M.D. journalist suggests guidelines for dual roles
Filed under: Conflicts of interest, Health journalism
Tom Linden, M.D., looks at the role of physician reporters in covering disasters, particularly in light of the Haiti earthquake which saw a number of high-profile physician reporters cover the story and render care.
As Linden points out in the Electronic News journal, the networks promoted their reporters’ medical efforts and showed them providing care. He brings up a number of relevant questions about the duties of a physician reporter, whether network s or stations should promote them providing care, privacy of patients and more.
Beyond asking questions and discussing the implications of such coverage and promotion, Linden proposes a set of guidelines “to help clarify boundaries between medical and journalistic practices.”
In short, he says it’s bad journalism and inappropriate for physician reporters to report on themselves providing care.
When physician journalists become the story, medical reporting loses its way.
Linden, a professor of medical journalism in the School of Journalism and Mass Communication at the University of North Carolina at Chapel Hill and director of the medical and science journalism program, is no stranger to the subject, as he has worked as a medical journalist for CNBC and local news stations.
Related
- Press release about Linden’s piece
- Debate over M.D. reporters in Haiti continues
- Doctor or journalist? Roles become blurred in Haiti
Lundberg’s list of why health care costs are rising
While people on the streets, experts and legislators debate the causes of rising health care costs, George Lundberg, M.D., editor-at-large of MedPage Today, does no such hand wringing.
He declares that a survey of the topic that was posted by his publication missed the point and did not provide the correct answers.
Lundberg, who edited the Journal of the American Medical Association for 17 years and is a member of the Institute of Medicine, lists what he sees as the “Primary Drivers of Rising Healthcare Costs.”
Health series tries to reach those often left out
Filed under: Health journalism, Hot Health Headline
Kate Dailey of Newsweek has teamed up with Public Radio International for a 10-part series, “DIY Checkup: Taking Control of Our Health.” The project looks at “what people can do to live better, no matter their genetics, history, or economic status.”
Dailey, in a blog post about the series, recognizes that some of the standard pieces of advice, such as going to the gym for exercise or eating fresh fruits and vegetables, are not relevant for significant parts of the population. People who work on their feet all day and people who live in food deserts are not getting the messages in a way that make them relevant to their lives.
As Dailey says, “the language that doctors and journalists often use to talk about personal health often leaves many people out.”
Part one of the series lists things people can do to significantly improve their health. Listen to part one:
Med school rankings: Social mission vs. U.S. News
A contrarian system for ranking medical schools published recently in the Annals of Internal Medicine has already attracted a fair amount of press attention, which — along with innumerable self-congratulatory press-releases — should show just how much sway those rankings hold in the medical education industry.
Atlanta’s Morehouse College topped new social mission rankings, but rated only 30th in primary care in the established U.S. News rating system. Photo by Steve Schwartz via Flickr
The alternative rankings score schools on “social mission” and result in a top-20 led by historically black colleges and a bottom 20 full of U.S. News favorites.
Much has already been said about the mental judging and ranking of physicians, but there has been less mentioned about how the rankings were arrived at.
The social mission rankings relied on the AMA Physician Masterfile, a $180 set of data that relies heavily upon self reporting. It “includes current and historical data for more than one million residents and physicians and approximately 82,000 students in the United States,” including international medical graduates. Using this set, the researchers used a simple formula:
The percentage of graduates who practice primary care, work in health professional shortage areas, and are underrepresented minorities, combined into a composite social mission score.
