I think you're missing the point. In Royal Pains, Hank is just a concierge doctor. But Grace is having to live a double-life. No one can know she works for the mob. Everyone knows Hank is a concierge doctor.
Of course there's a difference. You can get sued if your show is nothing more than a carbon copy of another one.
Without "Royal Pains," there is no "Mob Doctor."
Both provide on-call medical services for a clientele that eschews normal channels.
And I don't see the comparison between House and Monk at all. Monk put the pieces together and solved crimes. House diagnosed illnesses. Doesn't really compare.
"House" is actually a detective show - with a doctor as detective and disease as the crime/criminal. It follows all the detective show conventions and only a few medical show conventions.
The creators have said they based the character on Sherlock Holmes. The show uses many references to the Holmesian universe: House lives at 221B Baker Street, Wilson = Watson, the first patient was named Adler, the man who shot House was named Moriarty, House uses deductive logic to diagnose disease.
Both House and Monk were "defective detectives." "House" was a grittier show, so the writers could include drug addiction and other issues that a lightweight show like "Monk" would have to avoid.
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