Hospitalist: What health journalists should know
R. W. Donnell, an Arkansas hospitalist with a long-running blog and a few burrs in his saddle, has outlined what amounts to an exam for health care journalists. It’s based on the assumption that journalists should have some prerequisite knowledge before tackling difficult scientific issues. But, instead of just grumbling about the “lay press,” the man who calls himself “Dr. RW” takes the next step and actually writes the first draft of such an exam. As you might expect, it’s an eclectic document.
Photo by thegirlsmoma via FlickrMost of the questions address specific pieces of scientific knowledge and vocabulary, presumably the bits that Donnell has found to be most difficult for journalists, including:
- Scientific method
- DNA vs. RNA
- Define and distinguish: humoral immunity, cell mediated immunity, innate immunity, acquired immunity
- Describe Medicare’s prospective payment system and the financial conflict of interest it causes
Mixed in with the pop-quiz style questions are a few broader queries that seem to be staples of just about any AHCJ gathering, as they point to the fundamental dilemmas of the profession:
- Explain the hazards of examining scientific questions in the arena of public debate.
- Explain why scientific progress does not lend itself to sound bite reporting or “news of the day” journalism.
Likewise, there are others that should be familiar to any member who’s heard one of AHCJ’s leading voices deliver an introduction to health journalism:
- Define: relative risk reduction, absolute risk reduction, number needed to treat.
- Explain the difference between clinical significance and statistical significance in clinical trial results.
- Explain why consideration of biologic plausibility is important in the evaluation of health claims and why evidence based medicine often fails when biologic plausibility is not taken into account.
In the end, he admits that the list “is by no means comprehensive or even realistic,” and invites others to contribute. It’s a goofy mix of questions, but I’d be surprised if I was the only one who was mentally grading himself throughout the entire exercise.
Dissecting Gawande’s narrative structure
In a recent post, Not Exactly Rocket Science’s Ed Yong tried to break down Atul Gawande’s work and figure out why it can be so darn compelling. Yong and many thousands of others (myself included) were riveted by Gawande’s latest New Yorker piece, a treatise on palliative care.
Atul Gawande in action. Photo by Center for American Progress via Flickr.
It was a great read, but nothing shocking – much of it reminded me of sections of Gawande’s 2008 book, Better – and it clocked in at a mammoth 12,000 words. Yet, even in the age of bullet points and boldface, that didn’t stop anyone. Why?
Putting aside the fact that Gawande’s a wonderful writer who’s built a powerful brand for himself, Yong instead considered the power of Gawande’s narrative structure. It’s something I’ve noticed throughout the man’s work, and something that he can get away with as a prominent surgeon who writes for magazines: He saves the climax of his key anecdote (the patient’s outcome) for the end, and usually weaves it into several minor peaks and valleys in the course of the story.
These four sections are all obviously united by a common theme. But to hang together in a single feature, they need more than that. Gawande achieves this by using the tale of a terminally ill cancer patient, Sara Monopoli, to frame the four topics. It is obvious enough to use real-life stories to illustrate the theme of death and Gawande’s experience gives him plenty to draw from. But his critical move was to use a single story to frame all of the others.
Initiative to help reporters cover European health
AHCJ has launched an effort to help reporters understand and cover health issues in Europe.
This new resource includes a series of web pages devoted to European issues and resources, as well as a listserv to allow journalists to share information, ask questions, join a debate, open fresh debates or post requests and queries similar to what happens on AHCJ’s main discussion list.
There is substantial health news in Europe that is certainly relevant there, but understanding those issues may help reporters everywhere put their reporting on in a global context. European countries are seeing proposals for cross-border health care, issues around the movement of health professionals and the drain of qualified staff from the world’s poorest countries to Europe, the United States and Australia.
Trudy Lieberman, AHCJ’s immediate past president, is coordinating the effort.
“For many years we have wanted to enlarge the reach of AHCJ to help journalists in Europe tell the stories of their own health care systems,” Lieberman said. “We believe that American journalists can learn from their counterparts overseas and vice versa, especially when it comes to covering infectious diseases, new drugs and treatments, access to care and what it costs. This new resource now allows them to do that. We look forward to our new trans-Atlantic dialogue.”
AHCJ Executive Director Len Bruzzese says John Lister, a veteran health journalist in England and a senior lecturer at Coventry University, has agreed to serve as the European web coordinator. He will help identify issues and bring together resources from across Europe that will improve the quality of health and medical journalism and enhance its professional standing. On these pages, you will find some discussion points and background on some emerging issues in Europe, as well as a resource page, identifying useful sources of official and alternative information on topics in the news.
“John is excited about finding contributors from other European nations who can feed into the website and start some cross-border discussions – and perhaps collaborations,” Bruzzese said.
Pfizer-funded workshop raises questions of ethics
Filed under: Conflicts of interest, Health journalism, Pharmaceuticals
Christopher Weaver, in a piece from Kaiser Health News and NPR, writes about a Pfizer-funded seminar for journalists. To attend the annual seminar about cancer, hosted by the National Press Foundation, 15 journalists get an all-expenses-paid trip to Washington, D.C.
