Health News Review

Because, in a nutshell, we find them all the same way – online.  We don’t get ink on our fingers by reading a dozen or more newspapers every day.  We – like an increasing number of people around the world – get our news online where blogs look just like stories from the newspaper, where business of health stories pop up just as consumer health stories pop up, where no caveats or mastheads appear saying:

THIS IS A BLOG.  IT SHOULD NOT BE HELD TO THE SAME STANDARD AS OUR NEWSPAPER PRODUCT.  EVEN THOUGH IT’S DONE BY THE SAME PEOPLE AND APPEARS ON OUR WEBSITE ALONG WITH THE NEWSPAPER PRODUCT.

On our blog’s index page, for example, we post a clear explanation:

Why am I even writing about this issue?

Because some journalists have written to us stating that they think it’s unfair to apply the same standards to newspapers’ health care news blog posts as we do to their dead-tree-version of the news. Here are a few of the arguments sent to me (with my quick reactions in red):

  • Blogs are the things we try to squeeze in on top of doing a full day’s work.  (If it’s so important, your management should make it a recognized part of your full day’s work.  And if you need help conveying this message to your management, perhaps fostering a more open public discussion about the issue would help.)
  • We realize we’re giving readers a taste of something – which we think is better than nothing. (We don’t agree that something is better than nothing.  We think that incomplete, imbalanced health care news can actually be more harmful than helpful.)
  • Sometimes we blog when we think something doesn’t warrant a full story.  (Then put a big caveat in your first line:  THIS IS NOT WORTH A FULL STORY SO WE’RE BLOGGING ABOUT IT INSTEAD. This would tell readers that maybe it’s not worth their full attention.)
  • The blog post is intended to be short on reporter analysis and long on primary-sourcing–after all, this is why so many of us have been laid off: online readers seem to want to do it themselves! (Where is this intention explained to blog readers?  Where is the evidence that says that’s what they want?)

But as one sign of how confusing this is, here is the explanation given by one journalist recently:

“Usually our blog posts are clearly marked as such – since this blog was reverse-published in print, I think you reviewed the online version of that (which wouldn’t have mentioned the blog, and was actually shorter than the original blog post)”

Huh?  Readers are supposed to sort this out?  How?

To date, no journalist has posted any such comments online for public dialogue.  I just get emails from time to time from journalists we’ve reviewed.

Clearly, the issue is discussed internally in newsrooms.  One journalist wrote me:

It’s an existential issue we think about all the time – are readers best served by fewer reported stories, a whole bunch of blogs (like a ticker of news briefs) or a mix of both? And what’s the real difference between a blog and a story that appears online? To readers, it’s probably very little. But still, some recognition that we as writers aren’t under the mistaken impression that our blog posts are actually comprehensive reported stories would be nice.

We recently noted one prediction among the Nieman Journalism Lab’s predictions for journalism for 2012:

“News will increasingly be a conversation rather than a series of stories. In 2012, the divide will grow between journalists who are intently aware of and responsive to the needs of their communities and those who continue to make decisions based on long-ago-learned fortress mentalities. I wish I could say I were optimistic about crumbling fortresses. Instead, I’ll say that I’ll be on the lookout for examples of news presented as an ongoing, topical conversation rather than a series of journalist-driven stories. In an election year, being responsive to users’ actual information needs and being a part of a community’s conversation is more crucial than ever.”

So here’s a call for newspapers to open the dialogue more broadly and more often about how health care news is covered.  How it’s done in the newspaper, how it’s done in the newspaper’s blogs, how it’s done in briefs of fewer than 300 words, how it’s done in business stories as well as consumer health stories  – and how responsive these practices are to the needs of readers, viewers, listeners.

We have also recently been challenged by a network TV representative who wrote under the request – “between you and me – not for posting, please”:

If you are going to cover TV news, it would be very constructive if you could truly rate the various network stories, objectively compare coverage of stories, and call us out when we get it wrong, and when we get it right.  It would also be great if you could work to develop principles for network medical news coverage that recognize the 1:30 minute format. While it is great to have principles to apply to newspapers, it is rather ivory tower to apply the same standards to a different format.

