Gaps in evidence drive shared decision-making movement (#ahcj09)
Shared decision making is of public interest - at least to anyone who thinks they might one day go to the doctor.
“This must be gratifying to Jack Wennberg,” panel moderator Gary Schwitzer, publisher of HealthNewsReview.org, mused at the end of the question and answer session following the panelists’ presentations.
“He couldn’t get his work published for 30 years. He was laughed at, considered a pariah. Finally, he had to publish in Science, which is not exactly a standard journal for variations in health care.” Using Medicare data, his Dartmouth Atlas of Health Care demonstrated striking variations in the kind of care patients receive - and the resulting costs - depending simply on where they live.
As it has been applied, Wennberg’s pioneering research revealed a large number of medical procedures where there is no clinical consensus as to the course of treatment. In response, there is movement to educate - and mandate - physicians to include their patients in the decision-making process.
AHCJ member Chris King, of the St. Louis American, writes about the shared decision-making panel.
Mental health: Reporting beyond the labels (#ahcj09)
If you live with mental illness, tell the truth about it. If you report on mental illness, watch what you say about it.
This was the core advice from panelists on “Mental health: Reporting beyond the labels” on April 17 at Health Journalism 2009 in Seattle.
“People with mental illness are more likely to be victims than perpetrators,” said Jennifer Stuber, assistant professor of social welfare at the University of Washington. But despite the research, many media depictions of these people continue to promote stereotypes of their being dangerous to themselves and others.
Journalist Hilary Abramson writes about the panel.
Doctor shortage a ‘crisis’ in Wash. (#ahcj09)
Marc Ramirez of The Seattle Times writes about Health Journalism 2009, focusing on a panel about medically underserved areas.
He reports that Even as the population of older people and ethnic minorities continues to grow in those communities, the shortage is worsening as many current rural doctors reach retirement age and fewer available candidates emerge from U.S. medical schools.”
“It’s a crisis, there’s no question about it,” said Anita Monoian, chairwoman of the National Association of Community Health Centers.
Credit crisis, IRS changes affect hospital finances (#ahcj09)
If ever there was a time to dig into your local hospital’s finances, this is it, Karl Stark told journalists Friday morning.
The Internal Revenue Service has made the first significant change to its 990 form in 30 years, providing more details about charity care and community benefits.
“And there are all these financial pressures coming down on hospitals this year,” said Stark, health and science editor of The Philadelphia Inquirer. That may result in a new wave of closures and mergers.
“One of the issues that has been undercovered, in my opinion, is the effect of the credit meltdown on hospitals,” he said.
During a presentation at Health Journalism 2009, Stark provided advice on how to demystify the financial numbers.
Sandy Kleffman of the Contra Costa Times writes about some key points from Stark’s presentation.
Costs critical to stories about health care (#ahcj09)
Guest post by Jason Roberson of The Dallas Morning News
For the most part, health care journalists are shortchanging readers by not focusing more on costs, according to Friday’s AHCJ conference panel, “Explaining costs in health stories.”
Health care costs represent 16 percent of the nation’s gross domestic product, but only 28 percent of health-related stories cover costs, according to Gary Schwitzer, publisher of HealthNewsReview.org. His assessment comes from a three-year study of more than 750 health care stories.
In one of Schwitzer’s examples from the Associated Press, the writer failed to mention that the price of a new breast cancer drug would cost several thousands of dollars a month, putting it out of reach for most patients.
“Do you care about people like this when you write these stories?” Schwitzer asked.
Other panelists expounded on alarming health care cost increases and the need for clarity.
“Ten years from now we’ll be spending $4 trillion in health care,” said Glenn Melnick, professor at the University of Southern California. “Those are almost [Troubled Assets Relief Program] numbers.”
Health insurance premiums are not experiencing the same double-digit increases seen earlier in the decade, said Melnick, citing a recent PricewaterhouseCoopers report. But in such stories, journalists error in not explaining other insurance cost trends, like so-called benefit buy downs, where increased cost sharing or reduced benefits within the policy lowers nominal premium but not the real total cost, Melnick said.
In kicking off the panel discussion, moderator Julie Appleby, AHCJ board member and Kaiser Health News senior correspondent, offered two simple questions to help steer health care reporting in the right direction.
Said Appleby: “How much is it going to cost? And who is going to pay for it?”
Lewin group linked to private insurers
Filed under: Conflicts of interest, Health journalism, Hot Health Headline
In the Columbia Journalism Review, Trudy Lieberman, president of AHCJ’s board of directors, scolded journalists for not mentioning that Lewin Group, the consultants who released a recent study claiming that a public insurance option would cost doctors and hospitals money, is ultimately part of a major insurance company.
(Lewin Group is) part of Ingenix, which is owned by United Healthcare Group, the insurance behemoth that has been buying up insurance companies left and right, expanding its reach into just about every segment of the health-insurance market. Its flagship, UnitedHealthcare, helps make it the largest health insurer in the country. It’s a safe bet that United is not too keen on a public plan that might shrink its business.
