Sponsored journalist training on “precision medicine”: Zeroing in on a conflict of interest

The following is a guest post from Andrew Holtz, one of our longtime contributors, my former colleague at CNN, and a past president of the Association of Health Care Journalists.  This is at least the sixth time that we have addressed National Press Foundation workshop funding on this site.

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The question came from multiple colleagues: Is it okay for a journalist to accept an all-expenses-paid trip to a 4-day workshop on “Precision Medicine: Health Care Tailored For You” at the Mayo Clinic… that is funded by Mayo? Before hollering, “Hell, no!”, there”s an important nuance: the workshop program is being put together, and attendees selected, by the National Press Foundation, a not-for-profit that puts on a variety of training programs. The National Press Foundation says funders have no influence, that it controls its workshops from the choice of topic through the selection of speakers and conduct of the sessions. But what happened in this case seems a bit more convoluted; and it leaves me queasy about sponsors helping to set the agenda for journalists.

I contacted Sandy Johnson, a former Associated Press DC Bureau Chief who took over from the venerable Bob Meyers as National Press Foundation President last fall. She said (and I agree) that news organizations should train journalists, but they don”t; so her organization has been doing what it can to fill in the gaps. Johnson and the NPF web site say they come up with the ideas for training sessions and then seek support. In this case, she says she was impressed by a Mayo Clinic physician”s presentation at an NPF workshop on cancer. (That workshop was funded by Pfizer. We and others have criticized that ongoing sponsorship before. For example, here, here, here, here and here.)

Johnson reached out to a former AP colleague, Sharon Theimer, who now works in media relations at Mayo. “”So I started talking with Mayo about doing a program at their campus, which struck me as an incredible opportunity for journalists, to do a program out at the Mayo campus. So Sharon and I batted around some topics, and the President talked about precision medicine in his State of the Union speech, and that”s when we latched onto that,”” Johnson said in a telephone interview.

I was a bit perplexed. Before Johnson and I spoke, I had spoken with Scott Beck, the administrator of Mayo’ Center for Individualized Medicine, which is hosting the workshop. While he confirmed that NPF would choose the topics and speakers, with suggestions from Mayo, he said Mayo had suggested the topic to NPF, not quite the scenario outlined on the NPF web site, which says topics are chosen before potential sponsors are contacted.

Sharon Theimer at Mayo later clarified the timeline by email, saying Johnson approached her about Mayo sponsoring a workshop for journalists. The choice of a topic came later, after President Obama proposed spending $215 million on precision or individualized medicine. That announcement is certainly a news peg, but the process here was again not quite how the NPF web site portrays things.

Mayo Clinic considers itself a good candidate to receive some of the federal funding the President proposed. (Mayo Clinic blog posts here and here.) I asked Mayo’ Beck about the apparent self-interest the institution has in promoting discussion of precision medicine that includes Mayo experts.

“”About three and a half years ago, Mayo instituted a revised strategic plan that called for investments in three new centers within our institution. One of those was the Center for Individualized Medicine (CIM), which is what we are talking about,”” Beck told me by telephone. ““Each of these areas, and CIM is one of those, is an area that the institution felt strongly it needed to make an investment in, for what I think are all of the right reasons. And so we have made investments in this space for the last three and a half years or so, because it is important to us as an institution.””

He said that investment includes educating the public – and journalists. Of course, journalists get PR blasts from institutions every day, including Mayo Clinic, touting their strengths. Clicking delete on an email is easy, but when an all-expenses-paid trip is dangled in front of journalists who are starved for training opportunities, well, suddenly that topic looks a whole lot more interesting. If the invitation came straight from a hospital or medical company, I think most professional journalists would brush it off. That”s why the NPF”s imprimatur is critical.

I asked Johnson about how neatly this workshop appears to dovetail with Mayo’ strategic plan and marketing. ““Gosh, I never thought about it at all that way. I”d be very happy to do a similar program at Johns Hopkins or the Cleveland Clinic. I think this is an incredible source-development opportunity for a science or health journalist,”” she said.

