http://www.theglobeandmail.com/servlet/ArticleNews/TPStory/LAC/20041230/HPICARD30/TPHealth/
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How can we improve medical reporting? Let me count the ways

By ANDRE PICARD
Thursday, Dec 30, 2004

This is a time of year for resolution and reflection. It's a fitting time
to turn the tables and, instead of casting a critical eye on a specific
aspects of the health system, to look at how well (or poorly) the media
report on health news.

In a recent edition of the British Medical Journal, Gary Schwitzer, a
former medical correspondent at CNN and now a professor of journalism at
the University of Minnesota, presented his "10 troublesome trends in TV
health news."

While the list is too narrowly focused on TV, it serves as a good
jumping-off point.

Mr. Schwitzer makes the important point that most people today get their
health information from the media, and from TV in particular. This puts
heavy responsibility on journalists. But, in his estimation, health
reporting has many shortcomings, which he summarized like this:

1) Too brief to matter. The brevity of stories -- they rarely exceed one
minute on TV or 500 words in print -- means they lack context and
significant details.

2) No full-time health journalists. Networks such as CBC and CTV and
newspapers such as The Globe and Mail have full-time beat reporters, but
they are the exceptions. Most media outlets operate on the wrong-headed
assumption that any reporter can jump effortlessly from covering city hall
to the intricacies of cyclo-oxygenase-2 inhibitors.

3) No data to back up sensational claims. Far too many unproven -- and at
times frankly ridiculous -- claims get aired or printed without even the
most cursory examination of data.

4) Hyperbole. Each day there are reports of miracle drugs and treatments
that are, at best, incremental improvements.

5) Commercialism. At times the "news" is thinly veiled promotional
material.

6) Single sources. Health stories with a single source are commonplace.
They lack balance.

7) Baseless predictions from basic science. Far too many studies conducted
in test tubes or on mice are touted as potential treatments in people. If
only it were so simple.

8) FDA approval treated as an accomplished fact. Consumers are often left
with the impression that experimental treatments and drugs in early phases
of research will be on the market imminently, as if testing and regulatory
approval were mere formalities.

9) Little coverage of health policy. Trivialities like cosmetic medicine
(Botox and the like) get more coverage than critical issues like access to
care and defining what is in the medicare "basket of services."

10) No time for enterprise. Much health reporting is little more than
regurgitation of news releases, medical journal studies and press
conferences. There is little investment in in-depth or investigative
journalism.

Mr. Schwitzer's list is a good one, but it is incomplete. Here are 10 more
troublesome trends:

1) Story selection. Cute trumps meaningful. Quirky or pathos-laden stories,
such as the separation of conjoined twins, tend to get more extensive
coverage than those with broad policy implications, such as research
questioning the value of breast self-examination.

2) Black and white. Health stories tend to be black or white. Vioxx bad;
Aspirin good. Trans fats bad; omega-3s good. But in science and health
research there are a lot of greys; there are rarely absolutes.

3) Jingoism. The media give disproportionate attention to home-grown
research, regardless of the importance or relevance of findings.

4) Short-sightedness. There is virtually no coverage of the greatest
threats to health on the planet: poverty, disfranchisement, and lack of
access to clean water, adequate nutrition and basic sanitation.

5) Too little training. Much research published in medical journals is of
dizzying complexity and its jargon is quasi-impenetrable. Journalists need
to understand statistics and technical language to decipher it, but media
outlets are reluctant to invest in training.

6) Technology-obsessed. There is a widespread assumption in health stories
that newer is better, and that the solution to many problems is found in
better drugs and fancier equipment.

Again, the reality is that addressing basic determinants of health --
income, housing and the like -- carries far more impact.

7) Is it really a cure? The word "cure" is bandied about irresponsibly.
There are many ways of treating and managing disease, but virtually no
cures. And "curing" a rat of cancer is a far cry from curing it in a human.

8) A sense of proportion. SARS killed 44 people in Canada. Influenza and
pneumonia kill close to 5,000 annually. Health issues that affect the
economy and the lives of well-to-do Westerners are blown out of proportion,
compared to issues that affect broad swaths of the population.

9) Lack of skepticism. One of the most important traits for journalists is
a well-honed sense of doubt, about everything. When skepticism makes way
for cheerleading, the result is poor health reporting.

10) Kowtowing. There is a lot of uncritical reporting of the views of those
in positions of power -- physicians, professors, medical associations,
pharmaceutical company executives -- without questioning their
self-interest. This sucking up (for lack of a better term) does a great
disservice to health consumers.

Good health reporting should provide a straightforward, comprehensible
summary of health issues. It has to be more than regurgitation. It needs to
be balanced and provide context to information-hungry consumers.

Good health reporting should rarely be sensational, but always skeptical.

And there should be a lot more of it.

Until the media improve the quality of their work, their criticism of other
players in the health system can hardly be taken seriously.

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