JAMA, The Journal of the American Medic. April 8, 1992 v267 n14 p1969(3) The magical medical media tour. Many local television stations in the 1990s have a medical news reporter. But much of the medical news that is on the air may be the product of public relations efforts by physicians, hospitals, and pharmaceutical and medical device manufacturers. Many medical news reporters do not have the time or the expertise to distinguish between unbiased information and marketing releases. The type of stories preferred by most medical news reporters are those about new drugs and new treatments, rather than more relevant issues. Television stations often run video news releases that are produced by pharmaceutical and medical device manufactures. A certification program should be developed for broadcast medical reporters by professional organizations involved in medical communication. Many physicians are under pressure to promote themselves and their practices in the media. Physicians must assume responsibility for the information that they communicate in the media, and consider how this information may affect their patients. COPYRIGHT 1992 American Medical Association
grateful relief after treatment. The public relations firm has also provided the satellite coordinates and schedule for a
THE DISSEMINATION of health and/or medical science
satellite transmission of this same VNR so the station can
news via television in the 1990s is a booming industry.
"downlink" the video as a backup.
There is not only growth in the number of full-time medical reporters at local television stations, but there is also an
The newly appointed medical reporter you just met had
increase in the number of physician-broadcasters. What
been worried because no major medical journal will be
the viewing audience does not often see directly is the
released today, and she had no other story ideas. The
expansion of the public relations effort by physicians,
cooltipped laser loop hemorrhoidectomy story won’t be a
hospitals, and pharmaceutical and medical device
scoop since she knows all the other stations will have it,
manufacturers. But the audience is directly affected if and
but it will fill her quota for the day and she’ll at least keep
when television journalists fail to inject balance and
perspective into marketing messages often skillfully packaged by vested interests. This commentary offers
While hypothetical and fictional, the preceding scenario is
constructive criticism for improvements in the preparation
quite realistic. It happens in scores of television
and the training of those who deliver health and/or medical newsrooms every day. And it points to multiple maladies in science news to most Americans.
the way television tries to disseminate medical news. Television station management often invests only in
Step inside a local television newsroom for a brief tour. It
window dressing in the coverage of medical news, failing
may tell you something about how editorial decisions are
to train its so-called specialists in the development of the
made and how medical news is disseminated by television discriminating judgment so necessary in this area of today. Meet the woman who is called this station’s medical specialty reporting. Broadcast medical reporters, reporter. She has only held that title for 6 weeks, having
sometimes pressured to fill a daily quota and perhaps
been shifted from general assignments after a consultant
lacking the experience to be able to make crucial
advised the station management that medical news boosts judgments, ride the competitive flow of events, never ratings.
questioning sources and merely accepting spoon-fed information as fact. Pharmaceutical and medical device
Today, all stations in town are sending reporters to a news manufacturers quickly capitalize on this journalistic conference concerning what they have been told is "a new naivete, collecting free publicity through news stories. breakthrough in medicine." It is a cool-tipped laser loop to
Physicians and administrators of health care facilities
ensnare hemorrhoids. All stations have received the same become enamored with their ability to promote themselves telefax transmission, followed by the same press kit
or increase their fame or fortune via television.
containing a written news release (which also serves as a
Somewhere in all of this, the viewer (patient or consumer)
suggested script), the names of local physicians who can
is forgotten, as he or she tries to make sense of the "new
be interviewed on the subject, and some sample questions breakthrough" just proclaimed on the evening news. that might be asked of those physicians. To make the television reporter’s job easier, the public relations firm
Today’s television journalist has the benefit of some
managing the release of this information has also sent a
amazing technological tools to help reflect accurately what
video news release (VNR) with dramatic videotape of the
is happening in the world. But viewers of television medical
device being used in an actual procedure and a patient
news reporting today often get a distorted reflection, with a
interview--a man in agony before treatment and, again, in
hightech twist. When stories on the latest laparoscope,
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laser, or lithotriptor outnumber stories on issues
of the administration’s health policies. If a comedy show
concerning health policy, access to care, and quality of
can broach the subject, people who call themselves
care, something is out of balance. Most television medical
medical journalists should be able to find a way.
