Health care reporting among SABEW winners
Health care reporting fared well in this year’s Society of American Business Editors and Writers Best in Business Writing competition as the business of health care took center stage in many publications and earned awards for both breaking news and in-depth packages. The health-related winners:
Breaking news
Real-time News Organizations
- Dow Jones Newswires: “Deep Coverage On Drug Deal”
- Reuters: “H1N1 Flu: The Global Story”
Enterprise
Small Publications
- Sarasota Herald-Tribune: “Contaminated Chinese drywall”
Weekly Publications
- Pittsburgh Business Times: “Eli Lilly details payments to docs”
Projects
Giant Publications
- The New York Times: “Toxic Waters”
Large Publications
- Dallas Morning News: “The Cost of Care”
Magazine Enterprise
Small
- Bloomberg Markets: “Big Pharma’s Crime Spree”
Comments invited on latest draft of DSM
A new version of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders has come out every decade or so (it varies widely) since 1952. 
It hasn’t substantially changed since 1994, but the next revision is slated to come out in 2013. It’s a pretty big event, as the book’s diagnostic criteria are used around the world to determine who is diagnosed with mental disorders.
With the release of the new version, lines may shift and folks who were diagnosed with mental disorders may find themselves “undiagnosed.” Others will have labels changed and gain labels they didn’t have before.
The latest draft proposal of the May 2013 revisions, upon which public comment will be accepted until April 20, 2010, was posted on Feb. 9. APA workgroups will review the comments and begin trials soon after. Benedict Carey rounded up and evaluated some of the biggest proposed changes for The New York Times. In addition to bipolar disorders in children and autism spectrum disorders, Carey discusses the sheer significance of the changes.
“Anything you put in that book, any little change you make, has huge implications not only for psychiatry but for pharmaceutical marketing, research, for the legal system, for who’s considered to be normal or not, for who’s considered disabled,” said Dr. Michael First, a professor of psychiatry at Columbia University who edited the fourth edition of the manual but is not involved in the fifth.
“And it has huge implications for stigma,” Dr. First continued, “because the more disorders you put in, the more people get labels, and the higher the risk that some get inappropriate treatment.”
Radiation oncologists request more regulation
The New York Times’ Walt Bogdanich reviewed the American Society for Radiation Oncology’s new six-point plan, most of which seem to be a response to Bogdanich’s series (Part 1 | Part 2) on serious radiation errors. As a whole, Bogdanich writes, the plan seems to signal a push for more standardized, consistent and universal regulation of radiation treatment in the United States.
The group’s six-part plan includes creating a database of errors, enhancing accreditation programs, improving training, working with patient support organizations to help patients and caregivers better communicate with their radiation oncologist, further development of a compliance program for technologies from different manufacturers and providing expertise and support to policymakers to pass an act requiring national standards.
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FDA warns against promoting unapproved drugs
Filed under: Health journalism, Hot Health Headline
The New York Times‘ Natasha Singer looked into the FDA’s recent warning of prominent cosmetic doctor Leslie Baumann (bio) for the promotion of an unapproved drug, based on comments she made about Botox-like Dysport (she was an investigator in a trial of the treatment) in outlets such as Allure, Elle and the Today Show. Singer also considered the chilling effect this warning might have on other clinical investigators upon which the media has traditionally relied.
Now, some industry experts say the F.D.A. warning may curb the media enthusiasm of certain cosmetic doctors who until now have provided scoops about coming medical products — or have talked up the latest unapproved cosmetic uses for drugs and devices that the agency had approved only for other purposes.
“It’s a wake-up call,” said Nancy Behrman, owner of Behrman Communications, a public relations firm in Manhattan. Her firm has represented cosmetic medical companies as well as doctors. “The whole business has spiraled out of control, and we need to step back and slow it down.”
FDA representatives say that there’s a line between scientific discussion and drug promotion, and that investigators are welcome to talk to the media as long as they don’t cross it.
Thomas W. Abrams, director of the agency’s Division of Drug Marketing, Advertising and Communications, said that investigators were free to have scientific conversations about investigational drugs with their peers and with journalists. But an investigator should not promote any unapproved prescription drug — or an unapproved use of an already approved drug — as being safe or effective if the agency has not yet deemed it to be so, he said.
