Schwitzer health news blog

Hoosiers get health journalism lecture on the radio

The first part of a two-part, two-weekend interview appeared on Indiana Public Radio this weekend.

The guest: me.

The topic: health journalism.

Only 50 Ways To Leave Big Pharma?

On the Pharmagossip site, Dr. Adriane Fugh-Berman posts new lyrics to go with Paul Simon's "50 Ways To Leave Your Lover." Excerpt of the refrain:

There must be fifty ways to leave Big Pharma Fifty ways to leave Big Pharma

Have the reps take a hike, Mike
Buy your own pen, Jen
You don't need a free meal, Neil
Just get yourself free
Throw the samples away, Kay
You don't have to use new drugs
Pay your own CME, Lee
And get yourself free

Did handling of med school conflict of interest issues lead to this change in administration?

Professor Bill Gleason has posted on his blog the contents of an e-mail memo that announced that the University of Minnesota would "combine the position of Senior Vice President for Health Sciences with that of Dean of the Medical School. ... We are indebted to (medical school) Dean Powell for her leadership over the past several years. She and I are working together on transition issues and discussing a future administrative role for her in the area of medical education."

I've already had one reporter call me asking if I would tie this announcement to the recent controversy, reported by the Star Tribune, that Powell "appointed as cochair of the task force (on med school conflict of interest policy) a man who'd just come off three years of sanctions for his own serious conflict-of-interest violations involving a private company he owned."

How would I know?

I was on the task force and didn't even know the history of the events in question!

The thought crossed my mind when I heard the news, but U hierarchy hasn't shared any such info in my in-box recently.

And, no, I don't know what has happened or will happen with the task force recommendations, which took almost a year to draft.

Improvement in health news grades

Some good things are happening in health news coverage.

Of the first 12 stories reviewed in 2009 on HealthNewsReview.org, five have received the top five-star score.

In the three years of the project, there have never been so many highly-rated stories in such a sport span. In fact, only 13% of all 712 stories reviewed so far have received five-star scores.

Next week in a talk at the Foundation for Informed Medical Decision Making's Policy & Research Forum in Washington, DC, I'll also be presenting some new data that shows small - but I think significant - improvement on some of our criteria on which journalists have traditionally done most poorly.

This is especially significant, in my view, given the terrible times in newsrooms these days.

• bottom line pressure hurting the quality of health news.
• lack of training
• impact of layoffs and cutbacks
• shrinking news hole for health care news overall
• weakened newsrooms more vulnerable to PR and ad pressures

Many people continue to work hard every day to report health news in depth, emphasizing evidence, context and integrity. We applaud them.

At the same time, network television health news pieces continue to disappoint. Look at the thumbnail below of two recent ABC Good Morning America segments. One got zero stars, the other two.

Ethical questions about consumer-driven health care plans and marketing thereof

The marketing of these plans makes my skin crawl. “Put the consumer in the driver’s seat…give consumers the tools to make smarter decisions.� All noble goals. None ready for prime time yet.

Last week’s Journal of the American Medical Association published a commentary, "Consumer-Driven Health Care Might Not Be What Patients Need -- Caveat Emptor" by Robert Berenson of the Urban Institute and Christine Cassel of the American Board of Internal Medicine.

They write that the consumer-driven health care plan model "implicitly calls for a fundamental reordering of the patient-physician relationship, placing increased reliance on commercial ethics while eroding professional ethics as the guiding force for patient-physician interactions. ….

The consumer-directed health care goals of information sharing and involving patients in care decisions and in the societal need to manage scarce health care resources should be endorsed. But the notion that the way to achieve these goals is to further pit physicians and patients against one another as market suppliers and customers who aim to foster efficiency out of a competitive drive cannot be accepted.�

Meantime, last week at Consumer Reports in New York, a group of people interested in online health communication issues listened to a panel that discussed the potential – but mostly the flaws – of one set of consumer-directed tools – the current online ratings for hospitals and doctors. For example, Avery Comarow of U.S. News & World Report, who manages the magazine’s annual “America’s Best Hospitals� report, says they only started doing those rankings because the industry hadn’t. He talked about how “messy� and “incomplete� was the business of compiling these rankings. He said no online site has enough patient data to make a valid physician rating

Panelists talked about hospitals and doctors learning how to “game� the system to make their statistics look better than they really were.

