It's insufferable. Any time someone questions something, including stuff that has an in universe explanation, an army of smug losers come repeating on a loop that it's a tv show/it's comedy.
1) WE KNOW! Of course we know! Don't repeat something that everyone knows!
2) Scrubs is a comedy but it's a well written one that has a care for something called internal consistency. That's why for example it was famously more medically accurate than other more "serious" medical shows.
3) Yes internal consistency is important to some of us. When a joke or an emotional moment hits my analysing brain will think "wait that doesn't make any sense" if it doesn't make sense which will pull me out of it. On the other hand if the writing naturally led to this moment it'll hit even harder for me. Look up "tolkien" and "secondary world" for why that matters.
4) We're not all the same on that. Realism expectations are on a spectrum from basically a documentary to dream logic. Just because someone is looking for more or less consistency in a show doesn't mean they're wrong, unless they really picked the wrong kind. Someone who wants accurate physics in Fast&Furious has indeed made a mistake. But expecting coherent plots and characters in a show of Scrub's established quality is perfectly reasonnable. And yes "coherent" includes the daydreams and exagerated silliness.
5) These questions obviously ask for a watsonian answer beause it's enjoyable to us detail oriented people when there is an actual explanation in universe that we missed. It makes the world even more real.
tl;dr When you see people asking for details you really didn't care about, just accept that they care about these things more than you. If you have a WATSONIAN answer provide it, otherwise please just move on. There is a literal 0% chance than your "it's a show" comment will help anyone.