Set in a decaying urban institution, St. Elsewhere was often and aptly compared to Hill Street Blues, which had debuted a season and a half earlier. Both shows were made by the independent production com­ pany MTM Enterprises, and both presented a large en­ semble cast, a "realistic" visual style, a profusion of interlocking stories, and an aggressive tendency to break traditional generic rules. While earlier medical dramas such as Dr. Kildare, Ben Casey, and Marcus Welby, M.D. featured godlike doctors healing grateful patients, the staff of Boston's St. Eligius Hospital exhibited a variety of personal problems, and their patients often failed to recover.

St. Elsewhere's content could be both controversial and surprising. In 1983, for instance, it became the first prime-time series episode to feature an AIDS patient. Six years before NYPD Blue began introducing nudity to network television, St. Elsewhere had shown the naked backside of a doctor (Ed Flanders) who had dropped his trousers in front of his supervisor (Ronny Cox) before leaving the hospital and the show. It was also not uncommon for principal characters to die un­ expectedly. which happened on no fewer than five oc­ casions during the run of the series.

As a medical drama, St. Elsewhere dealt with seri­ ous issues of life and death, but every episode also in­ cluded a substantial amount of comedy. The show was especially noted for its abundance of "in jokes" that made reference to the show's own ancestry. In one episode, for example, an amnesia patient comes to be­ lieve that he is Mary Richards from The Mary Tyler Moore Show, MTM Enterprises' first production. Throughout the episode, the patient makes oblique ref­ erences to MTM's entire program history. Later, in the series' final episode, a scene from the last installment of The Mary Tyler Moore Show is restaged, and the cat that had appeared on the production logo at the end of every MTM show for 18 years dies as the final credits roll.

St. Elsewhere proved to be a fertile training ground for many of its participants. At the start of the 1992-93 season, creators John Falsey and Joshua Brand had a critically acclaimed series on each of the three major networks: Northern Exposure (Columbia Broadcasting System [CBS]),/' II Fly Away (NBC), and Going to Extremes (American Broadcasting Company [ABC]). Writer-producer Tom Fontana became the executive producer of Homicide: Life on the Street with Baltimore-based film director  Barry  Levinson.  Other St. Elsewhere, producers and writers  went on  to work on such respected series  as  Moonlighting,  China Beach, L.A. Law, Civil Wars, NYPD Blue, ER, and Chicago Hope. Actor Denzel Washington, virtually unknown when he began his role as Dr. Phillip Chan­ dler, had become a major star of feature films by the time St. Elsewhere ended its run.

St. Elsewhere also exerted a significant creative influence on ER, the hit medical series that debuted on NBC in 1994. While the pacing of ER is much faster, both the spirit of the show and many of its story ideas have been borrowed from St. Elsewhere.