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In every episode of "House, MD", it appears that he and his team only treat exactly one patient at a time (with the exception of Clinic duties or big emergencies - just talking about their average job here). I also can't recall mentions of patients being treated "in between episodes", though there might have been some. That would only account for around 20 patients a year.

Now, I have a lot of suspension of disbelief in series, but 4 to 6 doctors only treating a single patient is a lot of downtime, waiting for lab tests, new symptoms to appear, etc. Is it ever explained or mentioned in the series how many patients the team treats?

  • You see them moonlighting in other departments. For several seasons House gets made to work as a consulting physician – user7812 Dec 16 '15 at 13:05
  • A large proportion of their patients are enormously wealthy. Private everything, dedicated lab work, instant access to the hospitals lawyers. What makes you think that they treat that many people? – user7812 Dec 16 '15 at 13:08
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    House never waits for lab tests, he doesn't trust the morons in the laboratory. He has his team do everything. So very little down time for anyone but house. – cde Dec 16 '15 at 14:07
  • @cde lab tests take time, though. Some of these things need to run for a day before you have a result. That's what I mean with "wait" in that context. – YviDe Dec 16 '15 at 14:08
  • @YviDe not on the show they don't. And most wait time is due to volume of pending specimens at a lab (I worked at one). – cde Dec 16 '15 at 14:47
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Although there have been a few episodes with more than one patient (typically the second patient's treatment leading to the "a ha!" moment for the first one), you're correct that most episodes of House focus on a single case.

That is probably a bit unrealistic as a long-term trend. Indeed, there were several points in the show where House's budget was called into question, or cut, though he always managed to get around them. There are some mitigating factors here that help explain why this is so:

First, Princeton Plainsboro is a teaching hospital; the primary purpose of the hospital is to train new doctors. In a couple of episodes we see House teaching medical students (though he doesn't seem to like doing it), and it's probably reasonable to assume his other doctors do as well. It also means that the hospital is more flexible in allowing House to operate his department on the theory that he's "teaching" a team of diagnosticians how to be brilliant.

Second, the hospital also runs a free clinic, and we routinely see House and the other doctors doing clinic work in later episodes. The rest of House's team are also specialists, which makes me suspect that off-camera they do work in their specialty department as well (though I can't think of a specific case where we see this happen on-camera).

But most importantly, the conceit of the show is that House is the most brilliant diagnostician in the country. He only takes cases that are "unsolvable" by anyone else. The key here is that people choose to go to Princeton Plainsboro specifically to see House and his team. The ailments that they are treated for by House are complicated and frequently life-threatening, and require concerted attention by his team to figure them out. That's the kind of thing that the hospital can charge a lot of money for. It also tends to attract rich private donors (we saw more than one of those come through House's care) that are willing to help the hospital out after House saves their lives.

You'll note, in particular, that at one point House leaves the hospital at the end of one season. Even though Foreman and the others on the team are more that capable of running the department, Cuddy wants to close it down because Foreman just doesn't have the name recognition that House did. She flat out tells Foreman that the only reason PPTH has a diagostic is because House is there to run it.

In any "real" hospital, or even in House but with any other doctor, there's no way a team could be as selective as House is and stay operational.

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House had 177 episodes spanning 8 years. The first Five seasons had a Christmas episode, and others had plot happen during Christmas, providing a time span of about 8 years in the show as well. There were 177 episodes, and give or take a few with no main patient or two main patients, that means roughly 175 main patients. That's 22 patients per year. This seems about right from what we are told of House.

A Primary Care Physician (Your average main doctor) sees much more:

A general consensus appears to be that 1,500 patients is about the upper limit provided it is a practice in which the PCP has gotten to know most of the patients well over many years. Otherwise a lower number seems appropriate. But even at 1,500, PCPs say they still spend the full day seeing patients plus added time each evening completing their [Electronic Medical Record]. Having stated that 1,500 is about right, they then say that 1,000 would mean much better care. But this ideal is not possible; they need to have about 2,500 patients and about 24-25 visits per day to cover overhead and maintain an income of about $175,000 (Per the Medscape report on PCP income.)

A Concierge Doctor (On call, house visits) sees about a third of that for a larger fee. Depending on the Specialty, some may see much less. But 22 per year is abnormally small for a Doctor to live on. That said, House is an abnormal doctor.

Multiple times during the show we are told that House is super selective (He won't take a boring case), that House only takes one case at a time, and that he's essentially the last resort for most of these patients. They are the Only Diagnostic Medicine department in the country. He specializes in everything. But he's basically unemployable, and if it wasn't for Cuddy, wouldn't be working. In exchange for that and legal issues, House doesn't get paid what someone of his expertise should.

As Mike has pointed out, the hospital can charge a lot for these patients. Sometimes the patients are dirt poor, so Charity Care, but we also see extremely wealthy patients who throw their financial weight around to get what they want, which often includes concierge service and personalized care (unlike us poor people who can only get a doctor to pay attention for 5 minutes).

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