Those were just a few of the issues raised that indicate how far we are from having some of the tools that consumer-driven health plans promise.

Dr. John Santa, who heads Consumer Reports’ Health Ratings Center, says that until there’s a level playing field in the health care marketplace, true consumer-driven health care won’t exist.

Media Mill Video

Maggie Mahar has also blogged about why patients don’t use provider ratings systems and why that's “more bad news for consumer-driven health care.�

Milwaukee paper keeps hammering on conflict of interest

The Milwaukee Journal Sentinel has done it again.

This tough "medium market" (if I can call it that) newspaper faces tough economic times by scrapping to do more tough journalism. Just two weeks ago we blogged about one of their stellar health journalism efforts.

Yesterday they published a 1,700-word story (that's rare these days) raising more conflict of interest questions at the University of Wisconsin medical school. It begins:

The conclusions were clear: Women who took hormone therapy drugs were at increased risk for breast cancer, heart disease, stroke and blood clots.

The findings were so strong that researchers stopped a clinical trial in 2002, five years early, because it would have been unethical to continue giving the drugs to women.

But that same year, the University of Wisconsin-Madison's School of Medicine and Public Health began a medical education program for doctors that promoted hormone therapy, touted its benefits and downplayed its risks.

For the next six years, thousands of doctors from around the country took the online course that was funded entirely by a $12 million grant from Wyeth Pharmaceuticals, which makes the hormone therapy drugs used in the study, Prempro and Premarin.

The university received $1.5 million of that total, and university faculty received money as well.

Even after the course was no longer available, the Web site and course material remained on the Internet, accessible to consumers and doctors. The university dropped the site Jan. 15, one day after the Journal Sentinel began questioning UW officials about the propriety of the program.

The influence of drug companies on doctors - and, by extension, medical schools - is coming under increased scrutiny, with critics saying programs like the UW one are essentially marketing exercises.

"The wisdom of the crowds" isn't always wise - even that of online doctors

At a meeting of health bloggers at Consumer Reports in New York last week, there was a lively discussion that could have gone on for hours on the pros and cons of enabling "the wisdom of the crowd" to surface on health-related websites including blogs. In a very simplistic summary, those who promote such discussion say it democratizes the web and engages users in a "community" Those who have concerns are usually concerned about unmoderated discussions allowing quackery and downright harmful advice and information to be posted and remain online.

Consumer Reports' medical adviser Orly Avitzur, MD, mentioned one parallel concern: about the undue credibility that might be given to claims appearing on some physicians' websites.

Media Mill Video

The "wisdom of the crowds" is a complex topic, with many nuances.

Since I'm a journalist - from a traditional journalism background - the one area that I know gives me trouble is the news website that posts a story and user comments which are not moderated all the time. I have blogged about such a troublesome example I found in the New York Times. It's not hard to find many others.

(Please note: the video above is the first I've ever posted on this blog - after more than 4 years and more than 1,000 postings. It is an experiment. Let me know if you think such video clips are a good addition. There may be another tomorrow.)

Spine surgeons group toughens disclosure policy

The Wall Street Journal reports today:

A medical society representing U.S. spine surgeons has taken the rare step of requiring that researchers disclose not just the existence of financial ties to medical-device companies, but the dollar amounts as well.

The initiative is a response by the North American Spine Society to pressure from lawmakers, prosecutors and lawsuits by companies' former employees. Prominent surgeons doing research have been found to have significant financial relationships -- sometimes to the tune of millions of dollars -- with medical-device firms.
...
The society said its policy "is not a voluntary guideline, but a binding covenant which applies to all relationships engaged in by all participants in all" activities of the spine society. Failure to disclose would be a "sanctionable offense," the spine society said. Sanctions could include suspension, expulsion or public letters of censure. NASS sanctions wouldn't have any effect on a doctor's ability to practice, only on membership in NASS.
...
In recent years, medical-implant makers Zimmer Holdings Inc., Stryker Corp., the DePuy orthopedics unit of Johnson & Johnson, and Biomet Inc. have paid more than $221 million to surgeon "consultants," according to a Senate committee.

