Beyond Cures, Breakthroughs, and News Releases: Ideas for Covering Health & Medicine
There is too much cheerleading in health and medical news. For years, journalists were cheerleaders for the Cox-2 inhibitor drugs such as Vioxx, calling them "super-aspirins" in headlines in the New York Daily News, the New Orleans Times-Picayune, the Pittsburgh Post-Gazette, The Boston Herald, the Chicago Sun-Times, The Washington Post and USA Today. Indeed, such hype is now being severely throttled back in recognition of the harm these drugs can cause. The hype preceded the evidence.
Journalists were cheerleaders for the anti-cholesterol statin drugs, trumpeting a federal panel's recommendation last year that millions more should take statins. But many journalists either didn't check, didn't know, didn't care or didn't disclose that eight out of nine experts on the federal panel had financial ties to drug companies that made statins. In the past seven years, many journalists even passed along cardiologists' jokes that the drug should go in the water supply. But when the joke is repeated in The New York Times, The Washington Post, the San Francisco Chronicle and USA Today, it can take on a life of its own.
Journalists were cheerleaders for an experimental drug that shaved one day off the span of symptoms for a self-limited illness -- the common cold. (See sidebar.) Not all journalists who promoted the hype reported the punchline: an FDA advisory committee unanimously rejected the drug.
Some television journalists became cheerleaders for the government's spin on the Medicare reform legislation last year when they ran a government-produced video news release without labeling it as such.
We live in a time when there are multiple conflicts of interest when it comes to spreading health news and information. Among government, the drug and medical device industry, academic researchers, academic institutions and medical journals, there are many competing interests at play. The editor of the journal The Lancet recently said that the relationship between the drug industry and medical journals is "somewhere between symbiotic and parasitic." Journalists who are not aware of these conflicts, and who don't investigate them as a routine part of story research and interviewing, are not doing their job.
There is a troubling trend toward commercialism in health news, especially in television news. Single-source stories, in which commercial vested interests go unchallenged, dominate. Many TV stations refer viewers to links on the station's Web site. But those links may take users directly to commercial Web sites of those who are pitching products.
Is this journalism? TV journalists report on their own Lasik surgery, on their own CT scans, on their own use of wrinkle creams. Costs and evidence are generally not discussed. The Baltimore Sun in 2002 blasted two local TV stations for "an alarming parade of commercial tie-ins." Several stations across the country have sponsorship agreements with local medical centers that allow the institutions to place their content on the air.
Journalists who only report on medical breakthroughs or on the latest news releases from medical journals are not reflecting an accurate picture of the current health care system.
There must be a balance between stories about new therapies or technologies in medicine and stories about the cost, quality and evidence behind such new ideas. Journalists must tackle more stories about health policy: Medicare, Medicaid, the uninsured, rationing, retirees' benefits, resource allocation, chronic illness, and the cost and safety of prescription drugs. Journalists who concentrate on new ideas without covering questions of cost, evidence, quality and access may be contributing to the health care cost crisis.
It doesn't take much effort. Last year, a graduate student and I worked with a local television station for a few hours a week to help the station report on such health policy issues. The station (KMSP, Minneapolis) aired at least one story per month from January through the November 2 election, including two half-hour specials on health policy. Yet, in another arm of my research, I discovered that three award-winning television stations in different parts of the country virtually ignored health policy in their late-night newscasts in the 2004 election year. In 326 hours of news in 10 months on three stations, I found one story on the uninsured. On any given day in this country, it is estimated that we have 40-80 million uninsured. Yet no stories had health costs or quality as their primary focus. The stations devoted a total of seven minutes to discussion of the Bush or Kerry health policy platforms.
Enough with the problems. Let me point to some good things that are happening in health journalism.
I'm on the Board of the Association of Health Care Journalists, a six-year-old organization that has more than 750 members in 10 countries. This group is dedicated to improving the quality, accuracy and visibility of health care reporting, writing and editing. Last year I led the effort to publish a Statement of Principles for the organization. I urge not only writers and reporters but editors and news directors to read this statement and adopt these principles in their newsrooms.
I've also helped launch a graduate program in health journalism at the University of Minnesota's School of Journalism & Mass Communication. In it, students learn the skills and judgment to scrutinize the evidence behind claims made in the dissemination of health, medical and science news. Similar programs have been developed in a handful of other universities across the country.
Many journalists who cover health are overloaded with wide-ranging responsibilities for a complicated beat that can be varyingly viewed as health, medicine, health policy, basic research, science, finance or the business of health, politics and other specialized areas of news. It can be hard news or soft features. Some journalists are responsible for the entire range of topics. Some of the problems with the beat may occur because a newsroom doesn't use its personnel wisely; people working on features or wire stories or the "lifestyle" section may not even consult with the beat reporter.
Managers must allow time -- time for quality health journalism to be produced, time for teamwork and time for training for staff who need it. Otherwise, in many ways, they would be better off ignoring health and medical news rather than presenting inaccurate, imbalanced or biased news to a needy public.
Gary Schwitzer is a member of the health journalism graduate faculty of the University of Minnesota School of Journalism and Mass Communication. He covered health and medical news for 15 years at CNN, WFAA in Dallas and WTMJ in Milwaukee. He was also founding editor-in-chief of the MayoClinic.com Web site.