Singer also talks to another of the media’s favorite doctors, dermatologist Fredric S. Brandt, who said that, in future discussions with media he would take care to offer only scientific facts on unapproved drugs, and leave his opinions and recommendations out of the discussion.
Denmark sees results from electronic records
In The New York Times, Sindya Bhanoo examines Denmark, a country which has adopted health information technology to a high degree. Bhanoo finds that, while Denmark is in some ways an exceptional case, it can also provide a few principles to guide America’s proposed adoption of the same technology, chief among those being patience, persistence and a gradual pace.
Photo by juhansonin via Flickr
While Denmark does not have a standardized electronic medical records system, it does have a national patient registry and a wealth of examples of hospitals adopting innovations such as telemedicine (including remote monitoring and diagnosis), paperless prescriptions and electronic modeling. “Virtually all” Danish primary care physicians use electronic records, Bhanhoo writes, and nearly half of Danish hospitals have adopted them as well. To put those numbers in perspective, Bhanoo mentions that “about 10 percent of American hospitals and about 17 percent of American doctors use electronic records.”
Bhanoo writes that while the decade-long Danish push into HIT has not been perfect – it’s fragmented and hampered by budget constraints – it has achieved measurable success.
Several studies, including one to be published later this month by the Commonwealth Fund, conclude that the Danish information system is the most efficient in the world, saving doctors an average of 50 minutes a day in administrative work. And a 2008 report from the Healthcare Information and Management Systems Society estimated that electronic record keeping saved Denmark’s health system as much as $120 million a year.
In the end, Bhanoo concludes that while these same successes will be harder to achieve in the significantly larger and more complex American system, experts believe that a modified Danish roadmap should be able to produce results in the United States.
NYT’s Schwarz discusses football concussion beat
For the Columbia Journalism Review, Brent Cunningham talked to The New York Times‘ Alan Schwarz about his work as the nation’s leading (and probably only) full-time football head injury reporter. Schwarz, whose work covering concussions brought him to the Times in 2007, talks about how he got started on the beat and how his work has impacted the sport as a whole.
It’s all interesting stuff, especially when he discusses how his background in mathematics has helped him report on sports injuries and medicine, but the real payoff comes when Cunningham finally gets Schwarz to divulge his personal stance on concussions in youth football. It’s a crystallization of all Schwarz has learned, as well as a delicate balancing act between his personal and professional ethics.
Photo by Eagle102.net via Flickr
CJR: Let’s assume for a minute that your son, who you said is three years old, is actually ten years old and he is clamoring to play Pop Warner football. Would the fact that you would then have to decide disqualify you from covering the story?
Schwarz: No, it wouldn’t disqualify me, though of course that’s up to my editors. But there is something about working here—and I’m not saying we’re better than everyone else, blah, blah, blah—but there is something that really inspires you to do the right thing, and to do the thing that helps you to cultivate the trust that allows readers to take you seriously. So I would probably let him play because if I didn’t it would compromise the reporting. It would compromise the trust that others and even the league may have in me. Now, I would not send him out to slaughter, but getting one concussion is not that big of a deal—it just isn’t. And to suggest otherwise is incredibly irresponsible. So if my kid gets one concussion then yeah, he doesn’t play anymore probably. But to not allow him on the field is, frankly, an overreaction. And if I didn’t allow him to play then yeah, it would be harder to cover the story, if only in my own mind. I believe that the cost to others of my not being able to cover this story as well would be greater than the cost of my kid getting one concussion and never playing again. I’m a very mathematical guy. I follow certain precepts. And those are the things that make sense to me. And I can’t tell my kid he can’t play, because then what am I going to tell the league? What am I going to tell my editors? It doesn’t work. It’s dissonant.
Related
- Tip sheet: Concussions in young athletes
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- Technology in play to help make football safer
- Brain damage caused by football is cumulative
- ‘Playing through’ concussions is damaging
NYT: Millions drink contaminated water
Having exposed the nation’s toxic waters, The New York Times‘ Charles Duhigg has now turned his attention to the Safe Drinking Water Act. Duhigg has found that “since 2004, the water provided to more than 49 million people has contained illegal concentrations of chemicals like arsenic or radioactive substances like uranium, as well as dangerous bacteria often found in sewage.”
Furthermore, Duhigg found that only 6 percent of violators were ever fined or punished.
Duhigg used EPA data on Safe Drinking Water Act violations as well as other parts of the massive Toxic Waters database.