reporting today doesn’t help as much as it confuses, because it provides no context, follows no trends, and
It is easy to ignore the in-depth side of television medical
fosters unrealistic expectations on the part of the viewing
reporting because it requires a commitment of people and
money and time to do it. Most of the television medical reporters who responded to the survey mentioned earlier
Instead of a "gee-whiz" story on laser angioplasty, for
were hired in the past 2 years, a sign of growth in the field,
instance, television news could present a more balanced
but also a sign of inexperience in our "specialists."[7] It
report, including the view of some physicians that this new
shudder when I think of the complexity of the subject
technology has not proven itself--in comparison with other
matter, and add to it the competitive pressures that exist in
approaches--in peripheral arteries, much less in coronary
television today, and add to that the temptations of more
arteries.[1-3] But, for the most part, television news fails to
than 2000 VNRs a year (many of them produced by
put such questions in context. Applying less "gee whiz"
pharmaceutical and medical device manufacturers)
and more basic journalistic "why" might lead to a better
offering television reporters some free, slickly produced
story: analyzing the technology assessment vehicles that
allow proliferation of devices and procedures and which may, in no small part, be responsible for higher medical
An article in The Nation recently speculated that "the
costs. But television stories, often paralleling the news wire
powerful synergistic forces that drive television stations to
service stories from which they are derived, tend to fall
use drug industry VNRs include the weakening economics
prey to "breakthroughitis," an affliction of the journalistically
of local television, which enhances the desire for slick
news segments with designer features but not designer prices. In all but the very largest markets, such as New
While local television news has shown less maturity in this
York and Los Angeles, few stations can afford to originate
area of reporting, network television news has had its own
all the material used on their local newscasts."[9] In that
embarrassing moments, as in the coverage of the
same article, Jill Olmsted, a professor of broadcast
prescription drug tretinoin (Retin-A, Ortho Pharmaceutical
journalism at the American University in Washington, DC,
Corp., Raritan, NJ), the acne cream being converted into
said, "Because of the downsizing of news staffs and the
an "antiaging" cream.[4] One network, after touting that the
general financial crunch, stations are often running VNRs
product "can make fine lines and surface wrinkles
in their entirety or some portion of them." When that
disappear," concluded, "After today’s report on wrinkles,
occurs, the viewing audience, thinking it is watching a
people with acne better hope there’s some left."[5] Another
news report, is actually being duped by an extended
network spouted that the dream of "a cream that will
commercial announcement. Where is the disclosure, the
reduce the wrinkles of age and make skin young again . . .
labeling, the truth in advertising about what is being put on
now . . . could be a reality." That report’s summary
comment stated that, "Physicians across the country expect to be flooded with requests for the drug."[6] Were
There’s another kind of labeling I think the viewing
those lines written by journalists or by drug advertisers?
audience deserves. In return for the privilege of borrowing the public airwaves to deliver messages into our homes on
A 1989 survey of health news reporters[7] showed that
matters pertaining to public health and policy, broadcast
stories on new drugs and new treatments are favorites of
medical reporters should have to show how serious they
television medical reporters--second on a list of 25 health
care topics. At the bottom of the list were some topics that might be described as "old, dull, nonvisual stories": ethical
I will promote an admittedly radical idea: that is,
issues in health care, Medicare and Medicaid issues,
certification of broadcast medical reporters. I remember
mental illness, health care policy, and health care for the
when the American Meteorological Society first granted its
homeless. Sadly, these "less attractive" stories affect more
seal of approval to some television weather forecasters.
viewers than the "medical miracles" portrayed during the
When I first saw that, it at least distinguished the
television rating period (the so-called sweeps month).
meteorologist on one channel from the television
Recently, even the comedy writers for CBS-TV’s "Murphy
personality on the other channel who didn’t have the
Brown" program found a way to explore the issue of the
American Meteorological Society’s logo, and who
nation’s health policy debate, when they built an entire
presented his entire weather report along with a
half-hour show around Murphy’s need to find a way to jog
cat-puppet sidekick. I challenge the National Association of
alongside President Bush to get a quote for a story critical
Science Writers, the American Medical Writers
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Association, and the Radio-Television News Directors
reporters depend on scientific authorities, press
Association--three organizations that might, logically,
conferences, and professional journals in writing their
develop such a certification process--to open a dialogue
stories. The result: many journalists (even those who have
on certification of broadcast medical reporters who have
little formal training in science or the scientific method)
met certain educational or background criteria. That might
frequently adopt the mind-set or "frame" of scientists; they
help viewers distinguish the professionals from the
interpret science in terms defined by their sources, even
when those sources are clearly interested in projecting a particular view. . . . Unaggressive in their reporting and
Too many of today’s broadcast medical reporters are
relying on official sources, science journalists often engage
puppets--marionettes whose strings are yanked daily by
in retailing the views of their sources rather than
self-promoting physicians or their paid public relations
investigating the methodologies and the evidence behind
appointees or by fiercely competitive hospital hard sellers
or by pharmaceutical flacks. In one recent example of the fox guarding the henhouse, the influence of high-powered
Indeed, public relations people and pharmaceutical or
public relations reached new depths inside the newsroom.
