Mayo Clinic woos reporters with fellowship offer

Mary Chris Jaklevic is a freelance health reporter and regular contributor to this blog. She tweets as @mcjaklevic.

The Mayo Clinic is deploying a new tactic to influence journalists: An all-expenses-paid residency program.

The clinic’s Facebook post about the residency.

Last week the health system invited reporters to apply for a five-day fellowship at its Rochester, Minn., campus entitled “Mayo Foundation Journalist Residency: Behind the Scenes in Surgery.” Mayo described the program as “an in-depth look at the latest developments in surgery.”

In previous years Mayo has sponsored workshops on health topics that were run by the National Press Foundation, but Mayo is no longer listed among the foundation’s funders. Neither the NPF nor Mayo responded to inquiries about why they’ve cut ties.

Mayo also sponsored an educational track at this year’s Association of Health Care Journalists (AHCJ) conference, covered here.

No third party will make sure content is balanced

By striking out on its own to offer training, Mayo will fully control the content and select the journalists who will attend. HealthNewsReview.org has written at length about the conflicts of interest posed by industry-sponsored journalism training, but Mayo’s latest move seems even more problematic, since there will be no third party to make sure the content is balanced.

In an email, Mayo Clinic Media Relations Director Karl Oestreich told me:

“Education is a fundamental part of Mayo’s mission as a not-for-profit academic medical center. We decided to create the program after receiving an overwhelmingly positive response from journalists who attended similar programs we sponsored over the past few years. Journalists routinely request and appreciate this type of access to physicians and researchers, whether through a Mayo program or similar residency programs at other academic medical centers.”

Let’s break that down.

“Education is a fundamental part of Mayo’s mission.”

The Mayo mission statement reads: “To inspire hope, and contribute to health and well-being by providing the best care to every patient through integrated clinical practice, education and research.”

It’s a reach to say that educating journalists — as opposed to physicians and health professionals — is meant to be part of that integrated model of care, or that educating journalists about surgical advances would somehow lead to better patient care.

In 2015 HealthNewsReview.org contributor Andrew Holtz, a former AHCJ president, wrote that Mayo’s sponsorship of a NPF workshop on precision medicine appeared to “dovetail with Mayo’s strategic plan and marketing.” One could make a similar argument about a program highlighting Mayo’s extensive surgical offerings, which are one of its major selling points to patients.

“We decided to create the program after receiving an overwhelmingly positive response from journalists who attended similar programs we sponsored over the past few years.”

If the response was positive to the NFP training programs, why not entrust NFP or another journalism organization to train journalists?

“Journalists routinely request and appreciate this type of access to physicians and researchers, whether through a Mayo program or similar residency programs at other academic medical centers.”

So Mayo should continue to provide reporters with access on an as-needed basis.

‘It’s a sales pitch’

There’s not a lot of mystery about what Mayo is attempting to do. Holtz characterized this residency program as a “plain old ‘fam tour,’ as in the all-expenses-paid ‘familiarization’ tours that resorts and other travel businesses give to travel agents (and travel writers) with the clear intention of garnering recommendations and new business.” 

He added: “I’m trying to think of reasons that a journalist would accept…

  • If you report for a local news outlet, then what should interest your audience is the health care provided at local institutions, which means arranging to view surgery in your hometown, not a distant place. Most hospitals are happy to arrange for reporters to view procedures, so there’s no need to travel.
  • If you report for a national news outlet, then it seems that you would select a story of interest, and if it involves a specific surgical procedure, then go to an institution that will show you what you want to see… not just passively accept access to procedures that an institution wants to show off.”

He also said: “The Mayo trip sounds fun, especially for reporters at news outlets that no longer have a travel budget. But it’s a sales pitch, with an agenda set by the source… and that makes it difficult to see the journalistic value of attending. Journalists should pick their stories and sources, not the other way around.”

Mayo said journalists will be able to “personalize” part of their reporting, but Holtz said the way to do that is “by exercising full control over who they talk to. Reporters who want to do stories about surgery should do their homework, decide what the story is, and then seek out a variety of sources.”

Mayo also said it will include “outside speakers,” but that’s little assurance of balance since it seems unlikely that Mayo would expose reporters to any messaging that doesn’t line up with its interests.