As I”ve said and written over the years, it bothers me when those with a financial interest in getting media attention hold the purse strings of training for journalists. A decade ago, while I was on the board of the Association of Health Care Journalists (AHCJ), we adopted a strict funding policy that bans even advertising by drug, device or other health care companies or providers. But that policy does allow conference funding by academic medical centers, which could include the Mayo Clinic. One distinction is that AHCJ conferences and workshops typically include a variety of funders and a broad array of topics, so it’s less likely that a meeting would sync tightly with the strategic plan of a particular academic institution.

That said, I”m sympathetic to Johnson”s desperation as she and others at the National Press Foundation hunt for ways to put on workshops for journalists.

“Who couldn”t be passionate about wanting to train journalists in an era of zero training budgets and where reporters are getting their information from Twitter. “This is an incredible opportunity for journalists, four days immersed in a topic,”” she said.

Media coverage of health topics already skews toward medical treatments, procedures, devices, drugs, things that people get paid to do to patients. There is a paucity of coverage of policies, community characteristics, economic or social factors that a great body of research (National Research Council report, Slate.com article) shows have greater effects on health than do medical interventions. That”s one of the factors explaining why people in the US are less healthy than those in other countries even though we spend far more money on medical treatment than anyone else. (Commonwealth Fund report: “the U.S. underperforms relative to other countries“)

So even when the reporting coming out of a workshop, like this one on precision medicine, is rock-solid and skeptical, the workshop inevitably leads to more stories on this topic, displacing other topics those reporters might cover. Thus, when journalists are more likely to get free trips to workshops about medical treatments for disease than they are to sessions on the conditions or policies that foster or hamper health, the result will be a health news agenda that continues to tip toward the interests of the medical industry.

Andrew Holtz postscript:  At one point in our discussion, Sandy Johnson of NPF asked if I had scrutinized the sponsorship of a different NPF workshop that I applied for a few months ago. It was on global tobacco issues and held in conjunction with the World Conference on Tobacco or Health. I told her, yes, before I applied I asked about the funding, learned it came from the conference. Then I looked up conference funders and found a variety of public agencies, foundations, and an oil company. I also told her that the coverage plan I worked out with an editor included a commentary piece on the troubling conflict of interest issues raised by sponsorship of journalist training. As it turned out, the workshop was geared to journalists from outside the US. I was not selected, though as we wrapped up our phone call, Johnson said NPF was considering a US tobacco issues workshop. I”d consider being involved. Of course, the funding would be a factor.

Publisher’s note:  HealthNewsReview.org is now offering conflict-free training to interested newsrooms and even to health care public relations professionals.  We can help writers learn to do a better job of evaluating evidence. We can suggest ways to write about research in a more accurate, balanced and complete way. And we offer to take our training directly to interested newsrooms, news organizations, or health care communication office settings.  Training will be provided by me and members of our team of industry-independent editorial contributors. Write to me at feedback@healthnewsreview.org if interested.   – Gary Schwitzer, Publisher. 

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Elaine Schattner

March 25, 2015 at 6:36 pm

Hi Andrew (and Gary), I get the point here. But the problem is, how and where can health journalists learn about cancer and genomic medicine? (an hour or two at an AHCJ meeting won’t do it.)

Andrew Holtz

March 26, 2015 at 12:31 pm

Hi, Elaine,
Yes, the fundamental problem is the abdication by most news businesses of the responsibility to provide training for journalists.
That said (and taking a guess at the kind of “cancer and genomic medicine” you want to learn about), I have found it’s generally pretty easy to get briefings from experts in the field, because the many cancer centers around the country are more than eager to connect with journalists. As for training that’s assembled by other groups, in addition to AHCJ, there are briefings and material offered by the Natl Cancer Institute, American Cancer Society, Natl Breast Cancer Coalition, USC/Annenberg, NIH, MIT and so on.
As I said in my post, I think there’s an overabundance of coverage on medical interventions… basically too much coverage of products and esoteric or experimental approaches that are relevant to only a small number of patients (and certainly irrelevant to the vast majority of readers and viewers/listeners, who are mostly concerned with staying healthy). So medical institutions or companies who sponsor training on things they are doing simply add to this imbalance in coverage.
When we see as many training opportunities on topics such as overtreatment or social determinants of health, then I’ll be less concerned about research centers or companies enticing reporters with free trips. I’ve worked for many years (through AHCJ and elsewhere) to create more such opportunities. It’s not enough, but if we each continue to press for more of what we need, rather than what others want us to learn, then we’ll continue to make progress.