The following is a guest post by our blog contributor, Trudy Lieberman. The longer she’s been covering health care issues, the more tuned-in she seems to be about claims she sees in health care public relations.
Back in 2002 Dartmouth researchers Steve Woloshin and Lisa Schwartz concluded in JAMA that press releases from medical journals did not routinely highlight limitations of the studies they reported or disclosed the role of industry funding the research. In 2009 Woloshin, Schwartz, and other colleagues examined more press releases in a paper in the Annals of Internal Medicine, this time from academic medical centers. They found the centers were promoting preliminary research data while omitting important caveats the public needed to judge the relevance of the results.
Puffy press releases from the healthcare industry have now gone way beyond disclosure lapses from medical journals and academic medical centers. Increased competition for patients and exploding healthcare technology have spawned tons of releases that are perfect fodder for myriad Internet sites and traditional media looking to fill their health news holes. A sample of some 20 press releases I collected over the last few months shows how the medical business stretches the definition of “news” hoping for a mention in a blog post, news story, TV segment, or tweet that will help sell a product or service, and burnish the brand.
“My work on promotion and marketing in medicine suggests benefits are hyped and harms tend to be hidden way too often,” says Ray Moynihan, co-author of “Selling Sickness” and now a senior research fellow at Bond University in Australia. “This bias can flow from the press release straight into the media coverage, distorting public debate and painting an overly rosy picture of what healthcare can deliver.”
How rosy was what I wanted to know. My sample, albeit small and nonscientific, gives a flavor of what journalists and ultimately the public are up against.
What prompted my little analysis was the “earth-shaking” news from New York City’s Mt. Sinai Hospital that the hospital had reached 100,000 likes on Facebook, “making it the first hospital in the Tri-State Area and one of seven hospitals in the nation to achieve this milestone.” What’s more NurseJournal.org ranked it among the top five social-media friendly hospitals nationally, a distinction that may have prompted this quote from the hospital system’s chief communications officer Leonard Achan, “Mount Sinai’s social media strategy has been to offer dynamic and accessible expert content that empowers and inspires our audience to live healthier lives.” Still, why would anyone pick up such a release? I e-mailed Sid Dinsay, associate director of media relations, asking him how much pick-up the release generated. We couldn’t find any. Dinsay didn’t respond so I turned to Earle Holland, former assistant VP for research communications at Ohio State University, and now a member of the HealthNewsReview.org editorial team, to help me peel back the hidden messages of this press release and others. “Social media is an excellent way to bring in patients,” he told me. “If 100,000 people looked at you on Facebook, that means you should join the crowd of people who think you’re good. It’s a popularity contest and says nothing about the quality and care or the capability of the medical center.”
There’s a variation on this theme: If a hospital or high-tech company announces it can attract all-star talent or make prestigious business deals, others, too, might think they’re great. Take the release from the Back to Health Center in Alexandria, Va., announcing that the practice “has welcomed several new licensed massage therapists to their team of chiropractors, acupuncture physicians and natural childbirth educators.” Those new therapists allow the practice to “meet the increasing demand” for high quality massage therapy in the area and, of course, send the message that the enterprise is so good and in demand that it can attract great staff that will reel in new customers. A release from RadNet, which calls itself the leading provider of freestanding, fixed-site diagnostic imaging services in the U.S., announced it had snagged a contract to provide national cancer screening services in Qatar. Hey, if a foreign government selects your company as a vendor, you must be awfully good, and that can only help sell more machines at home.
Promoting a hospital’s survivors also polishes the brand. Sentara Norfolk General Hospital in Norfolk, Va., highlighted its 10th annual burn survivors’ reunion. “It invigorates me to see survivors like this carrying on with their lives,” said burn surgeon Dr. Jay Collins. “It can be a long road to recovery and they’re living normal lives.” Translation: if you were badly burned, how about coming to Sentara?
But veteran research communications pro Earle Holland said, “If you have a celebration of survivors, it suggests you are successful and if you have that condition, you go there. It is clever and nothing but salesmanship and marketing.”
Some releases I examined used the “we are the first to do whatever” pitch What better way to create an aura of excellence than to tell the world you’re first to use whatever new device or treatment, which comes along. The Tucson Medical Center and Stereotaxis, which bills itself a “global leader” in innovative technologies for treating cardiac arrhythmias, did just that in an early January press release announcing they teamed up to bring the first Stereotaxis Vdrive® robotic navigation system with V-Loop variable loop catheter manipulator to the U.S. Doctors operate the hand controls of common diagnostic and therapeutic catheters from a control room during a procedure to treat cardiac arrhythmias. “We are excited and proud to be the first to offer this impressive innovation in the U.S. and particularly to the residents of Southern Arizona,” said Dr. Darren Peress, the medical director of the electrophysiology lab at the Tucson Medical Center. But should the residents of southern Arizona run out to get the new procedure? The new system just received FDA clearance in September 2014. Holland pointed out that being first may not always be the best. “The first person to do the procedure may not do it as well as the 100th person,” Holland told me. We know one word of advice to patients has been to check on the volume of procedures a particular facility has done and how many the doctor or surgeon has performed. The theory is the more they do the better they are.
Holland had a final thought about press release puffery. What he calls “pie in the sky” language suggests some new, hyped intervention might do something, but he cautions it might not. Case in point was a recent release from MDxHealth for a product called ConfirmMDx® for prostate cancer, an epigenetic test developed to rule out the presence of undetected cancer in men with benign prostate biopsy results. The press release announced at a recent conference that data demonstrated “the prognostic value” of its technology. “The data support the ability to predict the presence of clinically significant cancer in biopsy-negative patients based on the DNA hypermethylation of the biomarkers in the Confirm MDx test,” the release said.
It added there is an “unmet medical need for a clinically effective diagnostic test” to address the false-negative results of prostate biopsies. But the release provided no specific performance data about how well the product supposedly met that unmet need! It simply said: “Performance of the proprietary ConfirmMDx genes and technology has been published in 45 studies on over 5,000 patients tested.” But it provided no data from those 45 studies. And no links to those studies.
You get the picture. Press release puffery goes on and on.
Starting next month, HealthNewsReview.org will begin publishing systematic, criteria-driven reviews of health care news releases. We think this will be an important addition to our project, and potentially, a way to improve the public dialogue about health care interventions.
(Publisher’s note: I prefer the term “news release” to “press release.” Maybe that’s because I didn’t come up through the ranks of journalism as a print reporter. But broadcast and online journalists have never cranked it out on a printing press, so many of us tend to prefer the term “news release.” I let it go as “press release” in this piece because different people in this piece used the term press release. But, in general, I will encourage the term news release on this site. – Gary Schwitzer, Publisher.)
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