The series was pitched to ABC Entertainment, who gave the green light, and the show was picked up as a mid-season replacement for Boston Legal in the 2005 television season. Francie Calfo, executive vice president of development at ABC Entertainment, commented that ABC was looking for a medical show that was unlike the others airing at the time. She pointed out that “[m]edical shows are hard, and it was hard trying to figure out where ours could be different. But where everybody else is speeding up their medical shows, [Rhimes] found a way to slow it down, so you get to know the characters. There’s definitely a strong female appeal to it.”
“ER is high-speed medicine. The camera flies around, adrenaline is rushing. My show is more personal. The idea for the series began when a doctor told me it was incredibly hard to shave her legs in the hospital shower. At first that seemed like a silly detail. But then I thought about the fact that it was the only time and place this woman might have to shave her legs. That’s how hard the work is.”
— Rhimes on the creation of Grey’s Anatomy
Rhimes initially conceived Grey’s Anatomy as a statement against racism. She endeavored to create a show that featured a racially diverse cast that allowed viewers to relate to characters regardless of race. While creating characters, as well as writing the first script, the series’ writers had no character descriptions in mind, and hoped to cast the best actor available for each part. Rhimes has explained that if the network did not allow her to create characters this way, she would have been hesitant about moving forward with the series. Female roles in particular were developed as multi-faceted characters. Rhimes offered her insight on this, “I wanted to create a world in which you felt as if you were watching very real women. Most of the women I saw on TV didn’t seem like people I actually knew. They felt like ideas of what women are. They never got to be nasty or competitive or hungry or angry. They were often just the loving wife or the nice friend. But who gets to be the bitch? Who gets to be the three-dimensional woman?”
Before the series debuted on March 27, 2005, there were a few early releases to close friends and family of the producers and actors. The show was scheduled to run in the Boston Legal time slot for four weeks. However, high ratings and viewership led to it holding onto the slot for the remainder of the season. ABC Entertainment President, Steve McPherson, commented on the scheduling change: “Ultimately we decided that, without having adequate lead time or marketing dollars to devote to moving either show so late in the season, we’d continue to let [Grey’s Anatomy] build on its tremendous momentum through May.” The show’s title, Grey’s Anatomy, was devised as a play on words: a reference to both Henry Gray’s medical textbook, Gray’s Anatomy, and the title character Dr. Meredith Grey (Ellen Pompeo). Prior to broadcast, it was announced that the show’s title would change from Grey’s Anatomy to Complications, although ultimately this did not come to pass.