5-Star Friday: Celebrating some slow journalism

We’ve just wrapped up a busy week of scrutinizing the news coverage of the world’s largest cancer meeting.

5-Star FridayIn many ways medical meetings symbolize what is functional and dysfunctional about our current health care system.

On the plus side, you’ll find a host of incredibly talented and committed providers eager to learn and eager to make progress. Troubling influences also are evident as medical research is more industrialized and promotional — and much of what is presented and promoted is not yet ready for primetime.

Some of these same problems — too much, too soon — plague journalism. But apparently, the reporters we feature below didn’t get that memo. Their reporting is “slow” in the best sense of the word: careful, considered, and taking the time to dig beneath the surface.

Gary Schwitzer | Publisher & Founder

A Promising Cancer Treatment Made Patients Worse, Not Better  • Denise Grady • The New York Times

Gary Schwitzer, Publisher

Perhaps especially because it was published in the same week that we have all been bombarded with cancer news from the American Society of Clinical Oncology (ASCO) annual conference – a good share of it hyperbolic, simplistic, or incomplete – this New York Times piece stood out with an important reminder.

Prompted by a letter to the editor of the New England Journal of Medicine, it is not the kind of thing that most health care journalists notice — much less decide to write about.  But this item was newsworthy, so kudos to Denise Grady of the Times for jumping on it.

She leads the story responsibly, in context and with perspective, noting that immunotherapy drugs have helped many people in recent years reach “remarkable recoveries.”  Next, she transitions to the NEJM story, about three patients with an uncommon blood cancer quickly becoming much worse after a single treatment with one such drug.

Her nut graf – the paragraph that tells you the kernel or essential theme of the story – was this:

The cases are a sobering reminder that immunotherapy is still in its early days, and can unleash powerful forces that are not fully understood. Patients and doctors are eager to try the treatments when other options have run out, even for cancers in which they haven’t yet been tested. Sometimes those hail-Mary efforts work. But they can backfire.

Grady discussed drug costs, quoted five immunotherapy specialists, and wrote a story nearly three times longer than the letter to the editor upon which it was based.

Journalists who write about health care must get beyond reliance on spoon-feeding from news releases from medical journals, academic medical centers, industry and elsewhere.  Our 12 years of data show an undeniable pattern of a majority of stories that exaggerate or emphasize potential benefits of interventions while minimizing or totally ignoring potential harms.  That, as we have demonstrated, carries a strong potential for harming patients. 

The Times certainly delivered a story that was fit to print.

Mary Chris Jaklevic | Reporter-Editor

Pain & Profit • J. David McSwane and Andrew Chavez • Dallas Morning News

Mary Chris Jaklevic

Imagine being confined to a bed for 17 hours a day with no one to look after you, utterly alone and unable to move. That’s the predicament of a 38-year-old paralyzed women featured in this series, which reports she’s one of at least 8,000 medically frail children and adults who are suffering with unmet medical needs since Texas put them into Medicaid managed care plans and failed to oversee the results.

What are those results? Patients are harmed, as essential benefits such as nursing care and medical equipment are yanked away, and private companies profit under what McSwane and Chavez reveal to be a system of “perverse incentives,” in which companies pocket higher monthly fees to cover the most vulnerable patients, with lax oversight. “Whatever benefits managed care may have for healthy kids, our investigation shows it’s not working for sick people,” they write.

Medicaid is often overlooked and misunderstood in discussions about quality of care, even though it covers 1 in 5 Americans, including many children and people with disabilities. This series provides a good primer on what it does and why we should pay attention to how it is funded and monitored.

Joy Victory | Deputy Managing Editor

A Death in Slow Motion • Charles Ornstein and Mike Hixenbaugh • ProPublica and the Houston Chronicle

Joy Victory

These days, medical sagas often unfold in real-time, online. Such was the case for James Lewis, who received a heart transplant earlier this year. Initially hopeful, his wife Jennifer shared frequent updates on Facebook about his recovery. As the weeks stretched on, and Lewis’s complications piled up, her updates turn increasingly frustrated.

Reporters Charles Ornstein and Mike Hixenbaugh use the Facebook posts, along with interviews and reporting, to craft a remarkably gripping read. It’s one of several articles from an investigative series, Heart Failure, that examines the decline of a historic heart transplant program.

Jill U. Adams | Associate Editor

She paid nothing for opioid painkillers. Her addiction treatment costs more than $200 a month. • by German Lopez • Vox

This Vox story shows how insurance coverage can be terribly misaligned with appropriate health care. Journalist German Lopez, who covers the opioid beat with terrific reporting and insight, profiles a woman who became addicted to her prescription pain killers and wanted to quit. She entered an intensive outpatient treatment program and was prescribed medication for addiction. But her insurer, who fully covered her Vicodin for pain, wouldn’t cover her Suboxone for addiction. Lopez further explores the restrictions on buprenorphine with voices from health insurers, addiction specialists, and policy experts.

The incentives are all backwards, as illustrated by this plaintive quote from the featured patient:

“It’s way easier to get opiates or heroin. … It’s so much easier than dealing with this bullshit.”

Michael Joyce | Writer-Producer

Doctors Scrutinize Overtreatment, As Cancer Death Rates Decline • by Richard Harris • NPR Health Shots

Michael Joyce

A slew of journalists covered the world’s largest cancer meeting (ASCO) this past week and — as we noted in following their coverage — filed stories with plenty of positive spin, minimized harms, and even promises of “holy grails.”

But veteran NPR science journalist, Richard Harris, didn’t do that. He saw something different.

Harris found three examples of studies suggesting less treatment may be more, and plainly asks: “Why are doctors giving patients challenging and unnecessary treatments?”

I could summarize his proposed explanation here but I suggest you read it for yourself. It’s as insightful and clever a distillation as you’ll read. It goes right to the core of one of the most insidious problems plaguing our medical-industrial complex.

Please Note: These stories have not been subject to our rigorous, 10-criteria systematic review for accuracy, balance, and completeness. Rather, they represent pieces of health care journalism and opinion writing that members of our staff found compelling and wanted to share with others.

5-Star Friday is a regular feature on HealthNewsReview.org. You can find a list of previous installments HERE.

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