device manufacturers aren’t the only puppeteers in the
A public relations firm proudly announced that a St Louis,
daily manipulation of the medical media. The reporting of
Mo, television medical reporter had been hired as a
medical news on television is also affected by the
consultant, available to discuss "the role of video in
changing environment in medicine. If a young physician
pharmaceutical marketing." What appeared to be a simple
was once intimidated by the pressure to publish, today’s
career shift was complicated in the next line of the
physician may be overwhelmed by the pressure to
announcement: the reporter would continue in his position
promote himself or herself on the air. Often, the root of the
on the air as a medical reporter! How could a television
problem with broadcast medical reporting is a physician
station allow an employee to appear as a reporter,
acting as the loudest advocate of his or her own work. In a
knowing that person was also being paid by a public
recent New York Times article,[11] a public relations
relations company? There was a time when a journalist
consultant for a California surgeon beamed: "We’re on the
would be fired for such a professional conflict of interest.
phone 40 hours a week for him; we mail out videos, press
Now, it is announced publicly in a news release! That is a
kits, action photos; we give him an angle, a special hook.
new chapter in the journalist’s code of ethics.
He is a celebrity." That same article quotes a public relations agency survey of 2500 editors and reporters
The audience expects carefully prepared, independently
around the country that found that "90% of ideas for health
researched news stories, just as the television station
articles had originated with a public relations
promises in its promotions. But today’s onslaught of public
person"--higher than even the percentage for
relations spoon-feeding overwhelms the inexperienced
medical reporter marionette. It’s the puppet who is most prone to putting single-spokesman, simple-minded stories
In the "Doctor’s Business" section of Medical World
on the air without seeking second opinions. It’s the puppet
News,[12] new opportunities are often listed. Recently, the
who is most likely to use VNRs without scrutinizing the
column promoted a syndicated medical television program.
slant of the seller and without telling the audience that part
Physicians "are becoming media savvy and learning to
of what they’re seeing was paid for by an advertiser. It’s
speak in sound bites," according to a television medical
the puppet who may lack the natural, healthy skepticism
reporter in Houston, Tex, who interviews local physicians
that is supposed to be inbred in journalists.
for the local segment of the syndicated program. A Houston radiologist says the program "reinforces the idea
In this election year, some political reporters have already
that the hospital is up to date and cares about its patients
been criticized for tactics in attack journalism. Some feel
and the community at large." The article says that
political reporters have crossed a line from healthy
reinforcement costs the hospital $195 000 per year.
skepticism to ugly cynicism. It is ironic that, with television medical reporters, the pendulum may have actually swung
American Medical News[13] also carriers periodic advice
too far the other way, with healthy skepticism replaced by
columns for physicians. One was headlined, "How to Get
naive head nodding. Dorothy Nelkin of Cornell University,
Your Name in the Newspaper or on the Air." It advised,
author of Selling Science: How the Press Covers Science
"It’s no surprise that there has been a significant
and Technology, focuses on a particular problem with the
awakening among physicians, who see news coverage not
only as an acceptable means of practice marketing, but a free one as well. What is notable is the fact that so few
While political writers routinely go well beyond press
physicians really understand how to gain access to this
briefings to probe the real stories behind the news, science
fountain of marketing abundance." Perhaps it is only a few,
- Reprinted with permission. Additional copying is prohibited. - JAMA, The Journal of the American Medic. April 8, 1992 v267 n14 p1969(3) The magical medical media tour.
but they have left a telltale trail, claiming cures and
seconds for story airtime. (Try explaining a medical journal
creating demand for unproven treatments mostly
article in 90 seconds!) Worse, it doesn’t allow its young
unchallenged by journalists or medical organizations.
journalists the time to think, to learn, to anticipate, to analyze, to question, to check other sources, and to
The pressure to publish or to promote raises some new
develop those sources in the first place before ever putting
ethical dilemmas for any physician who may have contact
one word on the air. It doesn’t invest the time or money to
with the news media. Before clipping on the microphone
train young journalists in this specialty area of reporting.
