection. This is something that the doctors are at least always conscious of avoiding. Although, it’s also one of the first things viewers would pick up on as well, as no one would buy into these doctors if they were operating in street clothes, so having the characters always obey this rule makes sense for the visual aesthetic of a medical drama.

9 Break: Use Birth Control if Not Planning to Become Pregnant 

This one sounds specific at first glance, but it actually isn’t as it is a repeated occurrence throughout the show. Cristina Yang got pregnant twice in her eleven seasons on the show despite never wanting kids to begin with. April also accidentally got pregnant twice, once on the night of her wedding, and also while she and Jackson got together in the middle of breaking up.

Furthermore, Callie got in an argument with her wife, Arizona, spent the night with Mark Sloan, and wound up pregnant as a result. Unplanned pregnancies are a surprisingly common theme on Grey’s Anatomy and while it would make sense for people to use birth control if not actually planning to become pregnant, that’s not something that the characters have ever really adhered to.

8 Follow: Remain Professional When Speaking to Patients 

T R Knight in Grey's Anatomy

Luckily, the doctors of this series tend not to lose their temper or speak out of turn with their patients, even if they almost always wind up disclosing way too much of their personal lives. Although, Meredith did yell at one of her patients, teenage pageant queen Katie Bryce after she paged Meredith 911 to entertain her on her first day.

However, after that incident, Meredith quickly learned not to do anything like that again and the rest of the doctors tend to be good about this as well. They might confront a patient with the reality of their situation, but in typical doctor fashion, they’ll do their best to do it in a calm and collected manner as any professional person should.

7 Break: Do Not Have Relationships With Patients 

This can obviously lead to some problems because Izzie Stevens was in a relationship with Denny, and after he signed a DNR while waiting for a heart transplant, she cut his L-VAD wire to ensure that he would be moved to the top of the transplant list. Also, Alex had a relationship with a Jane Doe, who called herself Ava because she had no memory.

This affected his performance at work and caused him to repeatedly break the rules and hospital protocol to spend time with her. One of the doctors even married a patient so that he could use her health insurance. There are tons of problems that can come about, naturally, from having relationships with patients, especially while that person is still under their care.

6 Follow: Patients Must Be Inside the Hospital to Receive Care 

For the most part, the doctors tend to follow this one. On Izzie’s first day, however, she treated a woman without a green card who refused to come into the hospital for fear of deportation. It was dark and raining, which caused Izzie to worry that she didn’t have enough light to take care of the woman’s forehead laceration, something that naturally indicates that the procedure should have been conducted inside the building.

She also treated an injured deer at one point, obviously outside the hospital, but that is an outlying situation. After that first day, she’s gotten better at following this particular rule and the rest of the staff have seemed to follow it fairly well, too.

5 Break: HIPAA 

HIPAA is a law enacted in 1993 protecting, among other things, a patient’s health information. While sometimes the doctors manage to protect their doctor/patient confidentiality, it seems to only occur when it is convenient for the plot. Throughout the show, there have been several major violations of HIPAA that would probably have gotten the doctors’ medical licenses revoked.

One of the most glaring examples was when Alex Karev allowed his patient girlfriend, Ava, to observe him performing surgery on another patient from the operating room gallery. This compromised the patient’s privacy, by allowing Ava to know the details of his condition and procedure. These violations are not uncommon on the show and would certainly cause huge problems for doctors in a real-world environment.

4 Follow: Don’t Steal Patients 

The interns and residents steal patients from each other all the time, however, they do not steal patients from other services. Now that the show is in its 15th season and all of the doctors are attending physicians, they do not steal each other’s patients nearly as much anymore.

In the first season, Meredith went over another intern’s head to steal a heart patient from the Neonatal Intensive Care Unit, and while Dr. Burke backed her up on it as she made the right diagnosis, he did yell at her and threaten to make her residency difficult if she ever pulled that again. Over the years, the doctors have learned how unprofessional and inappropriate this is and now they almost always follow this rule.

3 Break: Medical Ethics 

In the world of medicine, there are some pretty obvious lines that should not be crossed, but the doctors on Grey’s Anatomy have crossed many of these lines on several occasions. When Izzie cut Denny’s L-VAD wire, she breached medical ethics, to say the least. While she meant to move him to the top of the transplant list, she ultimately put his life in danger.

In season seven, Meredith was working with Derek on a clinical trial for an Alzheimer’s treatment, and when Richard Webber’s wife was enrolled in this trial, Meredith rigged the medical supplies to ensure that Richard’s wife would be given the medicine over the placebo. This put the integrity of the trial at risk and could have prevented other patients from benefitting.

2 Follow: Hippocratic Oath 

The Hippocratic Oath is a promise that doctors make at the beginning of their medical career. Among other things, when they take this oath, they swear to do no harm. While the doctors of Grey’s Anatomy may not be able to save all of their patients, they generally abide by this oath and do not intentionally inflict harm upon their patients.

An obvious exception to this would be the instance in which Izzie cut Denny’s L-VAD wire. In her mind, though, she was doing this to help him. That situation is definitely not the norm on this one, though, and most of the doctors have proven successful (for the most part) at keeping from bringing any intentional harm to those under their care.

1 Break: Don’t Live With Your Co-Workers 

While not a specific hospital rule, this is a good rule for professional life in general, especially in an environment like this one. This rule is broken from the second episode of the show, when Meredith allows Izzie and George to move into her house against her better judgment, and by the third episode, she is sick of living with them and their constant complaining about who has the bigger room and the bigger closet.

While eventually they learn to live together, George eventually ends up getting involved with Meredith, and after realizing she regretted it, she moves out, which made their work life very awkward. Furthermore, when Arizona decides to rent a room in her house to an intern, it all goes well until the intern comes home to find Arizona involved with his sister.

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Can you think of any other rules that the staff has followed (or broken) on the show? Let us know in the comments!

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