Hyping health stories: journalists need to do better

Health care journalists got some bad press last week following the release of a study that showed more often than not they fail to provide the necessary information to make health stories complete, meaningful and tell them in context.

I’m torn. I want to defend journalists who report on this incredibly complex beat and continue ripping on them. So I’ll do a little of both.

The key finding from University of Minnesota Journalism professor Gary Schwitzer’s study published in PLoS Medicine Journal was that “after almost two years and 500 stories, the project has found that journalists usually fail to discuss costs, the quality of the evidence, the existence of alternative options, and the absolute magnitude of potential benefits and harms.”

A veteran CNN health reporter, Schwitzer founded the Web site HealthNewsReview.org to grade health news stories. The study is based on those reviews. I interviewed Schwitzer when the site launched. Gary also wrote a post for THCB that talks a little bit about what his project hopes to achieve.

In defense of my colleagues

When the quality of your profession is attacked, the instinctive reaction is to line up with a list of defenses like “You have no idea the constraints we’re working under.” “You don’t understand how a newsroom works.” “We’re underpaid and overworked. What do you expect?” This must be how doctors and nurses feel when outsiders who’ve never worked in a hospital attack them on quality.

These are tired excuses, but I’ll expand on a few anyway.

In his conclusion Schwitzer wrote, “Time (to research stories), space (in publications and broadcasts), and training of journalists can provide solutions to many of the journalistic shortcomings identified by the project.”

Has he been in an American newsroom lately? Hemorrhaging advertising revenues have forced newsrooms to trim every ounce of fat, leaving editorial teams skinnier than Kate Moss. Asking for additional time to research, for extra training or a bigger news hole to explain the important nuances of a story is like asking for a steak at a vegetarian restaurant – not going to happen.

That means most reporters attempting to write with some authority about health care issues have received no training and are expected to report and write stories sometimes in just hours. Having a week to thoroughly research a topic is a luxury few reporters I know ever experience. I do believe most health reporters want to raise the quality of their reporting, but feel undermined by the lack of resources and sometimes their superiors.

If all health care is local, nowhere is health coverage worse than small media outlets in local markets. Young, inexperience, overworked and underpaid reporters are expected to cover crime one day and hospitals the next. Few small newspapers or TV stations dedicate a reporter to covering health, therefore no one in the newsroom has any expertise on the topic. When reporters must relearn what CMS, HHS, Medicare and Medicaid are before each story, they certainly won’t understand any historical, political or economic context.

We could do betterTypical newsroom morale is lower these days than the mercury on a January morning in Minnesota, and professional pride seems to be dropping precipitously. It’s reasonable to assume that reporting quality may closely follow the decline.

That’s not acceptable. Journalists have a professional responsibility to get the story right. Sometimes they will make mistakes and have to run a correction, but they should try their best to make every story as accurate and complete as possible. We expect our doctors and nurses to do their best every time, even when they’re exhausted, and the same standard holds true for journalists. That’s the ethical thing to do.

Editors have a responsibility to demand high quality work and not be satisfied simply to have copy to broadcast or print. They also have a responsibility not to hype stories for the sake of selling newspapers or increasing viewership. Health care is more often than not a "hard news" story, meaning the topics have political, economic and societal consequences, but too often editors treat it as fluff and afterthought.

Another problem with health journalism is the "copycat" effect. You’ve seen it. The New York Times or Associated Press runs a story and
soon it’s on every cable news station, newspaper Web site and many
blogs. Too few journalists at smaller outlets feel confident to draw contradictory conclusions, or they lack the time and resources to do the original reporting necessary for a dissenting voice. That’s not serving the public’s best interest.

There is hopeRecognizing the challenges of health reporting and need for factual and balanced information, foundations and journalism schools have stepped in to offer training. The University of Minnesota and University of North Carolina began masters level health journalism programs at their J-Schools. The Association of Healthcare Journalists also formed in the last decade to improve the quality of health journalism through education and networking.The Kaiser Family Foundation’s media fellows program has supported health journalists for more than a decade, but more recently the California Endowment began funding a health journalism fellowship program at the USC Annenberg School of Journalism. Fellowship director Michelle Levander has a generous budget and is working her tail off to teach journalists during weekend retreats about health policy, health insurance, hospital quality and statistics so they can read medical studies. The program is only an introduction to the health beat, and it aims to inspire journalists to continue learning.

Nontraditional media sources are also, in my opinion, raising the quality of health information. While it’s true that many blogs take their cues from the "traditional media," never before have journalists had this amount of instant feedback from true experts. Also, journalists can now read blogs by industry insiders, (such as THCB for one) to track new ideas or developments. Anthony Wright at the Health Access blog has also stepped in to provide detailed coverage of health happenings in Sacramento. While he runs a progressive organization, he omits the politics when giving updates on legislation.

Many people, particularly the elderly, still turn to TV news and newspapers for health information. But that’s changing rapidly. If traditional media wants to maintain readership in this category on the Web, and thereby keep those advertising dollars, their investment strategy needs to change. They need knowledgeable reporters capable of writing with authority, whom readers will consider reliable, unbiased sources.

The NY Times has built a health magazine on its Web site. To a lesser extent, USA Today has followed suit. The L.A. Times’ health page isn’t as attractive, but has lots of hard news health stories. Clearly, they see the ability to make money on these sites. Smaller newspapers could follow their lead, but instead of duplicating the content, figure out ways to produce high quality content that is intensely local so they become the go-to place for health information in their market.

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  1. Ben Goldacre (UK doctor-come-journalist) does a good job from time to time lampooning healthcare journalism. His blog ‘Bad Science’ is worth bookmarking.
    And, as mentioned in another comment, a good resource for critiques of the research that underpins healthcare stories can be found on the new NHS website in the UK in a section called Behind The Headlines.
    See: http://www.nhs.uk/News/Pages/NewsIndex.aspx
    There are common, routine, even predictable mistakes that journalists writing about healthcare issues make over and over again, and they can be learned (or unlearned) via services such as Behind The Headlines.