Medtronic Inc. has been accused by former employees and the government of inducing surgeons to use its spine products through questionable payments. In 2006, the Minneapolis company agreed to pay $40 million to the government to settle civil charges in federal court in Memphis, Tenn., that it paid kickbacks to doctors, but denied wrongdoing.

The NASS disclosure policy is available online (although it is not immediately clear if what's posted is the latest version.)

I can't help but think that only a few days ago I blogged about the "gaping holes in medical school disclosure policies that didn't require the actual dollar amount of financial ties to be disclosed. And a Minnesota orthopedic surgeon commented in response to my blog posting:

"Please Mr. Schwitzer, pursue the whole story and not just the attention grabbing, tabloid headlines. People deserve to know the whole truth, ever (sic) if it sells less well than tabloid journalism."

It looks like surgeons like him shouldn't just be writing to little bloggers like me. They may want to start writing to their own professional organizations (like NASS), to Senator Grassley, to journal editors, and to all the other boogeymen out there.

BTW, I don't make anything from this blog. You don't see any ads. I'm not paid to do it.

UMN med school prof tired of "foot-dragging" on conflict of interest policy

A University of Minnesota medical school professor who calls himself "The Whining Dinosaur" on his blog has stirred up the med school conflict-of-interest policy discussion again with an editorial in the Minnesota Daily.

I go out of town for a day and he stirs things up partially by using some of my comments as the stirring spoon!

That's OK.

I stand by what I said. And, while he said some nice things about me in the editorial, I also applaud how he writes to keep these issues alive - for whomever we reach in this little blog world.

Consumer Reports online health summit

I'm at Consumer Reports in NY today for a session, "A Healthier Web: Blogging, Rating & Community."

On Twitter, you can follow the discussion among several bloggers who are attending.

Right now listening to predictions from Craig Newmark, founder of Craigslist.

Lunch with pharma at breast cancer conference

Breast Cancer Action staffer Allison Young posted her thoughts about drug companies making their pitches at the annual San Antonio Breast Cancer Symposium held in December. She wrote about the pharma-sponsored advocacy luncheons she attended there. Excerpts:

"Genentech started off with a feel-good video about their relationship with patient advocates, some of whom were in the room. But all this high-priced PR seemed to fall by the wayside during the presentation when the scientist said, “We use progression-free survival as a marker because we find it meaningful� and the advocates, one by one, responded, “Well, we think our overall survival is what’s really meaningful.�

I anticipated a similar scenario at the Novartis luncheon, but I got the impression that Novartis had misjudged the audience and its realities. These are women living with breast cancer attending a scientific conference, and while there were varying degrees of pink ribbon fashion in the room, everyone was hungry for good information. They quickly bristled at the celebrity actress talking about how convenient it was to have 28-day infusions while traveling freely around North America, or the suggestion they brush their teeth more often to prevent dental side effects caused by Zometa (zoledronic acid). The advocates represent patients across the country who might have HMOs or no insurance at all, who were not given full and accurate information about potential side effects before taking Zometa, and who have a really hard time getting their team of doctors to work together: “I can’t get my surgeon to talk to my oncologist, and you want me to get my oncologist to talk to my dentist?� Ms. Gelb asked.

The day before I left for San Antonio, I received a call from a BCA member who had osteonecrosis of the jaw from taking zoledronic acid. And I know that as soon as I’m back in San Francisco, I’ll still be talking to women who are living the reality of breast cancer, minus the free lunch."

Patients unaware of docs' conflicts of interest

Close on the heels of the WSJ story last week that exposed gaping holes in med school conflict of interest policies comes this article in the Medical Journal of Australia.

Objective:

To seek the views of patients attending general practice about doctors’ interactions with the pharmaceutical industry and their wishes for disclosure of this information.

Design, setting and participants:

906 patients attending three general practices in metropolitan Sydney during October –November 2007 completed an 18-item anonymous survey exploring their perceptions of doctors’ competing interests.

Results:

Most patients (76%) were unaware of any relationship their doctor may have with pharmaceutical companies. Patients wanted to know if their doctor obtained any benefits in cash or kind from the pharmaceutical industry (71%), financial incentives for research participation (69%) or sponsorship to attend conferences (61%). Most agreed that disclosure of competing interests by doctors is important (84%), believing this disclosure would help patients make better informed treatment decisions (78%). Eighty per cent of patients stated that they would have more confidence in their doctor’s decisions if interests were fully disclosed, with strong support for verbal disclosure during the consultation (78%).
Conclusions:

Patients are currently not aware of their doctors’ competing interests but do want to know of doctors’ interactions with the pharmaceutical industry, indicating that disclosure of competing interests would improve their confidence in doctors’ decisions.