Compare this with the intricate (some might say Byzantine) calculus U.S. News methodology:
Quality Assessment (weighted by .40) Peer Assessment Score (.20 for the research medical school model, .25 for the primary-care medical school model) Assessment Score by Residency Directors (.20 for the research medical school model, .15 for the primary-care medical school model) Research Activity (weighted by .30 in the research medical school model only; not used in primary care medical school ranking model) Total Research Activity (.20)Measured by the total dollar amount of National Institutes of Health research grants awarded to the medical school and its affiliated hospitals, averaged for 2008 and 2009. Average Research Activity Per Faculty Member (.10) Measured by the dollar amount of National Institutes of Health research grants awarded to the medical school and its affiliated hospitals per full-time faculty member, averaged over 2008 and 2009. Primary-Care Rate (.30 in the primary-care medical school model only; not used in research medical school ranking model) The percentage of M.D. or D.O. school graduates entering primary-care residencies in the fields of family practice, pediatrics, and internal medicine was averaged over 2007, 2008, and 2009. Student Selectivity (.20 in the research medical school model, .15 in the primary-care medical school model) Mean MCAT Score (.13 in the research medical school model, .0975 in the primary-care medical school model) Mean Undergraduate GPA (.06 in the research medical school model, .045 in the primary-care medical school model) Acceptance Rate (.01 in the research medical school model, .0075 in the primary-care medical school model) Faculty Resources (.10 in the research medical school model, .15 in the primary-care medical school model) … the ratio of full-time science and full-time clinical faculty to full-time M.D. or D.O. students in 2009
The U.S. News data is collected through a proprietary survey (which relies heavily on self-reporting), along with parsing of NIH grant data.
PEJ: Reform coverage centered on politics
Filed under: Government, Health care reform, Health journalism
Six basic facts about how the media handled coverage of health care reform have been distilled from a study of more than 5,500 health care stories in the mainstream media from June 2009 through March 2010.
A new report from the Pew Research Center’s Project for Excellence in Journalism finds that coverage was dominated by the politics of the debate and there was far less coverage of how the health care system works. Some other findings:
First, health care coverage followed a roller coaster trajectory, spiking dramatically at times and plunging at other points. And the media platforms best suited for ideological debate proved to be especially interested in the subject—particularly the liberal talk media. In the war of words over health care, however, the opposition seems to have prevailed, as their terms and ideas showed up far more often than the key ideas of supporters of the Democrats’ reform plans. The media also seemed to focus far more on the politics and the passions that drove the debate than the health care system it was trying to reform.
Finally, President Obama’s presence as a key figure in health care coverage vacillated markedly over the 10 months studied, lending credence to the idea that he did, at times, lose control of the narrative.
The report’s conclusion tells us that, in the heat of the battle, when politics became most partisan, the media focused on those aspects rather than the system. It points out that while some outlets did good work, “the public seemed consistently confused by the health care debate and had a difficult time sorting out fact from fiction.”
ER visits caused by nonmedical use of opioids double in 5 years
Filed under: Health data, Hot Health Headline, Tools
The latest Morbidity and Mortality Weekly Report from the CDC focuses on the rapid increase of emergency department visits caused by the abuse and misuse of prescription painkillers. The report is based on a review of the five most recent years of data from the Drug Abuse Warning Network.
DAWN’s national estimates are based on a 220-hospital sample. According to DAWN, “nonmedical use” means “taking a higher-than-recommended dose, taking a drug prescribed for another person, drug-facilitated assault, or documented misuse or abuse, all of which must be documented in the medical record.”
The big takeaway?
… the estimated number of ED visits for nonmedical use of opioid analgesics increased 111% during 2004-2008 (from 144,600 to 305,900 visits) and increased 29% during 2007–2008. The highest numbers of ED visits were recorded for oxycodone, hydrocodone, and methadone, all of which showed statistically significant increases during the 5-year period.
It’s a number-heavy report, so I’ve put together a quick overview with the help of the DAWN and MMWR reviews, as well as this DAWN report. You’ll find it below.
Outpatient care can lead to more infections
Filed under: Health data, Health journalism, Health policy, Hospitals, Hot Health Headline
With a nod to the established dominance of outpatient surgery, NPR health blogger Scott Hensley explores a recent JAMA study which demonstrates that outpatient, same-day surgery carries with risks of infection that Hensley said were “a lot higher than they should be.”
Random inspections of nearly 70 surgery centers in three states found that two-thirds had at least one significant lapse in controlling infections. One common problem was the use of single-dose medication vials for more than one patient — found in 28 percent of the inspections.
Quite a few stakeholders have thoughts on the study, starting with a companion editorial by surgery professor Philip S. Barie (bio). The relevant trade group has also produced a response, as has HHS Secretary Kathleen Sebelius. Both say about what you might expect. The industry group says that an industrywide infection clampdown and new CMS standards for such activities have helped control the problem in the time since the study’s data was collected, and Sebelius trumpets current and future HHS efforts to avoid as many health-care-associated infections as possible.