for the interview, or before stepping behind the lectern at
Failure to take that time helps explain how we get the
the carefully arranged news conference, a physician
familiar stories of quick fixes, magic bullets, and daily
should have the unseen audience in mind--the viewers
breakthroughs that feed hysteria and hypochondria,
who will hear a physician on television tonight in a
thereby harming, not helping, those who get most of their
90-second story. Perhaps physicians need to hear from
health and/or medical science news from television.
one their peers. A family physician recently wrote[14]
[1]King EJ. New interventional devices and the need for
about a week’s worth of patient demands following
restraint. Radiology. 1989;170:945-946. [2]Strandness DE
television publicity concerning various medical news
Jr, Barnes RW, Katzen B, King EJ. Indiscriminate use of
stories: parents insisted on magnetic resonance imaging
laser angioplasty. Radiology. 1989;172:945-946. [3]Perler
for their son’s knee because a television sports medicine
B. A plea for truth in advertising. J Vasc Sur.
program implied a scan should be done, four patients
1990;12:373-374. [4]Vreeland LN. The selling of Retin-A.
specifically requested a new arthritis drug heavily
Money. April 1989:75-87. [5]CBS Evening News. January
promoted on television by a sports celebrity, and patients
21, 1988. [6]NBC Nightly News. January 21, 1988.
stampeded the office requesting blood tests for
[7]Robert Wood Johnson Foundation opinion survey. New
prostate-specific antigen, serum renin, Ca 125, and Lyme
Orleans, La: Healthcare Communications Systems Inc;
disease. The physician concluded, "All of my best efforts
October 1989. [8]Lipman J. |News’ videos that pitch drugs
can be undone in an instant by the education, free speech,
provoke outcry for regulations. Wall Street Journal.
advertising, free enterprise, and capitalism that are the
February 8, 1990;sect B:6. [9]Taylor ST, Mintz M. In video
veritas? a word from your friendly drug company. The Nation. October 21, 1991:480-484. [10]Moore M, ed.
Physicians who appear on television to promote
Health Risks and the Press. Washington, DC: The Media
themselves, and even those who appear with good
Institute; 1989:63. [11]Rosenthal E. Medicine promotes
intentions of communicating useful information, need to
itself, with professional help. New York Times. December
assume some of the responsibility for the quality, clarity,
11, 1991;sect C:1, 16. [12]Oppenheimer J. Doctors on TV
and context of the message delivered and for the impact of
talk shows say viewers and practices benefit. Medical
that message. Consider the role of physician advocates in
World News. September 1991:59. [13]Kirkland D. How to
contributing to the media controversies of the past decade,
get your name in the newspaper or on the air. Am Med
ie, artificial hearts, interferon and interleukin 2,
News. September 2, 1988:13. [14]Buenaflor M. What is a
tetrahydroaminoacridine in Alzheimer’s disease, tissue
gatekeeper to do? Medical World News. July 1991:66.
plasminogen activator in coronary artery disease, and
Gary Schwitzer Mr Schwitzer was formerly the medical
chronic fatigue syndrome. Were these all merely
news producer-correspondent for Cable News Network,
media-created controversies, or were there physician
Atlanta, Ga, and is now affiliated with the Foundation for
accomplices furthering public confusion in these
Informed Medical Decision Making, Hanover, NH. The
views expressed herein are those of the author and do not reflect those of the foundation.
In fairness, the criticisms outlined herein cannot be directed at all public relations people, at all physicians, or at all television medical journalists. However, after 17 years in television medical journalism, I know it is a fair critique of many currently engaged in the dissemination of health and/or medical science news. The spotlight should perhaps also be shined on the work of many print journalists; I chose to focus on television because I know it better.
Time can heal some of these problems. It takes time to cover a medical news beat. Television often doesn’t take that time. It usually doesn’t allow more than 90 to 120
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do not change during prednisone weaning, there are individual variations in response. GEP score change during prednisone weaning is not influenced by gender, age or he-modynamics. This heterogeneity in GEP response has to be borne in mind when usingthese results exclusively to guide weaning pts from prednisone following TX. Further,larger studies are needed to study this preliminary observation.
The information in this leafl et will help you fi nd the right expert care to meet your needs. One out of every four people who go to A&E could have been treated elsewhere in the community, or could have self-treated. Your local pharmacy can help treat common illnesses. A&E and 999 services are for life-threatening and emergency conditions only. By following a few tips, we can all give