Possible violation of ethics guidelines

Oestreich declined to say how the much the program is costing Mayo or where the money will come from. He also declined to say how much it would cost for journalists who want to pay their own way.

Click to see our full coverage on this issue.

The response will be interesting. There aren’t many newsrooms these days that can afford to give a reporter a week off for training. More to the point, news organizations may violate their own ethics guidelines by allowing their reporters to attend.

For example, the Associated Press Media Editors’ Statement of Ethical Principles reads:

News organizations should accept nothing of value from news sources or others outside the profession. Gifts and free or reduced-rate travel, entertainment, products and lodging should not be accepted. Expenses in connection with news reporting should be paid by the organization. Special favors and special treatment for members of the press should be avoided.”

Even if a news organization were to pay for it’s reporter’s travel and accommodations, which Mayo offers as an option, a fellowship could be construed as a thing of value or special treatment.

Likewise the Society of Professional Journalists’ Code of Ethics says journalists should:

“–Avoid conflicts of interest, real or perceived. Disclose unavoidable conflicts.

–Refuse gifts, favors, fees, free travel and special treatment, and avoid political and other outside activities that may compromise integrity or impartiality, or may damage credibility.”

Similar language has been adopted by the AHCJ, which also calls for a “dispassionate relationship with sources.”

Accepting free training is at least a “perceived” conflict that should be avoided.

What do you think? Let us know

Weighing the impact of the NFP’s industry-sponsored health care workshops back in 2015, Trudy Lieberman, also a former president of AHCJ, wrote:

“But when journalists attend events such as the NPF’s on the sponsor’s dime, they are taking a gift, plain and simple. As innocent as that may appear, a gift implies reciprocity. How does the receiver repay? Favorable treatment for the giver; a reluctance to ask tough questions; directly or indirectly promoting their points of view; or a nod to their products and services when it’s appropriate for a story?”

There’s also a practical issue of disclosure. If a journalist attends this residency, would they be obligated to disclose it every time they write about one of the topics on the program, or mention Mayo Clinic in a story? It seems that to be fair to readers, they would have to at least consider it. I don’t know of many reporters who would relish that obligation.

These problems signal that Mayo’s leadership has a fundamental misunderstanding of the way journalists operate, or should operate. All one can do is urge journalists to think about the implications before hitting “send” to journalistresidency@mayo.edu.

I’d be interested in hearing from journalists about whether they think there’s any value to attending this residency program. Would you apply for it? Why or why not? And what disclosures do you think journalists who do attend should make in their future reporting? Use our contact form to submit a private comment.

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Comments (5)

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Craig Stoltz

July 25, 2017 at 7:10 am

Hi HNR — As a former healthcare journalist [and HNR contributor] I rarely disagree with your stuff. In this case I do. This piece feels strained, like it’s trying to reach a bit too wide and deep to cobble together facts that suggest a high risk of malfeasance.

I don’t think this “fellowship” — sure, the label may be a spin — is necessarily or even likely to result in corruption of its participants. A journalist who attends this isn’t prohibited from asking tough questions — what does the data show about 3-D printing outcomes? What does the new imaging protocol add to diagnosis or treatment vs. costs? Where does the extra money come from and go? I’d hope Mayo wouldn’t choose softies and easily misled dupes for the fellowship so they can avoid hard questions. I’d hope they’d choose influential journalists who can benefit from the knowledge.

And, to the main point: Will indeed the Mayo visit lead to cheerful coverage of Mayo and the presented techniques later on? I’d like to think that, back in my day, I wouldn’t have been influenced, but that may be vanity and sentiment talking. Disclosure: I never did anything like this when I was editor of the Washington Post health section, but a couple of my reporters did. We paid.

Try this: Announce that those who accept these fellowships will have their subsequent coverage of Mayo and the content presented audited by HNR. I suspect that alone will have a prophylactic benefit. And if some journalists later appear guilty of soft or friendly coverage, call ’em out, interview them, explore the facts energetically and fairly — and evaluate the benefits the journalist [and, by extension, the public] likely got vs. the evident corruptions.

