Why Health Reporting Is Hot !


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This is a presentation I made to journalism students at the Times School of Journalism. Doctors and health reporters working together can be a very powerful force for improving health in society.

Why Health Reporting Is Hot !

  1. 1. Dr Aniruddha Malpani, MD HELP – Health Education Library for People www.helpforhealth.org
  2. 2. <ul><li>The media is an important source of health information </li></ul><ul><li>Health articles are of lasting value </li></ul><ul><li>They can touch lives positively </li></ul><ul><li>You have a great power – and a great responsibility </li></ul><ul><li>A good health story can make you happy to be a reporter ! </li></ul>
  3. 3. Health <ul><li>Topic of perennial interest – great demand </li></ul><ul><li>Not much competition – few specialised reporters </li></ul><ul><li>In the US, health reporters are stars </li></ul><ul><li>Pulitzer Prize , books and bylines </li></ul><ul><li>US Surgeon General ( Dr Sanjay Gupta) </li></ul>
  4. 4. Important does not have to be dull ! <ul><li>“ For many of us, the “public service” part of journalism is why we do what we do. It's what keeps us in journalism instead of working for a PR firm.” </li></ul><ul><li>How can you make sure important health stories are not canned? </li></ul><ul><li>Balancing commercial interests with editorial integrity - this is the challenge ! </li></ul>
  5. 5. <ul><li>There have never been more opportunities to communicate health news and information </li></ul><ul><li>There’s never been better health journalism than some that is reported in this country today. </li></ul>
  6. 6. The challenge <ul><li>While brevity and immediacy are touchstones of news reporting, health and medical reporting must include sufficient context, background and perspective to be understandable and useful to audiences/readers. </li></ul><ul><li>Stories that fail to explain how new results or other announcements fit within the broader body of evidence do not serve the interests of the public </li></ul>
  7. 7. Challenging job ! <ul><li>Health writers are translators </li></ul><ul><li>They transform the jargon-laden language and arcane concepts of medicine into something the rest of us can understand and even appreciate. </li></ul>
  8. 8. Why is health reporting so bad today ? <ul><li>How Do US Journalists Cover Treatments, Tests, Products, and Procedures? An Evaluation of 500 Stories. 2008. PLoS Medicine </li></ul><ul><li>The daily delivery of news stories about new treatments, tests, products, and procedures may have a profound—and perhaps harmful—impact on health care consumers. </li></ul><ul><li>Journalists usually fail to discuss costs, the quality of the evidence, the existence of alternative options, and the absolute magnitude of potential benefits and harms. </li></ul><ul><li>Reporters and writers have been receptive to the feedback; editors and managers must be reached if change is to occur. </li></ul><ul><li>Time (to research stories), space (in publications and broadcasts), and training of journalists can provide solutions to many of the journalistic shortcomings identified by the project. </li></ul>
  9. 9. TV health stories are ill ! <ul><li>A 2002 Gallup poll showed that many Americans consider television their most important source of news and information on health. </li></ul><ul><li>It also showed that television is one of the least trusted sources of such news and information. </li></ul><ul><li>Too brief to matter </li></ul><ul><li>No full time health journalists </li></ul><ul><li>No data to back up sensational claims </li></ul><ul><li>Hyperbole </li></ul><ul><li>Commercialism </li></ul><ul><li>Single source stories </li></ul>
  10. 11. Rules of reporting have changed ! <ul><li>Deadline-pressured, budget-crunched news staffs routinely use portions of video news releases slickly-produced by vested interests in the health care industry, without telling the audience that part of what they're seeing is from slanted sources. </li></ul><ul><li>People are being thrown into this beat soon after getting their &quot;press card,&quot; and long before they're able to react with any seasoned judgment. </li></ul><ul><li>The television news industry has reacted to the void in health news specialists, scrambling to find anyone to plug into the spotlight, with an assumed title, and a promotable new niche. </li></ul>