(Thanks to Elena Pasca of the French Pharmacritique blog for this tip!)

Surprise! PhRMA chief doesn't want Medicare negotiating drug prices

I'll slip this in on the weekend because it's not really news and it's not at all surprising. PhRMA CEO Billy Tauzin is opposed to having the feds negotiate Medicare drug prices. The Medicare drug legislation he fought so hard to get passed while a Çongressman- even being singled out for praise by President Bush - bans such price negotiations. It closes the door on Medicare being able to wield its massive purchasing power in a way that could help health care consumers.

But that's not the way good old boy Billy sees it.

From the Kaiser Daily Health Policy Report last week:

Allowing Medicare to negotiate prescription drug prices on behalf of beneficiaries could reduce the number of drugs the program offers and result in higher costs for beneficiaries, Pharmaceutical Research and Manufacturers of America President and CEO Billy Tauzin said Wednesday, CQ HealthBeat reports. According to Tauzin, Medicare now offers access to thousands of drugs because the program relies on private-sector competition. Tauzin, speaking at a media roundtable, said, "When you put the government in the process you freeze out the private sector."

HHS Secretary-designate and former Senate Majority Leader Tom Daschle (D-S.D.) last week in testimony before the Senate Health, Education, Labor and Pensions Committee said the idea of allowing the secretary to negotiate drug prices "ought to be evaluated and looked at." Supporters of the idea have said it could save taxpayers billions of dollars and lower drug prices for all U.S. residents

It'll be fun to watch Billy function without his buddy in the White House.

By the way, if you never saw the 60 Minutes profile of Tauzin's role in the passage of the Medicare drug legislation, give it a look someday.

Gaping hole in med school conflict of interest policies

$20,000 or $20,000,000. Come on, it's just a difference of a few zeroes!

The Wall Street Journal story, "Medtronic Paid This Researcher More than $20,000 - Much More," should not be missed.

Plot:

Spine surgeon using Medtronic devices takes money from Medtronic.

How much money?

His university medical center only required him to say whether it was $20K or more a year.

So for five years he declared that "YES" he got more than $20K a year.

Disclosure policy satisfied, right?

It's just that the "more than" was astronomically MORE THAN - like up to $4.6 million in royalty and consulting payments a year, according to the WSJ.

The paper quotes the surgeon's med school dean agreeing that its disclosure requirements are insufficient and “indefensible.�

The WSJ reports that the surgeon says he doesn’t accept royalties on products used on his patients, and that since 1991 he has told patients about his royalty and consulting relationships.

Perhaps it should be made public exactly how that disclosure to patients is handled. I can't imagine.

"I have received $19 million in payments from a company to help develop and promote their products but that hasn't influenced my judgment in the least and I think this is the best product for you. Now, see my nurse to schedule the surgery."

We are all babes in the woods in our grasp of how complex the entanglement of conflicts of interest are in American health care.

Is "substantially equivalent" good enough for approval of new medical devices?

I think the American public would be shocked if they knew the guts of what was in the GAO report yesterday, "FDA Should Take Steps to Ensure That High-Risk Device Types Are Approved through the Most Stringent Premarket Review Process."

The report suggests that FDA review and approval of new medical devices has been lax, allowing companies to get approval through an easier process whereby they only had to show their idea/product was "substantially equivalent" to an existing product on the market. But that loophole was only meant for the smaller toys of the medical arms race. It wasn't meant for metal hip joints, pacemaker electrodes and pedicle screws for spinal surgery - all of which slipped through the easier review process, according to the GAO.

And journalists and the public should take this into account when they hear or report news of FDA approval of some devices. It's NOT terribly big news, in my view, to trumpet FDA approval of something that's only judged substantially equivalent to something already on the market.

NBC, for one, gave a big chunk of precious airtime to FDA approval of a laser hair comb. Whoopee. Our review on HealthNewsReview.org showed that it was only judged to be substantially equivalent to 10 other products already on the market!!!