Taken from an industry group report, this graph shows at a glance exactly why outpatient surgery is such a significant issue.
New IRS rules reveal hospital conflict disclosures
Filed under: Conflicts of interest, Health journalism, Hospitals, Hot Health Headline
The new IRS disclosure rules for nonprofit hospitals seemed to promise some interesting revelations, and now that they’re public, the Pittsburgh Tribune-Review’s Walter Roche has taken full advantage of the new disclosures. Roche checked out fiscal 2009 filings from the nonprofit hospitals in his area and found a big handful of conflicts ($10 million at one firm alone), all of which the nonprofits say are entirely above board.
Jennifer Chandler of the National Association of Nonprofits said it is not unusual or improper for nonprofits to have business dealings with board members as long as IRS disclosure requirements are followed.
“It has to be managed correctly,” she said.
The meat of Roche’s story is made up of a laundry list of disclosed conflicts, which include commercial dealings with board members and relatives.
News service to disclose when PIOs listen in
MedPage Today, an online breaking-news service for physicians, today instituted a rule requiring reporters to inform readers whenever a press officer has listened in on an interview.
“If a source’s comments are monitored by a press officer, then the person may not have been speaking freely,” said Peggy Peck, vice president and executive editor. “That’s information readers should have.”
Peck instructed her staff to use phrases like “said in a telephone interview that was monitored by a public information officer” whenever using quotes from such an interview.
Peck emphasized that a reporter’s goal should be to avoid having a press officer listening to calls or attending face-to-face interviews. “But if that is the only way a researcher will talk, we need to let our readers know that,” said Peck’s memo to eight reporters.
Peck is a member of AHCJ’s Right-to-Know Committee, and the rule sprang from the committee’s work to end interference by public information officers in newsgathering, especially in the federal government.
“I applaud MedPage Today for taking this step and encourage reporters and editors everywhere to follow suit,” said Felice J. Freyer, chair of the Right-to-Know Committee and a member of AHCJ’s Board of Directors.
“Reporters have come to accept the presence of public relations people at interviews, but it’s really not acceptable. We all know that such eavesdropping hinders the free flow of information – and we need to let our readers know that this is happening.”
AHCJ is seeking input from reporters about their experiences obtaining information from the federal government. “If you’ve given up trying to reach federal officials because of past delays and obstacles, we want to hear about that too,” Freyer said. Please send your comments to felice.freyer@cox.net.
Related
- Tell us about your access to federal officials
- Major journalism groups demand agency end newsgathering constraints
- AHCJ calls on new administration to improve access to federal experts
UPDATE
Freyer would like to clarify that, in her quote above, “monitoring” would be a more accurate description of public relations staff sitting in on interviews because journalists are typically aware when PIOs are present.
AHCJ also is looking for positive experiences or examples in which relationships between journalists and press officers work well. Send those examples to felice.freyer@cox.net.
Study: Women’s health coverage focuses on control
Amanda Hinnant, an assistant professor at the Missouri School of Journalism, analyzed 148 health articles in nine top-selling women’s magazines from a feminist perspective. The resulting article “The Cancer on Your Coffee Table: A Discourse Analysis of the Health Content in Mass-circulated Women’s Magazines,” is summarized here for those without the necessary journal access. Hinnant found that most coverage hewed to what could be called a post-feminist view and focused on the control the individual has over their own health with less regard for outside factors.
From the journalism.missouri.edu summary:
Most articles framed seeking better health as a way of taking control of your life, yet Hinnant suggested this was an illusion of control. “Mood, stress and energy are frequently substituted as symbols for health. Maintaining good health means constantly patrolling the borders for a bad mood, high stress and low energy,” she wrote. “What materializes is the notion that the pursuit of wellness will result in a life in control, when in fact it is a life that is controlled by the tyranny of constant surveillance.”
There were a few political and socially oriented stories (particularly in Glamour), but Hinnant found weight loss to be the most popular topic. Typically, readers were encouraged to lose weight not for aesthetic reasons, but to improve wellness, improve heart health and prevent cancer.
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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
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- 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