  11. 12. Naïve Journalists <ul><li>Unaggressive in their reporting </li></ul><ul><li>Not critical or skeptical enough </li></ul><ul><li>Over-reliance on official “ scientific” sources </li></ul><ul><li>Journalists often end up retailing the views of their sources rather than investigating the evidence behind those views. </li></ul>
  12. 13. Puppeteers <ul><li>Public relations people </li></ul><ul><li>Pharmaceutical or device manufacturers </li></ul><ul><li>Today’s physician may be overwhelmed by the pressure to promote himself or herself on the air. </li></ul>
  13. 14. The Seven Words You Shouldn't Use in Medical News <ul><li>Cure, miracle, breakthrough, promising, dramatic, hope and victim. </li></ul><ul><li>I didn't dream up the list; it was given to me by sick people I had interviewed over a 30-year career in health journalism. </li></ul><ul><li>Veteran health/medical journalist Judy Foreman has written, &quot;Words are scalpels, every bit as sharp as a surgeon's tools, and sometimes, almost as dangerous.&quot; </li></ul>
  14. 15. 10 criteria of a good story <ul><li>The availability of the treatment/test/product/procedure </li></ul><ul><li>Whether/how costs are mentioned in the story </li></ul><ul><li>If there is evidence of disease mongering in the story </li></ul><ul><li>Does the story seem to grasp the quality of the evidence? </li></ul><ul><li>How harms of the treatment/test/product/procedure are covered in the story </li></ul>
  15. 16. 10 criteria of a good story <ul><li>Does the story establish the true novelty of the approach? </li></ul><ul><li>How the benefits of the treatment/test/product/procedure are framed </li></ul><ul><li>Whether the story appeared to rely solely or largely on a news release </li></ul><ul><li>Is there an independent source and were any possible conflicts of interests of sources disclosed in the article? </li></ul><ul><li>Whether alternative treatment/test/product/procedure options are mentioned </li></ul>
  16. 17. What would my mother do ? <ul><li>On the basis of my news account, what would my mother do or assume about a given medical intervention ? </li></ul><ul><li>Remember – the reader is not an idiot – the reader is your wife ! ( David Ogilvy). </li></ul>
  17. 18. Why is health reporting so bad today ? <ul><li>Lack of time </li></ul><ul><li>Lack of space </li></ul><ul><li>Lack of knowledge </li></ul><ul><li>Competition </li></ul><ul><li>Difficulties with medical terms </li></ul><ul><li>Problems finding and using sources </li></ul><ul><li>Problems with editors </li></ul><ul><li>Commercialism </li></ul>
  18. 19. The media and health <ul><li>Medical heroes </li></ul><ul><ul><li>New procedures </li></ul></ul><ul><ul><li>New research </li></ul></ul><ul><ul><li>“ Latest” </li></ul></ul><ul><ul><li>AIDS </li></ul></ul><ul><ul><li>IVF </li></ul></ul><ul><ul><li>Cancer </li></ul></ul><ul><ul><li>Heart disease </li></ul></ul><ul><ul><li>Celebrity illnesses </li></ul></ul>
  19. 20. The media and health <ul><li>Medical villains </li></ul><ul><ul><li>Greedy doctors hungry for money </li></ul></ul>
  20. 21. Challenges <ul><li>Medical science – can be complex to understand – and to explain ! </li></ul><ul><li>Doctors are not good communicators ! </li></ul><ul><li>Speak Greek – difficult to explain this to laypeople </li></ul><ul><li>Tend to sensationalise because it’s easier to do this </li></ul><ul><li>Space limits </li></ul>
  21. 22. Doctors v/s Journalists <ul><li>Doctors often treat reporters with suspicion </li></ul><ul><li>Can also be publicity hungry </li></ul><ul><li>Conflicts of interest </li></ul><ul><li>Journalists and doctors: different aims, similar constraints </li></ul>
  22. 23. Doctor v/s Doctor <ul><li>Doctors can be very political </li></ul><ul><li>Can be very competitive ! </li></ul><ul><li>Bad-mouth each other </li></ul>
  23. 26. Suggestions <ul><li>Look at the big picture first </li></ul><ul><li>Provide background </li></ul><ul><li>Ask questions ! </li></ul><ul><li>Need context </li></ul><ul><li>Don’t get intimidated by the expert ! </li></ul><ul><li>KISS </li></ul>
  24. 27. Cultivate doctors <ul><li>Doctors have big egos </li></ul><ul><li>Learn to think like a doctor does ! </li></ul><ul><li>Empathy is key </li></ul><ul><li>Doctors are busy people; and don’t suffer fools gladly; expert in a narrow area; may not be articulate </li></ul><ul><li>May not understand your deadline or constraints. Educate them ! </li></ul>