Breakthrough? Depends on how you spell hype.

"How in the hell can a guy walk out in 20-below zero and not wake up?"

Ambien?

The Star Tribune reports:

After Hayward, Wis., electrician Timothy Brueggeman froze to death while sleepwalking barefoot in his underwear Monday night, authorities were initially baffled. ...Going through Brueggeman's bedroom, investigators found a possible answer -- a bottle of Ambien. The most-prescribed sleep aid in the United States has helped millions, but it has also has been linked to hundreds of cases of sleepwalking, sleep-driving and even sleep-shoplifting. Such cases led to a class-action suit against Sanofi-Aventis. The drugmaker, which maintains that Ambien is safe when taken correctly and not mixed with alcohol or other drugs, didn't respond to requests for comment Wednesday.

One more thing I hate about airplane tray tables

Sneak attacks by drug ads.

You know when you pull down that damn tray that it won’t be big enough, that it’ll push back into you if the huge person in front of you reclines his/her seat, and that it may be broken and not level – so putting a cup down becomes a liquid-balancing act at 36,000 feet with your new white shirt on (the only one you have for this trip).

But this week I pulled down my tray table on a flight and – SURPRISE!!! – a huge ugly orange drug ad jumped out at me. People sitting around me gasped.

As you can see from the photo I took with my trusty 2 megapixel iPhone camera, the rhino was horning into my onboard tranquility (yeah, right!) by hawking Zicam Gel Swabs. I don’t even want to think about where those swabs are supposed to go.

Ah, but the label reads “homeopathic.� What a relief. That makes the whole experience worthwhile.

Are doctors loyalties divided?

The Milwaukee Journal - a paper facing all the struggles (and maybe some more) that any news organization faces - continues to shine through it all with its health news coverage.

Reporter John Fauber has a two-part series this week on "doctors moonlighting for drug companies." Excerpt:

It's a practice that increasingly is drawing criticism because of concerns that it can influence patient care and raise the cost of treatment, in addition to blurring the line between research and marketing.

The deans of the state's two medical schools say they would like to ban the practice or severely limit it.

"I am very bothered by our faculty using our school's name in giving non-academic promotional, marketing talks," said Robert Golden, dean of the UW medical school. "It's a major issue we are talking about now."

In October, the Wisconsin Medical Society, as part of its recommendations for ethical behavior, said doctors should not serve as speakers. The group has no authority to regulate or stop the practice.

See part one.

And part two.

The Gupta Chronicles

While I was on vacation last week, many web surfers found my name when searching for articles on Sanjay Gupta’s work after the announcement that he was being considered for the Surgeon General position.

Because of a failure in search engine functioning, some surfers weren’t able to find what they were searching for and asked me to provide an index. Here’s some of what I’ve written:

• on non-evidence-based screening test advice for men

• on an “unquestioning – almost cheerleading – approach to health news�

• about a journal article that pointed out his involvement in a doctor’s office waiting room video program that “overtly offers sponsors, including drug companies, the chance to boost sales of their products.�

• about the political newsletter CounterPunch and the Chicago Tribune asking readers:"Do you trust CNN's Dr. Sanjay Gupta?"

• about Trudy Lieberman’s article describing ineptitude by CNN and Gupta in coverage of health policy news.

• about Gupta vs. Michael Moore regarding “Sicko�

• about the waste of air time speculating over the cause of death of Anna Nicole Smith.

• about a one-sided view of the controversy over mammography for women in their 40s.

• about a Pfizer ad for Pfizer’s sponsorhip of the “Paging Dr. Gupta� program.

• about some laughable, some dangerous coverage on Gupta’s “Housecall� program

• about bad judgment employed in his live TV news coverage of Raelian cloning news conference.

Two of his stories were reviewed on HealthNewsReview.org:

• about disease-mongering of wrinkles on CNN

• a review of his CBS story about a treatment for addiction to painkillers that got one of our lowest scores.

One of the smartest pieces I saw was by Sandy Szwarc on her Junkfood Science blog.

My summary:

1. What does the President want from a Surgeon General? Is it just PR & glitz? Then let's stop the charade and abandon the position. Like ending the Pony Express - a once good idea whose usefulness is past.

