There are, unfortunately, doctors who game the system, and who care more about money than about helping people, though they are outliers. There are also patients who are rightfully frustrated and angry due to negative or harmful encounters with these doctors. But in New Amsterdam, valid critiques of the incentives that allow bad actors to enter (and flourish in) medicine are supplanted by vague fearmongering and outlandish claims; scapegoating all doctors means overlooking the real, serious flaws in the health-care system.

If New Amsterdam has erred in identifying depraved doctors as the single biggest problem with American health care, the solutions the show proposes are equally disturbing. Never mind that banning residents from patient care, as Goodwin suggests, would dismantle the pipeline for training new doctors, exacerbating the impending physician shortage. Or that removing the emergency-department waiting room would mean filling beds on a first-come, first-served basis rather than by medical need. Or that hiring 50 new attendings and an unspecified number of nurses, as Goodwin does in the first few episodes, would strain any hospital’s budget. In the only episode thus far to directly address the hospital’s finances, Goodwin offers a rare glimpse into his ostrichlike mindset, declaring, “The fiscal thing is really not my strong suit. I prefer to talk about the patients.” The absurdity of this statement, coming from the director of a hospital, confirms that Goodwin lives in a world without consequence. There are no trade-offs in this medical fantasy.

At the forefront of the show is Goodwin’s haphazard, manic leadership style, apparently inspired by Jim Carrey’s character from Yes Man. Goodwin’s colleagues repeatedly note that the medical director previously ran, and turned around, a failing clinic in Chinatown. Yet viewers are left with no sense of how he accomplished that—unless it was by uncritically accepting every offhand suggestion from the people around him. Attention spans, like cardiac surgeons, seem to have no place at New Amsterdam. Whims become policy, facing only token, if any, objections from the quietly skeptical administrator who tails Goodwin through the hospital, the business-minded dean of medicine, or the comically mute board of directors. The audience is meant to admire Goodwin’s fast-moving, shoot-from-the-hip reforms (he’s the anti-bureaucrat!), but the reality is that in medicine, pure intuition has fallen out of favor. With evidence-based medicine still in its relative infancy, many doctors are only now coming to terms with how frequently our gut instincts can be wrong.

Part of the problem with New Amsterdam is format. If the medium is the message, prime-time procedural dramas venerate the quick fix at the expense of substance. They rely, by necessity, on simplified, stylized versions of difficult medical problems. Surgical and medical “cures” abound. Ideas invariably work—if not on the first try, then certainly on the second or third. Story lines wrap up neatly by the end of each episode. Relative to real-world medicine, which is often messy and uncertain, TV medicine can be intensely satisfying and comforting to watch, tapping into an ever-growing societal obsession with instant gratification. The danger is that an inability to delay gratification, and to weigh nuance, is what brought about much of the dysfunction in the health-care system in the first place. Good medicine, and effective reform, takes patience.