Health care journalists, including HealthNewsReview.org’s Gary Schwitzer and AHCJ president Charles Ornstein, say reporters need to be careful and avoid even the appearance of a conflict of interest.
Foundation president Bob Myers says the pharmaceutical company does not have input on the meeting and an attendee of last year’s meeting, AHCJ member Joy Robertson, says she doesn’t remember Pfizer ever being mentioned at the event.
Commenters on the KHN/NPR include AHCJ members Ornstein; Andrew Holtz, M.P.H. (also a board member); Elaine Schattner, M.D.; and Schwitzer. Schattner, a licensed, non-practicing physician and medical educator, says “This is precisely how Pfizer and other companies try to influence physicians who, in their sometimes-arrogance, tend to think they’re “above” subtle persuasion. Are journalists any better?”
Journalist Merrill Goozner also has written about the seminar and says that that Pfizer has dictated the overall agenda:
Pfizer didn’t make an unrestricted grant to a journalism training organization. The money is being spent to train journalists in how to cover cancer.
Goozner points out, as does Holtz in his comment on the NPR/KHN piece, that “journalism spends less on training than almost any other profession” and that journalists have few opportunities to get out of the newsroom for professional education.
Covering Health wrote about this seminar and this issue last year. It’s worth noting, as we did then, that the Association of Health Care Journalists and the Center for Excellence in Health Care Journalism seek to minimize the possibility and appearance of inappropriate influence from outside parties. Pharmaceutical companies, insurance companies and medical device makers are examples of organizations with with AHCJ will not partner. Read AHCJ’s complete fundraising policies.
AHCJ’s Statement of Principles, which identifies challenges that health care reporters face and suggests how to meet those challenges, addresses the topic:
- Refuse gifts, favors, and special treatment. Refuse meals from drug companies and device manufacturers and refuse to accept unsolicited product samples sent in the mail.
- Weigh the potential benefits involved in accepting fees, honoraria, free travel, paid expenses from organizers of conferences or events against the desire to preserve our credibility with the audience and the need to avoid even the appearance of a conflict of interest.
- Also weigh the potential benefits of accepting awards from organizations sponsored by an entity with a vested interest in health care against our need for credibility.
- Weigh the potential conflict in accepting support from public, private, or foundation sources.
AHCJ-National Library of Medicine fellows chosen
Six journalists have been named to this year’s class of AHCJ-National Library of Medicine fellows. The fellowship program was created to increase reporters’ access and understanding of the considerable resources available at NLM and the National Institutes of Health.
The fellows, selected from dozens of qualified applicants, will visit the NIH campus in September for hands-on workshops about how to use and get the most from several government research databases, such as PubMed, MedlinePlus, ClinicalTrials.gov and ToxNet. Fellows also will meet with senior NLM and NIH researchers and officials. 
The journalists chosen to take part this year are:
- Karla Gale, medical journalist, Reuters Health
- Jamie Hirsh, associate health editor, Consumer Reports
- Sally James, independent journalist, Seattle
- Sandra Jordan, health reporter, St. Louis American
- Hiran Ratnayake, health reporter, The (Wilmington, Del.) News Journal
- Miriam E. Tucker, senior writer, International Medical News Group/Elsevier
“We were very happy to be able to work with the Library of Medicine to offer this fellowship again this year,” said AHCJ Executive Director Len Bruzzese. “Last year’s fellows found the information and instruction very valuable in attempting and completing more complicated stories.”
Related
Endowment funds local health reporter
Filed under: Health journalism, Hot Health Headline
Let’s get the headline out of the way first: The Merced Sun-Star is hiring a health care reporter!
Now, the interesting part. The Sun-Star’s new 18-month spot is funded by The California Endowment, which you may remember as a key backer of California Watch. 
It’s part of the endowment’s 10-year plan to improve local health.
Merced County was chosen as one of the 14 places in the state to work with the endowment in a 10-year plan to help transform communities and neighborhoods into places where everybody can be healthy, safe and ready to learn, according to Building Healthy Communities.
Thanks to that larger mission, the Merced health care reporter will cover some interesting sub-beats in addition to the Sun-Star’s traditional health coverage.
The endowment started with 10 goals to accomplish over the next decade. After polling folks in those communities, it set three priorities over the next three years: create healthier youngsters to grow, learn, play and lead, which organizers call “Healthy Youth Development;” prevent and reduce violence; and link economic development to community health.
They’re areas that are certainly not foreign to health care journalists, and a reminder that reporting on the health of the community means thinking beyond hospitals and outbreaks.
AHCJ members will probably already remember that this isn’t the first time Merced has taken the lead in health care journalism innovation, and that the new reporter is really the next step in an ongoing process.
Update
The California Endowment’s Mary Lou Fulton posted some background on the project, a sort of “how-to” primer she wrote for foundations looking to support local news. In addition to explaining why the foundation chose to fund local projects, Fulton also spends a considerable amount of time addressing concerns about editorial independence and conflicts of interest.