2. What does the American public need from a Surgeon General? I suggest "Nothing."

3. The prevention & wellness messages that Gupta so often promoted on CNN can go too far - pushing screening tests outside the boundaries of evidence and ignoring that such screening may cause more harm than good. If that is the message that he would promote as Surgeon General, I would consider that a non-evidence-based abuse of the bully pulpit. And a huge mistake by the Obama administration. See Gilbert Welch's pre-election essay in the NYT on the overpromotion of screening/prevention by both Obama and McCain.

4. The industry conflict of interest questions that have arisen are cause for concern. Usually where there's smoke, there's fire.

5. On the air at CNN he too often acted as a doctor not as a journalist. That's because he really wasn't a journalist. He wasn't trained as one - CNN threw him into that situation. There are countless more pre-eminent doctors and countless better health communicators than Sanjay Gupta. So what's his qualification?

6. Presumably Surgeon General Gupta would work closely with new HHS secretary Tom Daschle. Several passages from Daschle's book, "Critical: What We Can Do About the Health Care Crisis," raise questions in my mind about the Gupta appointment. Daschle wrote about "using evidence-based guidelines and cutting down on inappropriate care" as effective ways to control rising health-care costs. But Gupta's reporting, as noted in the entries above, often didn't reflect a great appreciation for evidence-based health care. Daschle also wrote, "It is relatively easy to misinform the public and stoke fears, no matter how strong the desire for reform." Promoting screening outside the boundaries of evidence is fear-mongering. These are potentially troublesome disconnects for an Obama health care team.

We interrupt this vacation.....

Can't I just have a few days away without feeling the need to comment on health care/health journalism news?

I've been away from the mainland for two days and now I hear that:

1. CNN's Sanjay Gupta may be picked as Surgeon General.

2. One of the best health news bloggers in the U.S. - Ed Silverman of the Star Ledger of New Jersey's Pharmalot.com blog, has taken a buyout and will no longer run that blog.

I'm shocked by both pieces of news.

1,000 blog postings – time for a vacation

I just stumbled upon the fact that yesterday’s blog entry was my 1,000th blog posting in four years.

Out of 7,247 blogs hosted on the University of Minnesota server, this blog is the 6th most active.

Last month it was rated as the 21st most widely referenced health blog by Wikio.com.

But now I’m taking a break, taking my wife someplace warmer than Minnesota (No, that doesn’t mean Iowa!), and reading a few good health policy-related books in the sun.

Call me Beach Wonk if you like but in a week I’ll have a better tan than you.

TV news directors make another bad deal on health care news

In this economy I don't begrudge anyone's ability to make a buck. There are companies that make a lot of bucks selling "breakthrough" TV health news segments to TV stations to fill air time. Presumably the stations don't think they need their own fulltime health reporter, can't afford to hire one, and/or find it cheaper to pay for this "off the shelf" TV health news product from an out-of-town provider.

The Grade The News website gave a thorough description of the practice with one company. Excerpt:

"The company, Ivanhoe Broadcast News, allows local reporters to put their names on stories they didn't report, film or write -- without mentioning Ivanhoe. Stations also are permitted to omit geographical information, giving viewers the false impression that the stories were locally produced and the patients and doctors quoted in the stories could be their neighbors."

The company’s signature product is called “Medical Breakthroughs reported by Ivanhoe.� More power to entrepeneurs like Ivanhoe who make money (actually a lot of money) doing this. That’s a business decision.

Shame on the stations that take this "quick and dirty" route to health news coverage. That’s a journalism ethics decision.

I wrote recently about a local TV health reporter who blogged about this practice - only to discover that the station news director hijacked the reporter’s blog and deleted the blog entry. Pretty clearly this is not something stations are proud of - nor should they be.

Well Ivanhoe is back in the news and this time it's with the blessing of the entire TV news industry's professional group - the Radio-Television News Directors Association, which announces:

"In celebration of Ivanhoe Broadcast News’ 30th anniversary, Ivanhoe and The Radio and Television News Directors Foundation have joined forces to provide two new training opportunities for journalists.

RTNDF and Ivanhoe are offering a post-graduate internship for a recent journalism graduate. The three-month internship will provide professional training in health reporting at Ivanhoe headquarters in Orlando, Florida, in the summer of 2009.

The second opportunity is for a working reporter or producer at a television station, who will receive a two-week fellowship to travel to the Ivanhoe headquarters to focus on health and medical reporting."