Gary and team, you’ve built a powerful bully pulpit. I invite you to…well, explore the evidence and report on your findings.

    Kevin Lomangino

    July 25, 2017 at 10:25 am

    Craig,

    Thanks for your comment. I welcome scrutiny of our stance on this issue but in this case, I think your argument is misguided. No matter what kind of journalists Mayo chooses for the fellowship (“softies” or hard-nosed), and regardless of what you may or may not have done back in the day, there is a pretty clear literature demonstrating that gifts — such as an all-expenses-paid week-long trip to the Mayo campus to be educated about Mayo’s cutting edge medical care — have an influence on the recipient. That’s why ethics guidelines for journalists prohibit them. Will every journalist be influenced? Who knows. But there are certainly examples which show that these kinds of arrangements lead to coverage favorable to the sponsoring organization. For example, as Paul Thacker wrote about a Coca Cola-sponsored journalist training at the University of Colorado:

    “The tactic bore fruit. In one example, a CNN reporter attended the 2014 journalism conference and later contributed to a story that argued that obesity’s cause could be lack of exercise, not consumption of sugary soft drinks. Critics told The BMJ that Coca-Cola’s $37 000 support for that particular conference and the resulting story was a better bargain than an advertisement placed on CNN’s website.”

    I wish our “bully pulpit” was big enough to allow us to track the the subsequent writing of all the fellowship participants and determine whether Mayo got its money’s worth. But we are a small operation, staffed mainly with part-time contributors (many working pro bono). We simply don’t have the resources to follow through on your suggestion and I’m not sure it’s feasible even if we did.

    Again, thanks for reading and commenting.

    Kevin Lomangino
    Managing Editor

      cassels@uvic.ca

      July 25, 2017 at 8:01 pm

      Unlike Craig, I didn’t think this piece felt strained, but I can see why he might have felt that way. I think it would be a great contribution to the literature if there could be some tracking of the impact of such a fellowship. Indeed, imagine if you could develop a simple “reporting on surgery” metric then compare the subsequent reporting of those who completed the fellowship against a control group of similar ‘surgery reporters’ who didn’t benefit from the Mayo largesse. (It would take a few years and some careful tracking but frankly, it wouldn’t be too difficult to design and then compare groups. Additionally, with a blinded evaluation of a sample of stories, a few years down the road from surgical ‘fellows’ versus surgical ‘non-fellows we might indeed find out the impact of this junket. When there are deep differences in opinion in terms of whether ‘x causes y’ and both sides claim to be able to predict the outcome of a trial, I say strong disagreement means that there might be arguable ‘equipoise’ and it is worth a trial. I know that my biases would lean in the direction of Kevin, (that the investment of Mayo journalists will produce a payoff) but I would most like to point to a carefully controlled trial that shows he’s right. I find Craig’s challenge to evaluate the fellowship junket shouldn’t go unmet and maybe we (or me) should write a grant proposal to measure that very thing….

Addi Faerber

July 31, 2017 at 12:32 pm

I agree that this fellowship is ripe for inappropriate conflicts of interests in the fellow’s reporting. We definitely need to bring back the NIH-sponsored Medicine in the Media conference!!! https://prevention.nih.gov/programs-events/past-programs-events/medicine-in-the-media
Well-trained [health] journalists are in the public interest.

    Gary Schwitzer

    July 31, 2017 at 7:27 pm

    Addi,

    Thanks for your comment.

    The NIH Medicine in the Media workshop series offered precisely the kind of assistance that journalists assigned to cover health care news need. You knew you were getting top flight teachers – not just from one institution – but speakers and organizers from several institutions. And the intensive training helped journalists learn how to evaluate evidence across all topics. It wasn’t dominated by one specialty and one topic – surgery, as in the Mayo “residency” fellowship.

    In the NIH Medicine in the Media series, journalists learned how to scrutinize: absolute versus relative risk; how not all studies are equal (research design); cautions about observational studies; P values and confidence intervals; disease mongering; the tradeoffs of cancer screening, and much more.

    These were basics that need to be broadly applied daily by health care journalists. Not hyper-focused concerns from one specialty hosted by one medical center.

    Gary Schwitzer
    Publisher