Blogging the first day of AHCJ boot camp
The Columbia Daily Tribune’s Jodie Jackson Jr., who is one of AHCJ’s Midwest Health Journalism Program Fellows, is blogging about this week’s AHCJ Health Reporting Boot Camp on his North County News blog. Jackson writes that, after day one, he’s already enjoying spending time in the company of other like-minded journalists and learning from some of the profession’s finest.
It was a good start to what promises to be a busy, information-packed week of learning new and honing old skills to provide more and deeper coverage of health care issues, or as Len Bruzzese put it, finding ways to create “a smarter, more engaged public,” and “hopefully a more responsive government.” Pretty heady issues, but Bruzzese seems in position to make that challenge.
The boot camp, which is designed for the eight Midwest Fellows and select students of Missouri School of Journalism, runs through Friday. Jackson promises that he’ll keep blogging as the week goes on, so check North County News (and Covering Health!) for updates.
Reporters encounter hospital’s lack of transparency
Filed under: Health data, Health journalism, Hospitals, Hot Health Headline
Blythe Bernhard and Jeremy Kohler of the St. Louis Post-Dispatch investigated a string of serious mistakes at a local hospital and found the story of a 16-year-old girl who suffocated in a bean-bag chair after being sedated. It’s a remarkable and chilling story on its own and, as AHCJ Immediate Past President Trudy Lieberman points out, it’s made even more valuable for health journalists thanks to Kohler’s willingness to explain his investigative process.
Acting on multiple tips referring to a botched 2007 kidney removal, Kohler began the laborious process of triangulating the error. You should really take a minute to read his entire explanation, but if you really don’t have time, just take note that his path was something like this: Tips from sources -> Joint Commission -> Missouri Division of Insurance -> National Practitioner Data Bank -> Missouri Department of Health and Senior Services -> Missouri Board of Professional Registration for the Healing Arts -> The actual hospital.
And even then, he was unable to get clear confirmation that surgeons had removed the wrong kidney from a patient. Instead, the hospital cited privacy regulations.
Last week, officials with SSM Health Care, the St. Louis-based corporation that operates DePaul and several other hospitals, said they could not speak about specific patient cases because of federal privacy laws. “The desire to defend ourselves and paint an accurate and full picture does not outweigh our patients’ right to privacy,” they said in a statement.
Even a subject like this, which clearly involves what Kohler calls “information that patients in need of a surgeon would be interested in knowing,” the obstacles between readers and the truth about a “never event” appear insurmountable.
Health Journalism 2011 set for Philadelphia
Filed under: Health journalism, Member news, Studies
Put AHCJ’s annual conference on your calendar: April 14-17, 2011, in Philadelphia.
The program will include dozens of panels, field trips, newsmaker briefings, Freelance Pitchfest, world-class speakers, 2010 Awards for Excellence in Health Care Journalism luncheon and a number of other special events. Expect sessions on covering health care, health research, public health, health policy, consumer health and the business of health.
Local and national planning committees have begun gathering conference ideas for review. The organization has negotiated a a discounted hotel rate of $149 a night at the Sheraton Society Hill.
More details will be available in the weeks ahead, but set these days aside now for the best annual training event in health journalism.
New project covers health care in Florida
A health journalism project has launched in Tampa, Fla., supported by the Corporation for Public Broadcasting, reports the Tampa Tribune [see second story on the linked page].
The Healthy State Collaborative Local Journalism Center is a two-year project “aimed at strengthening collaboration among six public broadcasting stations geographically centered in Florida,” according to its website. Those stations are WUSF-Tampa, WEDU-Tampa, WMNF-Tampa, WGCU-Fort Myers, WMFE-Orlando and WUFT-Gainesville.
The site will offer health care coverage through audio, text, video, photos, blogs, social networking, dynamic syndication and mobile applications and hopes to engage a younger, well-educated audience.
Jennifer Molina, formerly of Newsweek.com, is the project’s executive editor. Her staff will include a multimedia manager, a community engagement specialist, and five reporters, each assigned to a participating station. According to the Tampa Tribune report, Molina is in the process of hiring reporters.
The Corporation for Public Broadcasting issued a call for grant proposals “from groups of 3-6 stations willing to form multi-platform reporting Local Journalism Centers around a single topic or issue that will result in an elevated quality and quantity of journalism.”
In announcing the initiative, Patricia Harrison, CEO and president of the Corporation for Public Broadcasting, said the centers were intended to “enhance public media’s ability to meet the information needs of local communities at a time when access to high quality, original reporting is declining.”
The project is one of seven in the country to develop news coverage of an issue relevant to each region. [Video of the announcement of the programs.]
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Spend a week at the CDC studying public health, meeting sources. Apply for the AHCJ-CDC Health Journalism Fellowships today!
- Reporting on the intersection of health, environment
- Tip sheet: Covering cuts to Medicare reimbursements
- Briefing: Reporting on health reform between now and 2014
- Covering high-risk insurance pools: Tips for reporters
- Health care reform has passed: What's next?
- Health and education: Covering these intersecting beats
- Reporting on the business of health care
- Health reporting resources for journalists on state and local government beats
