Its pretty much just showing what it's like to set up an aquarium professionally for someone. I work for a business that does that and guess what? A lot of typical people want saltwater tanks with fake corals and fake plants. That's how it works, for us who care about it more than it just being decoration, it doesn't make sense, but for decoration people don't care. It's got fish, its got fake coral, it's fine.
They didn't make the show for hobbyists, they made it to show what a professionally maintained aquarium can look like if you can spend that kind of money. Personally I like the show, I find it entertaining to see what they can do.
As far a the accents. Be kind, it's not like they're fake.
People like Tom Barr who have clients that love what he does are excluded, they pay a hefty price for that. But general tanks (doctors office, ect) like the saltwater fake Coral just fine. At least that's how it Is here in KC