Related
- Paper’s investigation reveals contaminated drinking water
- Reporter finds efforts to monitor groundwater contamination leave much to be desired
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NYT’s Moss continues to follow E. coli story
The national gag reflex alert level has slipped back to “yellow” in the months since New York Times reporter Michael Moss’ epic rendering (pun intended) of the journey that meat (and the E. coli that tags along) take on the way to your hamburger patty, but that doesn’t mean Moss has abandoned the issue.
Moss’ latest reports have followed the evolution of the issues raised by his report (and related earlier efforts). Since that first story, Tyson’s started to clean up its act (or at least let others clean that act up for them), the pinpointing of another outbreak ratcheted up the pressure and lawmakers have introduced legislation that would require that ground beef components be tested for E. coli.
Bankruptcy: Health insurance for the desperate
In The New York Times, reporter Kevin Sack visits Nashville, Tenn. to tell stories from the front lines of health bankruptcy, stories which he folds into larger discussions about health care reform. Apart from compelling anecdotes, Sack’s most interesting angle was that bankruptcy is equivalent to a painful insurance safety net for many Americans.
“This has really become the insurance system for the country,” said Susan R. Limor, a bankruptcy trustee who calculated that 13 of the 48 Chapter 7 liquidation cases on her docket one recent afternoon included medical debts of more than $1,000.
Under Chapter 7, a debtor’s assets are liquidated and the proceeds are used to pay creditors; any remaining debts are discharged, and filers are left with a 10-year stain on their credit ratings.
“You can’t believe how many people discharge medical debts,” Ms. Limor said. “It’s a kind of trailing indicator of who’s suffering in this economy.”
Sack writes that proposed health care reform bills in both houses seek to solve the medical bankruptcy epidemic by expanding Medicaid eligibility, subsidizing health insurance and capping annual out-of-pocket medical costs.
AHCJ Immediate Past President Trudy Lieberman adds another anecdote to the mix in a post on CJR.org, this one based on an engineer from rural Illinois. Despite a relatively good health plan from his employer and the relatively good health of his wife and children, he was forced to declare medical bankruptcy earlier this decade and now the bills are mounting again. Lieberman carefully chronicles the man’s expenses, teasing apart premiums, deductibles and everything else, then comes to the conclusion that proposed health care reforms won’t do him much good.
NYT Mag takes deep look at data-driven medicine
Filed under: Health care reform, Health data, Hospitals, Hot Health Headline
David Leonhardt, writing for New York Times Magazine, profiles Brent James and Intermountain Healthcare, the hospital network he helps oversee. Idaho native James has turned the Utah- and Idaho-based network into a world leader using data to make positive changes to medical outcomes. James’ basic process is based on the idea that if there’s variation in treatment, then that variation will produce varied outcomes. He and his people track that variation and those outcomes, “identify variation and then figure out which treatments have not been working.”
Leonhardt’s carefully choreographed piece at once runs deep into Intermountain, and wide across the entire health care reform debate, illuminating how evidence-based medicine works and addressing criticism of it. A few highlights:
- Electronic medical records make James’ work much easier, and much more effective.
- Simply presenting doctors with a well-considered default choice, whether it be electronically or in the form of a pre-written prescription they must choose to either sign or discard, can have a significant positive effect on outcomes.
- Intermountain’s statistics are impressive and numerous. One example: “A protocol for dealing with one broad category of pneumonia cut its mortality rate by 40 percent over several years.”
- Dartmouth Atlas father John Wennberg called James’ work “the best model in the country of how you can actually change health care.”
- Intuition, a cornerstone of medical decision-making, has its place but rarely outperforms data-based decision-making.
- Not every implementation of evidence-based medicine will work. It must be done right. This involves heavy administrative oversight and a careful persuasive approach to dealing with physicians.
- Intermountain’s pioneering work is often rewarded by a hit to the bottom line as their hospitals reduce the need for costly (and profitable) additional procedures.
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Health Journalism 2010, AHCJ's annual conference, features a world-class program with story ideas, sources, stronger reporting skills, chances to meet newsmakers and network with other journalists.
- 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
- Shortened Lives: How location, lifestyle affect health
- Covering a complex story for the long haul
- Aging in the 21st Century: Presentations and tip sheets
- AHCJ calls for better information from Joint Commission Web site