  25. 28. Covering medical conferences <ul><li>You translate medical research into news. </li></ul><ul><li>Research presented at scientific meetings receives prominent media attention. The public has a strong desire to know about the latest developments in science and medicine </li></ul><ul><li>Press coverage is attractive to the sponsors of the meetings, the scientists, their institutions </li></ul><ul><li>Win- win ? </li></ul>
  26. 29. Covering medical conferences <ul><li>Scientific meetings are intended to provide a forum for researchers to present new work to colleagues; the work presented is preliminary. </li></ul><ul><li>The presentations represent work in progress. Many projects fail to live up to their early promise. </li></ul><ul><li>Press coverage at a premature stage may leave the public with the false impression that the findings are widely accepted. </li></ul><ul><li>As a consequence, patients may experience undue hope or anxiety or may seek unproved, useless, or even dangerous tests and treatments. </li></ul>
  27. 30. Making sense of medical jargon
  28. 34. Quality of answers depends upon quality of questions <ul><li>Why is there a need for a new therapy?  </li></ul><ul><li>How is the new therapy supposed to work differently than others?  </li></ul><ul><li>How long has it been studied? </li></ul><ul><li>In how many people?  </li></ul><ul><li>In how many mice? </li></ul><ul><li>What is known so far?  </li></ul><ul><li>And finally – the most important question – what is not known?  Careful researchers and careful journalists always answer that last one.  </li></ul>
  29. 35. Medical experts <ul><li>Petra Boynton </li></ul><ul><li>The most easily accessible 'expert' may not be the best qualified. </li></ul><ul><li>What an expert can discuss. </li></ul><ul><li>What an expert can not discuss. </li></ul><ul><li>A checklist to help judge the credentials of an 'expert'. </li></ul><ul><li>A list of doctors and professional bodies to help find experts. </li></ul>
  30. 36. How to spot PR based research ! <ul><li>PR companies have caught on to a new way to sell stories to the press – research. </li></ul><ul><li>The media are frequently sent press releases about the results of a shocking or surprising ‘new study’. </li></ul><ul><li>PR companies are media savvy – great stories for lazy reporters ! </li></ul><ul><li>Their quality may be questionable. </li></ul><ul><li>Often just an exercise in headline grabbing </li></ul><ul><li>Don’t get manipulated and misled – you need to protect your readers </li></ul>
  31. 37. Don’t become a bakraa ! <ul><li>Be well-read </li></ul><ul><li>Be sceptical </li></ul><ul><li>Look for background </li></ul><ul><li>Do your homework </li></ul><ul><li>Be willing to read and study – it gets easier with time ! </li></ul><ul><li>Check and re-check </li></ul><ul><li>Don’t get carried away </li></ul><ul><li>Check with other experts </li></ul><ul><li>Look for balance </li></ul>
  32. 39. WHO European Health Guidelines for Professional Health Correspondents <ul><li>1. First, try to do no harm. Human rights and the public good are paramount. </li></ul><ul><li>2. Get it right. Check your facts and your sources, even if deadlines are put at risk. </li></ul><ul><li>3. Do not raise false hopes.  Be especially careful when reporting on claims for 'miracle cures' or potential 'health scares'. </li></ul><ul><li>4. Beware of vested interests.  Ask yourself 'who benefits most from this story?' </li></ul><ul><li>5. Reject personal inducements. Always make it clear if material is being published as a result of sponsorship. </li></ul>
  33. 40. WHO European Health Guidelines for Professional Health Correspondents <ul><li>6. Never disclose the source of information imparted in confidence. </li></ul><ul><li>7. Respect the privacy of the sick, the handicapped and their families at all times. </li></ul><ul><li>8. Be mindful of the consequences of your story. Patients who may be sick or handicapped have lives to live long after the media have lost interest. </li></ul><ul><li>9. Never intrude on private grief. </li></ul><ul><li>10. If in doubt, leave it out. </li></ul>
