In a convention center in Las Vegas, 150 physicians—all general practitioners and members of the American Academy of Family Physicians—were waiting for a training session on the symptoms of rheumatoid arthritis to begin. An attractive young woman slowly made her way up to the stage and then, visibly wincing with pain, took her place in a seat next to a panel of four medical specialists. For nearly an hour they discussed the crippling illness and the woman demonstrated its symptoms. Afterward, one sympathetic doctor came up to reassure the patient: Modern medicine, he said, could certainly help her.
That brought smiles to the faces of Joe and Margaret McGovern, who had hired the woman, a perfectly healthy professional actress named Seret Scott, to impersonate a rheumatoid arthritis victim. Scott is one of more than two dozen actors who work for the McGoverns’ New Jersey-based company, Simulations, Inc., posing as sufferers from everything from kidney disorders and Parkinson’s disease to agoraphobia and separation anxiety. “The idea isn’t to fool people,” says Margaret, 42, “it’s to educate them.” In its two years of operation the McGoverns’ company, the only one of its kind in the country, has provided what they call “patient simulators” to medical schools, conferences like the one in Las Vegas and makers of educational films. They have also landed as clients five of the nation’s largest pharmaceutical manufacturers, who use the actors to show salespeople and doctors how their products work.
Simulations’ actors may never win Oscars, but their performances have won raves from audiences. Dr. Martin Peper, a University of Minnesota psychiatry professor, says the first time he interviewed a supposedly depressed middle-aged man provided by the McGoverns, “There were 500 people in the room, and they were literally on the edge of their seats. It is really a great tool.” According to the McGoverns, actors perform the job better than true patients. “You may want to be able to do the same thing over and over again,” explains Joe, 44. “Every person with a disease has good days and bad days. On a good day, your teaching aide is unconvincing. On a bad day, you don’t want to manipulate a patient.”
There are other advantages. “If you want to show the effects of a medication,” says Joe, “it might take two months in real life. With a patient simulator, you can make it happen in two minutes. You can also feel free to talk about the illness in front of a class or circulate videotapes around the country. As for salespeople, because of medical ethics, they never get to see real patients. There’s a gap in their education, but patient simulators can fill it.”
The McGoverns, both natives of Jersey City, N.J., got the idea of feigning infirmities while Margaret was studying acting at nearby Douglass College. She had gone back to school at 35 because, after raising their two daughters (now high school seniors), “I found I was left talking to the dogs.” When Rutgers Medical School came to her class looking for someone to impersonate a depressed housewife, “I became their star depressive,” she recalls. Later a pharmaceutical company started using her regularly and asked her to recruit friends for similar roles. Margaret continued to work as a simulator but harbored high hopes that “Broadway was waiting for me.” It wasn’t. But Joe, a professional chemist who was running training programs for industrial managers, foresaw “a dynamite business in simulations.”
Now he handles the financial side while Margaret deals with the actors. As many as 200 have turned out for auditions, Margaret reports; she looks for stamina and improvisational skills (and steers clear of hypochondriacs) when casting.
As Simulations’ director, she rehearses each “patient” thoroughly. Portrayals are based on actual case histories, and Margaret turns for final approval to specialists in the disease being enacted. “They teach us the tricks of the trade,” says her husband. “Even emotional illnesses have a physical effect. People stare or hold their bodies in certain ways.” Adds Margaret: “If a doctor can explain it, we can do it.”
The McGoverns work out of their four-bedroom house in Martinsville, N.J. They take a break from their busy schedule to watch Ryan’s Hope, their only addiction, but otherwise their off-time is scarce as the business grows.
Dr. Peper suggests that simulators could be used in giving physicians board exams, and there are 150 drug companies that could use Simulations’ services but have yet to be approached. “The possibilities are endless,” says Margaret. “We haven’t even scratched the surface.”