In any given medical drama, the conflict is rarely restricted to doctors vs. diseases. Very often, there will be doctors that attempt to assert on their fellow healers one of two diametrically opposed ideologies. It is practically a given that there will be at least two doctors on opposite sides of the issue who are constantly at odds with each other.
One doctor ("Good Doc") holds her role as a medical practitioner in the highest esteem. She is equally likely to be a jaded expert physician or a young idealist. The other doctor ("Bad Doc") insists that making money is an important part of the medical profession. He is often a senior or higher-promoted doctor.
Usually, "Good Doc" will insist that "Bad Doc" is a heartless greedy bastard who sees patients as walking (or rolling or comatose) piggy banks in need of a good MRI-hammer or two, regardless of whether it's true. "Bad Doc" will usually insist that he is a pragmatist who understands that the hospital must help itself in order to help others, despite any evidence to the contrary.
Common sources of head-butting between Good Doc and Bad Doc are:
- Handling of uninsured patients: Good Doc will treat them anyway and take the loss, Bad Doc will say, "Get them stable and send them off to the state hospital."
- Distribution of transplant organs or slots in medical trials: Good Doc will usually try to steer them to poor, unconnected patients, while Bad Doc will give them to wealthy patients who could potentially afford alternative, but less pleasant/effective, treatments. Bad Doc will often justify this by detailing exactly what program their endowment will be funding.
- Buying new hospital equipment: Good Doc thinks they need the best they can afford, Bad Doc will opt for a cheaper version.
Not really common in medical dramas set outside the USA, but... let's not go there, huh?
- Black Jack, though he charges exorbitant amounts of money for his services, sincerely fights for the lives of his patients; he has a Dr. Kevorkian-esque rival who is presented sympathetically (as in, he also wants to end unnecessary suffering), but who vehemently disagrees with Blackjack.
- Say Hello To Black Jack, another medical manga, is almost entirely focused on this trope, chronicling the travails of an idealistic young doctor facing various challenges from the medical establishment. What's interesting is their variation on the Type-1 Bad Doc. Rather than directly bringing up money at all when lecturing him, the antagonistic hospital administrator tells him that jumping through too many hoops for the sake of individual patients is wasteful and small-minded. The real goal of the hospital should be funding its medical research programs to benefit all of mankind in the long run, rather than worrying too much about specific individuals. This basically turns the whole dynamic on its head, from idealistic humanitarianism vs. pragmatic capitalism to two different pie-in-the-sky idealists arguing over individualism vs/ collectivism.
- Monster, where being a "good doc" backfires in epic proportions.
- Team Medical Dragon: The main conflict driving the plot of the story is the confrontation between those medical professionals who want to keep the corrupt system the same and value their own advancement and salaries over patient's lives and those willing to risk their careers in order to help patients ethically.
- Patch Adams staring Robin Williams centers around the conflict between the traditional view of medicine being about treating diseases and how emotional attachments to patients helps neither doctor nor patient, and Dr. Adam's view of medicine being about treating people and engaging with them as more than just their ailments.
- In 1938 film The Citadel, Manson starts off as a crusading Good Doc, doing pioneering research on tuberculosis. However, he is seduced by the Dark Side and becomes a profiteering Bad Doc, scamming wealthy hypochondriac ladies with quack treatments for non-existent illnesses. It takes the return of his old friend and once-fellow idealist Dr. Denny, and Denny's death at the hands of a Bad Doc surgeon, for Manson to turn over a new leaf.
- John Q.: The kidnapped doctors and nurses get into it during a debate over HMO coverage.
- In Circle of Magic. The first three books, a rivalry is set up between Rosethorn, one of the main characters' teacher/foster mother, who's a Jerk with a Heart of Gold who due to her Green Thumb genuinely cares for the things she plants. Dedicate Crane, however, is described as petty, mean and much more interested in personal gain. When a plague sweeps the city, forcing them to work together as researchers, these roles just get enforced, with Crane seeming overly cruel to his underlings. Eventually subverted, when its proven that Crane's strictness was there for very good reasons, and he genuinely works hard to help cure the disease.
- Doctor Cox (Good Doc) and and Doctor Kelso (Bad Doc) fought regularly, often trying to draw J.D. to support their point of view. Played with in that although he was the Bad Doc (in more ways than one), Kelso's point of view isn't always entirely the wrong one, being Type 1 as much as Type 2.
- The chief of medicine that temporarily replaced Kelso was a Type 2 through and through. However, she does chew the others out for ousting her out a job after she went through the trouble of relocating, when they ought to know that she'll simply be replaced by someone exactly like her, and they've therefore accomplished nothing. This is partly what spurs Dr. Cox into taking the offer for the chief's job.
- House: Though Dr. House doesn't seem to care as much about his patients as he does solving the puzzle, he still hates to lose anybody under his care; he runs into a number of obstructive bureaucrat types (Vogler being one) who only care about the hospital's reputation. Cuddy, as dean of medicine, has to balance these objectives.
- Babylon 5:
- The Good Doctor: Shaun, Claire and Glassman are the good doctors, putting patients and morals first. Melendez, Andrews and Kalu are bad doctors, mostly interested in money and their career aspirations. Fridge Brilliance when you realise that St. Bonaventure, the patron saint of the hospital, was a very clever man but also always a humble and practical one, a description that applies to Shaun but certainly not Melendez or Kalu.
- Charité at War: A rather unusual political version of this trope. Sauerbruch the good doc is anti-Nazi and tries to avoid handing over soldiers with self-inflicted wounds to the army for court martial, and he firmly protects resistance fighter von Dohnanyi and is disgusted with and horrified of the eugenics programme. De Crinis the bad doc is an evil Nazi who fully supports the entire eugenics ideology and denounces wounded veterans.
- Trauma Center has Derek Styles (good doctor) and a number of rivals, including "death doctor" Tyler.