The relationship is disclosed in the study and Lieberman turned up evidence indicating that there may be no formal protections in place for Lewin Group’s editorial independence. She wondered why journalists, particularly those behind a widely used AP story, did not provide readers with any information or context on Lewin’s insurance industry ties and called on reporters to remedy their error next time Lewin Group comes up.
Jones does health disparities in 10 voices (#ahcj09)
AHCJ member Chris King, of the St. Louis American, writes on his blog about Sarah Jones‘ performance on Thursday night at Health Journalism 2009.
Sarah Jones
In “A Right to Care,” the Tony Award-winning playwright and performer takes on the multicultural and class components of the U.S. health care system. Her performance highlights the broader racial, ethnic and socioeconomic elements of improving public health.
The character shifts were done almost entirely with her voice. The only props were a few rows of chairs with jackets thrown over them. As she changed characters she changed jackets, and (at most) eyeglasses.
Read all of King’s post, which includes a photo from Jones’ performance.
Sen. Wyden, Freelance PitchFest on tap today (#ahcj09)
Sen. Ron Wyden (D-Ore.) will be the spotlight speaker at today’s luncheon where he will talk about health care reform under a new president. Wyden sponsors the Healthy Americans Act, a proposal that he says would “provide affordable, high quality, private health coverage for everyone regardless of where they work or live.”
The luncheon will be followed by a series of drawings. Be sure to visit the Exhibit Hall between 2 p.m. and 3 p.m. for the chance to win one of these: a digital audio recorder, an iPod nano, a $50 dining card or a Starbucks gift pack. Remember, our exhibitors’ support helps us keep AHCJ conference registration such a great deal.
This afternoon, our freelance members will have a chance to meet editors and pitch stories to them in a fast-paced Freelance PitchFest. This is the second year we’ve offered this and demand was high for appointments with the editors.
If you’re on Twitter, follow the action using the hashtag #ahcj09 … for those of you not yet on Twitter, you can see what’s going on here.
McKenna talks about MRSA in pigs, farmers
In addition to the strains of MRSA that arose in hospitals and the community, there is one that seems to correlate pretty strongly with pig farmers and, in many cases, is present in both the farmers and their stock. Bonnie Powell, founder of The Ethicurian blog, interviewed journalist (and AHCJ member) Maryn McKenna about MRSA and the recent discovery in the Netherlands of a strain linked to commercial pork production.
CDC/Janice Haney Carr
This 2005 scanning electron micrograph depicts clumps of methicillin-resistant Staphylococcus aureus bacteria. Magnified 9560x.
[The presence of a clear link between factory farms and human cases of the pig-linked MRSA ST398 strain] depends on your standards of evidence. MRSA ST398 has been found colonizing pig farms and pig farmers in the US, Canada, and in the European Union. You can argue about how prevalent it is — it’s easy to cast doubt on whether it is common, because not very many studies have been done. But you can’t argue that it is there.
The argument over whether ST398 in pigs is causing MRSA disease in humans is more subtle. It definitely has in the Netherlands, though not often so far. Has it done so in the US? No one has done the microbiology to tell.
As for the food supply, McKenna says it’s theoretically possible to contract MRSA from meat.
If MRSA ST398 is in pork — it’s been found in Canada and Europe, but not here yet — then the issue is not eating the pork (as long as you cook it), but rather handling it. It is possible that you could handle raw pork, unthinkingly touch your eyes or nose, and colonize yourself.
McKenna, who is writing “Superbug: The Rise of Drug-Resistant Staph and the Danger of a World Without Antibiotics,” urges better testing and monitoring of MRSA and the outbreaks thereof, and cautions that, even if they are not yet shown to harm humans, resistant drug strains are still a matter of public concern.
McKenna also wrote a comprehensive primer for AHCJ to help educate reporters about MRSA and the surrounding issues.
Multimedia, social media for health journos (#ahcj09)
Presenters had lots of great information to share about social media, blogging, getting audio and using free online tools for journalists at today’s multimedia sessions at Health Journalism 2009.
We heard from SeattlePI.com’s Monica Guzman (@moniguzman on Twitter); Phyllis Fletcher of KUOW-Seattle and Robert Hernandez from The Seattle Times; Scott Hensley, founding editor of The Wall Street Journal’s Health Blog; and Daniel Lathrop, an independent journalist who recently worked for the Seattle Post-Intelligencer.
For links to their tip sheets, presentations and many other useful sites, see this tip sheet written specifically for health journalists.
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Awards for Excellence in Health Care JournalismDeadline: Feb. 3
- How I did it: Falsified charts in nursing homes linked to patient care
- Access Denied: Looking at a lack of health care availability
- Transparency & medical errors: Public reporting of patient harm is a potent force
- Focus on freelancing: Tips for buying liability insurance
- Why do some patients get stuck in hospitals for weeks, months?
- Investigate health professionals and the boards that regulate them
- Presidents of AHCJ, SPJ call for more openness from Obama administration
