Thursday, June 12, 2008

A different kind of harm

A note from a friend at a local school of journalism:

A medical journal (PLoS Medicine) published a
study that examined the accuracy of 500 medical/health stories by mainstream journalists. It says mainstream journalism health coverage may be harmful to the audience. At best we exaggerate, at worst our articles completely mislead the public. The article contains embarrassing anecdotes of medical coverage. It says that the mistakes are not intentional. We're just poorly informed about what we are covering.

And here is an editorial in the same journal summarizing the implications of the study. Excerpts:

When it comes to the quality of health reporting, why is the bar set so low? One problem is that today's health reporters may have been covering crime last week and politics the week before. They have rarely been trained to understand the complexities of health research.

There is also a broader context in which medical stories get exaggerated—the 24-hour news cycle means that media organizations are battling for audience share, which in turn means that “the press has moved towards sensationalism, entertainment, and opinion”.

Researchers benefit from the publicity because it may increase citations to their study and help their chances of promotion or tenure, while a highly visible story of a dramatic medical breakthrough can boost a journalist's career.

When a health story gets hyped, it is all too easy for medical journal editors to deny any responsibility. The reality, of course, is that journal editors themselves are the third party in the “complicit collaboration”—the journal's press release is the usual mechanism for linking the researcher to the journalist. Medical journals issue press releases about their upcoming studies partly because media publicity drives readers to the journal and builds brand recognition. A bland press release may be less likely to get your journal and the study noticed.

Schwitzer's alarming report card of the trouble with medical news stories is thus a wake-up call for all of us involved in disseminating health research—researchers, academic institutions, journal editors, reporters, and media organizations—to work collaboratively to improve the standards of health reporting.


Anonymous said...

Making medical journal content more freely accessible would help - the journalists might be able to get a medical person to interpret the actual article for them. When I read about a new New England Journal article in the newspaper, I always compare it to the real article when I receive the Journal - they are often quite different.


Anonymous said...

One of the advantages of writing books and articles about health for the public is the luxury, the time, and yes, the obligation, to check all information with my doctor and scientist sources. This brings both the satisfaction of getting correct facts for readers, and the educational benefit of learning from some of the leading experts in their fields. Although some of my work is for client hospital and health care organizations, I happily accept the media label of not being truly “objective.” Frankly, I’d rather be right.

Anonymous said...

As a layperson of professional writing, it is my opinion that only medical writers trained on such matters when composing thier pieces should do so free of influence. If you are a journalist and I am a doctor, I could pretend to be a journalist and you could pretend to be a doctor. Yet such acting harms others, so the written word should be as sacred as medicine.

Dan Abshear

Anonymous said...

There are many kinds of harm out there. As medical costs rise, pocketbooks are also in pain. A recent article from Proto magazine, the MGH quarterly, discusses how these rises are linked to administrative and billing costs.

As an admin here at BIDMC, I was wondering how the organization is tackling this issue. I'm sure this can be tied into SPIRIT somehow. It looks like other initiatives have been pretty successful. Below, find an excerpt from the article and a link.

"Administrative costs are only one element of health care delivery, but we’ve found thousands of ways to cut them,” Toussaint says. By eliminating overlapping responsibilities among employees involved in ThedaCare’s accounts receivable process, for example, the organization reduced receivables by $12 million in six months. And using the ThedaCare Improvement System to remove administrative hurdles in human resources has reduced the average time it takes to hire someone from 38 days to 18. All told, implementing lean management tools has saved the organization $23 million during the past five years—without cutting jobs and while improving service to patients."

e-Patient Dave said...

A strong antidote (or insurance policy) for this risk is often a good peer group. As someone said about this article on the e-patients blog, "This should be required reading for anyone interested in the power of e-patient groups, since these groups very often debunk improperly reported news."

Back in the '90s when I helped manage the ADD Forum on CompuServe (pre-WWW), it was the only place in the world to debunk idiotic or well-meaning-but-wrong articles, be it in Time or the local fishwrap. No different now, apparently.

And that's not limited to the press, btw; it applies too to well respected "establishment" databases. I never tire of saying (pardon the repeat) that for my cancer every bit of misleading information came from well established (peer reviewed) web sites, including the UpToDate database attached to PatientSite. I got the best, most relevant, and most useful information from a peer group - the cancer communities at (Including, they told me the best place in the northeast to get care for my cancer was at BIDMC.)

As I like to say, the best data is peer-reviewed - by MY peers, the ones whose butts are on the line if something's wrong.

A challenge here is that we don't yet (collectively) have a widely known list of peer groups on any given medical condition. So if someone has a conflaganulitamitosical knee, I have no idea where they can find a peer group. But that's why I go around talking up the power of Web 2.0 - all the tools exist to create those communities.