Why must this remain “between you and me” ? Why can’t we have a more open public dialogue about such matters?

Note how, just as with the newspaper blog objections, this TV person is calling for a different standard.  Why?  What would that standard be?  No one ever has ever – ever in 6 years of daily publishing on this site – suggested a different set of criteria.

I am, indeed, honoring this person’s request for anonymity in this case.  But here’s how I responded:

We did objectively review and compare network TV news stories on our site for 3.5 years and across 228 stories – applying our 10 standardized criteria.  We stopped doing so because it was labor-intensive (I am the only person working on this project fulltime), the scores were poor and not improving, and one of the 3 networks’ main health news contacts told me not to bother anymore because he wasn’t paying any attention to us!  Part of his argument was the same argument you are now making:  that TV news deserves/demands a different set of criteria.  But no one has ever suggested what such a specialized list of criteria would be.  If I had to scale back our list of 10 criteria, 3 that would not change were the 3 for which TV news did the poorest job in our ample 3.5 year, 228-story sample:  covering costs, quantifying benefits and harms.  In other words, giving a sense of the scope of the benefits and harms.  But I don’t agree with scaling back the 10 criteria.  Tell me which of the 10 don’t matter in (your network’s) news stories – and make your answer on the record this time – because I think that (your network’s) viewers should be told that one or several of these don’t matter in all (of your network’s) health new stories:

  • What’s the total cost?
  • How often do benefits occur?
  • How often do harms occur?
  • How strong is the evidence?
  • Is this condition exaggerated?
  • Are there alternative options?
  • Is this really a new approach?
  • Is it available to me?
  • Who’s promoting this?
  • Do they have a conflict of interest?

That’s what we’re trying to get at with our criteria.  It is our stake in the ground that these are 10 things that matter.  OK, maybe they’re not all going to be addressed in every story.  But this is our stake in the ground…our guidepost…our discussion starter.

All we review on this site is daily coverage of health care interventions.  How well do journalists cover news about treatments, tests, products and procedures?

The simplest overview answer is:  the average story tends to emphasize benefits and minimize or ignore harms and costs.That’s the average across more than 1,600 stories.

We believe that this becomes a health policy issue – that how journalists help set the agenda for public discussion of harms, benefits, costs, etc., becomes a national health policy issue. The seeds of overtesting and overtreatment and denial of evidence and rhetoric about rationing can become planted and fertilized every day by the way stories about health care interventions are handled.

We’re not going to stop doing what we’re doing – the way we’re doing it – until or unless someone suggests a better way.  There’s too much at stake.

And we welcome and invite a better dialogue.

Comments

LIvingDonor101 posted on February 2, 2012 at 11:39 am

I’ve spent the last three years advocating for better protections and care for living organ donors, and your last few paragraphs sum up my experience. Every day (really, I have google alerts), I read articles that are clearly regurgitations of a transplant program’s press release, or blatant attempts by would-be recipients to solicit a stranger into giving up a kidney.

These articles treat living donation as if it were akin to a pint of blood, and the only mention of risks (if there is one) is a quote by either the would-be recipient repeating what they have been told by their surgeon, or a quote from a transplant surgeon him/herself, which is always a variation on “it’s safe” – the most harmful lie possible to not just the living donor, but the entire public.

OPTN and the transplant industry know the living kidney donor mortality rate (4.4 every yr within 12 months of surgery), as well as the complication rate (20%), and incidence of depression, anxiety and PTSD (20-30%) in LDs yet they keep such information carefully away from the public eye. These reporters meanwhile, never look for information beyond the organizations and folks that benefit from living donor transplants, nor ask even the most basic of questions. Then they have the audacity to be defensive and angry when they’re criticized? Unbelievable.

Kudos to you and everyone at Health News Review for trying to keep everyone honest. It’s an often difficult and thankless job. I appreciate it.

Rose Hoban, RN, MPH posted on February 3, 2012 at 10:37 am

OMG. Gary… along these lines, I was participating in a webinar yesterday on helping DHHS flacks get their stories out.

There was a TV woman on the panel, and she said something about ‘having a headline that scares people always helps’ (that’s a paraphrase). It’s a good thing my headset was on mute because I was screaming!!!