When my friend and fellow former CNN medical correspondent Andrew Holtz heard of the RTNDA-Ivanhoe partnership, he wrote to me:

"The first question that came to my mind was: What are they going to teach... how to do single source stories where only the providers of a product or service are interviewed?"

Indeed, when you look at stories on the Ivanhoe website, you find single source stories with one spokesman from one institution touting one idea. No independent analysis. In fact, the online stories post a PR contact at each institution.

So it's a win-win for almost everyone:
• The health care institution gets the publicity they covet.
• The TV station can say it covers health news - even though it really doesn't.
• Ivanhoe makes more money.

The only loser? The audience - which gets "just add water" TV news slipped into the newscast as if it is the most important news of the day for that community. And it isn't.

Why doesn't RTNDA partner with the NIH Medicine in the Media workshop or the MIT Science Journalism Fellowships or with the Association of Health Care Journalists or with our HealthNewsReview.org project? (I wrote to RTNDF three times in 2008 without getting a response.)

Any one of the above organizations could help improve the state of TV health news – and help TV reporters assess questions of evidence, of cost-effectiveness, of harms (instead of always just the benefits of a new idea), and of conflicts of interest in health care and in story sources.

The RTNDA/RTNDF deal sends the wrong message to the industry: a message that promotes “breakthroughs� instead of explaining to audiences that breakthroughs are rare and that health care news demands more careful scrutiny at the local level every day.

2008 was a bad year for TV health news, with Eau Claire, Wisconsin news director Glen Mabie quitting over a decision his station had made to partner with a local medical center for delivery of that medical center's health care news. RTNDA was mostly silent on these quite common TV station arrangements with local hospitals.

2009 could be better. It's not off to a great start.

New England Journal of Medicine editorial on health care journalism

Susan Dentzer, editor-in-chief of Health Affairs and health policy analyst for the PBS NewsHour with Jim Lehrer has a commentary in this week's New England Journal of Medicine, "Communicating Medical News — Pitfalls of Health Care Journalism." Excerpt:

"In my view, we in the news media have a responsibility to hold ourselves to higher standards if there is any chance that doctors and patients will act on the basis of our reporting. We are not clinicians, but we must be more than carnival barkers; we must be credible health communicators more interested in conveying clear, actionable health information to the public than carrying out our other agendas. There is strong evidence that many journalists agree — and in particular, consider themselves poorly trained to understand medical studies and statistics.5 But not only should our profession demand better training of health journalists, it should also require that health stories, rather than being rendered in black and white, use all the grays on the palette to paint a comprehensive picture of inevitably complex realties. Journalists could start by imposing on their work a "prudent reader or viewer" test: On the basis of my news account, what would a prudent person do or assume about a given medical intervention, and did I therefore succeed in delivering the best public health message possible?

Although the primary responsibility for improving health-related journalism must lie with journalists, clinicians and researchers can help. When interviewed by journalists about a news development, such as a new study, they should offer to discuss the broader context, point reporters to any similar or contradictory studies, refer journalists to credible colleagues with differing perspectives, and mention any study limitations or caveats about the results, as well as any potential or real conflicts of interest among the study authors. It will take many expert hands to ensure that the health news the public reads really is fit to print."

Let's not lose sight of the fact that medical journals like the New England Journal of Medicine also play a role in this picture. As Trudy Lieberman points out on the Scientific American website,

"...much of daily health reporting these days is based on findings reported in medical journals. They, too, have come under criticism recently for failing to disclose authors' potential conflicts of interest, such as their ties to companies that paid for the research (those caveats are becoming more transparent). But journals usually publish "good" news — a phenomenon detailed in several studies this year that showed how rarely pharmaceutical companies publish studies with negative findings.

The journals, Lieberman notes, have same interest as the mainstream media. "They want to build an audience and hope because the American healthcare system is built on hope and money."

Unfortunately, neither the NEJM essay nor the Scientific American article mention the HealthNewsReview.org project, which, for almost 3 years has given daily evaluations and grades of health news coverage - e-mailing journalists to help them improve. Interestingly, one of the commenters to the Scientific American article did refer readers to HealthNewsReview.org as a "great learning resource for those who want to develop their critical thinking in this important area."