The dangerous duality of the TV MD-“journalist” – 2 examples in 2 nights on network TV news

Snyderman.jpgOne night this week, NBC’s chief medical editor, Dr. Nancy Snyderman, urged women over 40 to consider having the C-reactive protein or CRP test for heart disease. She said on the air:

“If you’re over the age of 40, this is the time to have a conversation with your doctor about this very simple blood test that’s covered by most insurance.”

Besser.jpgThe next night, ABC News’ senior health and medical editor, Dr. Richard Besser, said this on the air:

“Before you go on a cholesterol medication, I want you to ask your doctor about this: A coronary artery calcium test.”

These two examples once again bring into the spotlight one of the problems with some physicians who are put into the role of journalists. Perhaps their networks urge them to give advice. But this isn’t the Dr. Oz show or “Dear Abby.” And viewers aren’t having a clinical office visit with Dr. Nancy or with Dr. Rich – although that’s probably the warm, fuzzy feeling the network wants to convey.

It’s news. These both appeared on network NEWS programs.

Telling viewers what to ask their doctors about (or what to ask their doctors for) crosses a line. It is advocacy. It is like a doctor’s advice column on the air. But the news program is not labeled that way and neither were these specific health “news” segments.

The leading organization that promotes health care news standards – the Association of Health Care Journalists – in its Statement of Principles states that journalists should:

“Distinguish between advocacy and reporting. There are many sides in a health care story. It is not the job of the journalist to take sides, but to present an accurate, balanced and complete report.”

And in their one-sidedness, Snyderman and Besser overlooked dissenting opinions.

The U.S. Preventive Services Task Force concludes that the current evidence is insufficient to assess the balance of benefits and harms of using the nontraditional risk factors (including CRP and coronary calcium scans) to screen asymptomatic men and women with no history of coronary heart disease to prevent coronary heart disease events.”

And the ABC on-air story on calcium scans didn’t even include this important perspective that appeared in ABC’s own online verison of the story:

“Calcium scanning is one of the worst examples of medicine gone wild,” said Dr. Steven Nissen, chairman of the department of cardiovascular medicine at the Cleveland Clinic. “It’s taken on a ‘cultlike’ following.”

Not everyone goes to the ABC website. Many are still influenced by what they hear on the network TV news.

Now let’s be clear: There is a strong debate in health care about what’s being learned from such new tests. (This week’s edition of The Lancet has several papers and comments on the predictive ability of both tests.) It would be perfectly acceptable for Drs. Snyderman and Besser – in a clinical office setting – to give their advice to patients. It is advice that many doctors – although, as stated above, not all – would share. But we’re not talking about a clinical office setting here. We’re talking about journalism.

Medicine and journalism are noble callings.

Perhaps those who have chosen to be dual practitioners – with feet in both worlds – either need additional training in the fundamentals of journalism ethics and principles – or need to abandon one role or the other.

The duality – as demonstrated in these examples – can be detrimental to the core credibility of the news being presented.

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J.Daniel Flaysakier

August 22, 2011 at 5:34 am

We have experienced the same problem in france with theproducer of a daily medical show seen by the viewers as a ‘doctor journalist’. He has launched a campaign for a yealy prostate cancer screening , a position upheld by urologists but not by our NCI neither by the main cancer patient association.
At a time when Big Pharma is under scrutiny for its links with physicians, it is very interesting for various interests to use TV as a way to influence prescriptions.
I am sometimes extremely surprised, when attending majour symposia, to see how some preliminary results are reported on US national networks.
As you perfectly state it is quite difficult to be both on TV and in amedical practice in the same time.
When you raise that question, some ‘media doctors’ think it is jealousy.
As a physician by training, with a once a week activity in a teaching hospital, I can measure the difficulties not to cross the line.
But for the last 25 years, I have been a full time journalist, not a special envoy from the medical world to the medis world.

Michael Kirsch, MD

August 23, 2011 at 7:48 am

The medical ‘press’ loves surrogate markers, and the public doesn’t get the concept or the danger of relying upon them. This drivel ends up being a ‘surrogate’ for real news.