Thursday, January 08, 2015

A reporter who cares, too

Right after New Year's Day, I commented on a "top ten" list prepared by Akanksha Jayanthi at Becker's Hospital Review that contained the priority patient safety issues for 2015.  I indicated discourgameent because so many items on the list had persistently remained there, emblematic of lack of leadership and progress in so many health care settings.

Well, afterwards Akanksha revisited the subject, "partly in response to your blog and partly just to voice some of my perceptions and frustrations with the industry from the vantage point of a healthcare reporter."  She offered a number of personal reflections on the Becker's blog.  Excerpts:

As a healthcare reporter, I continuously research the industry, speak with healthcare professionals weekly and write about the issues daily, all of which objectively informs my perception. 

And the perception I have of the healthcare industry is one wrought with contradiction. Hospital executives, physicians and staff claim their No. 1 priority is the patient. It's upheld as the universal truth. But in this industry, talk seems oh-so-cheap because 440,000 deaths from preventable errors don't relay the message of "safety as a priority." If hospitals and health systems truly hold patient safety as a main concern, there is no excuse for such a figure.

And then she asks the key question:

When will leaders actually make purposeful moves toward addressing these issues and tangibly demonstrate their commitment to the patient?

Time is going quickly, and these safety concerns aren't budging.

And then she concludes:

So where does that leave us?

One of the main pillars of journalism is objectivity in reporting. Journalists are not to involve themselves with the stories they write. I apologize now to the professor of my ethics and communication class, because in this case, I would be remiss to not get involved.
I don't want to include hand hygiene on future lists of patient safety issues. I don't want to include medication errors. I don't want to keep writing about HAIs.

It's a new year, so let's develop a new focus on the most basic tenet of healthcare: caring for the patient. Re-visit my list of the top 10 patient safety issues for 2015 and push those to the top of your resolutions.

And this year, I hope to write a different story — one void of discouraging repetitiveness. We owe that progress to the patients.

Brava to Akanksha.  There is a lesson here for all health care journalists: Maintain your objective reporting standards in each story, but be sure that the stories you choose to cover are not restatements of industry pablum or self-serving press releases.  Find the drama in the fact that people are unnecessarily being harmed and killed.  Document and expose those cases.  Probe and explain to the public and the profession what has and has not been done to improve the situation.

Also, when new (often expensive) medical devices and therapies are introduced, ask the question:  Do these actually make care better for people?  On the AHCJ listserv recently, Norman Bauman noted:

A study in this week's BMJ found that when news stories exaggerated the results of health research, the original press release was usually exaggerated. About a third of the press releases had exaggerations. 

They scored the original papers, press releases, and news stories on (1) Advice to readers to change behaviour, (2) causal statements drawn from correlational research, and (3) inference to humans from animal research that went beyond those in the papers.

40% (CI 33% to 46%) of the press releases contained exaggerated advice

33% (26% to 40%) contained exaggerated causal claims

36% (28% to 46%) contained exaggerated inference to humans from animal research.

When press releases contained such exaggeration, 58% (CI 48% to 68%), 81% (70% to 93%), and 86% (77% to 95%) of news stories, respectively, contained similar exaggeration.

They said the responsibility in such cases rested not with the journalist, or the PR office, but with the researchers who let the press release go out with those claims. . . . So the action points are to read the original paper, or at least the abstract and discussion, not just the press release.


nonlocal MD said...

I think patients also have the responsibility to speak up about medical errors. In the past year friends have suffered 2 serious medical errors - one, a missed diagnosis of trauma-induced compartment syndrome in our local ER which resulted in almost-loss of limb and permanent foot drop; 2nd, a pharmacy error resulting in the patient taking a tablespoon per dose of a drug rather than the prescribed dose of a teaspoon, a 3 fold overdose.

Despite my urging in both these cases the patients 'didn't want to make a fuss." You may think you are being magnanimous but you are only leaving the door open for the next patient to be harmed. Speak up, be heard and demand followup.

Paul Levy said...

Excellent point!

Joe Hess said...

"When will leaders actually make purposeful moves toward addressing these issues and tangibly demonstrate their commitment to the patient?"

How do you know that they (who?) are not making (attempting) purposeful moves?

There are so many dynamic health care challenges faced each day. Where is the focus? Is like we are all looking at the same painting, but each of us are looking at a different part through a small straw multiple times in a day.

Lets talk about prioritization and which efforts by the leaders will produced improved outcomes.

I think there is power in open source collaboration.

Anonymous said...

Until the government forces them to, until the press highlights all the problems they refuse to fix, and they suffer bigger monetary payments than what they make in fixing the problems, it aint happening.

fairhavenhorn said...

Mr. Bauman's assignment of responsibility to the authors of the paper does not reflect reality. It is quite rare that the authors have any input into or control over the press release. Often, they never see the release. It's not practical for authors in many fields, not just medicine, to control press releases. When I worked in the environmental field we never saw the press releases unless someone outside our organization sent us a copy. We just wrote the reports, and were sometimes greatly surprised by what the press release said.

The medical device and drug releases are one area where there is a small exception to this. A press release by the manufacturer must be fully consistent with the claims registered with the FDA. It's only in situations like this where I've been able to comment on press releases before they went out. The release may still be enthusiastic, but we do review it to ensure that it matches the basic claims in the FDA filings and is justified by the data. But manufacturer releases for FDA approved products are only a very small fraction of the healthare press releases.