  34. 41. Reporter’s real world viewpoint <ul><li>&quot;Scientists expect us to include every counter story, every caveat, but you don’t have that luxury as a journalist. And your stories are competing with every other field of human knowledge. The person I have in mind when I write a story is the man who is only two clicks away from a story about the latest antics of Britney Spears.&quot; </li></ul><ul><li>“ You live in a bubble. Newspapers are imploding, we are struggling to deal with virtually no resources and increased demand for content and you offer no insight into how to produce quality stories under the circumstances. In a perfect world, we would all gladly embrace your guidelines, but it's far from a perfect world and you're obviously not acknowledging that.” </li></ul>
  35. 42. Useful tools <ul><li>Use technology cleverly to improve your efficiency ! </li></ul><ul><li>Google </li></ul><ul><li>Mailing lists </li></ul><ul><li>News alerts </li></ul><ul><li>RSS feeds </li></ul><ul><li>Web 2.0 </li></ul><ul><li>Blogs </li></ul><ul><li>Twitter </li></ul>
  36. 44. Problem areas <ul><li>Medicolegal </li></ul><ul><li>Medical negligence </li></ul><ul><li>Alternative medicine </li></ul><ul><li>Quacks </li></ul><ul><li>Cutting edge of research </li></ul><ul><li>Corporate hospitals and pharma companies ( spin experts) </li></ul>
  37. 45. Making sense of the medical literature <ul><li>Medical journal articles </li></ul><ul><ul><li>Abstracts </li></ul></ul><ul><ul><li>Full texts </li></ul></ul><ul><ul><li>Original articles </li></ul></ul><ul><ul><li>Review articles </li></ul></ul><ul><ul><li>Editorials </li></ul></ul><ul><li>Medical text books </li></ul><ul><li>Good health writers are </li></ul><ul><li>good health readers ! </li></ul>
  38. 46. How to read a medical journal article <ul><li>Publication. What type of journal is the study published in? Is the topic of the study appropriate for the journal? </li></ul><ul><li>Authors. Who are the authors of the article, and what are their credentials? Do the authors' credentials correspond to the subject matter? </li></ul><ul><li>Funding. Who sponsored the study? Does the sponsor stand to gain from a specific outcome? Is there a potential conflict of interest? </li></ul><ul><li>Title. Is the title descriptive or assertive? Does it accurately reflect the purpose, design, results, and conclusion of the study? </li></ul><ul><li>Abstract. Does the abstract adequately summarize the main text of the article? Are the data and conclusion consistent with what's presented in the main text? </li></ul>
  39. 47. How to read a medical journal article <ul><li>Introduction. Why was the study conducted, and what clinical question or hypothesis do the authors address? How does this study fit into the context of previous research conducted on the subject? </li></ul><ul><li>Methods. What is the design of the study? Are all of the items used in the study completely explained? Who are the subjects? How were they chosen? What are the inclusion criteria to be accepted into the study? What are the exclusion criteria to be excluded from the study? How large is the sample? Is the population being studied appropriate for the question researchers are looking to answer? </li></ul><ul><li>Results. Are the results statistically significant? Are they clinically significant? </li></ul><ul><li>Discussion. Are the key conclusions supported by the results? Are there any other ways to explain the data that the authors have not listed? Do the authors detail the limitations of their work? </li></ul><ul><li>References. Do the authors back up their statements with appropriate references? Do the authors cite their own previous work? </li></ul>
  40. 48. Tips <ul><li>Create an “expert panel” of doctors </li></ul><ul><li>Ask doctors in a different field for their opinion. More likely to get an unbiased opinion </li></ul><ul><li>Medical college doctors can be reliable and are usually unbiased </li></ul><ul><li>Medical librarians are information specialists </li></ul><ul><li>Use Web 2.0 for global networking </li></ul><ul><li>Materials written for patients can be very useful in helping you make sense of technical minutiae </li></ul>
  41. 51. Future <ul><li>Web reporting ( blogs, twitter) </li></ul><ul><li>Allows you to keep in touch with readers – feedback ! </li></ul><ul><li>Create your own online portfolio of articles </li></ul><ul><li>You, Inc </li></ul><ul><li>Look for a niche to master – become a guru ! </li></ul><ul><li>New online initiatives – myhealthpedia.in </li></ul><ul><li>Write and publish an online book ! </li></ul><ul><li>Citizen reporters </li></ul><ul><li>New story ideas </li></ul>