1) Medical journalism is often lacking in providing complete and balanced information about medical studies, procedures, and products. Many news stories fail to adequately discuss benefits, risks, costs, and alternatives. 2) There are several challenges facing medical journalists, including lack of time and resources to thoroughly research topics, pressure to produce more content, and reliance on sources like press releases that may promote certain findings. 3) Both journalists and academic medical centers could improve by taking more time to ensure coverage is balanced, explaining studies accurately and completely, and addressing potential conflicts of interest among sources. Developing relationships with expert sources can also help improve medical news reporting.

1. Shoot The Messengers?
Challenges in Medical Journalism
Ivan Oransky, MD
Global Editorial Director, MedPage Today
Vice President, Association of Health Care Journalists
Adjunct Associate Professor (Journalism), New York University
@ivanoransky
SGIM
San Diego
April 25, 2014

2. Disclosures
I am an employee of MedPage Today, LLC, which is not a
commercial entity, but is wholly owned by Everyday Health, Inc.,
a commercial entity in which I own stock options. I am not
discussing or referencing any product Everyday Health sells, but
because I am discussing medical journalism and that is what
MedPage Today does, I wanted to err on the side of disclosure

4. How Are The Media Doing?

5. How Are The Media Doing?
Schwitzer G. How do U.S. journalists cover treatments, tests, products,
and procedures? An evaluation of 500 stories. PLoS Medicine 2008
doi:10.1371/journal.pmed.0050095

6. 207 stories
• 83 (40%) did not report benefits quantitatively
• 124 did, but
- 103 (83%) reported relative benefits only,
- 3 (2%) absolute benefits only,
- 18 (15%) both absolute and relative benefits
• 98 (47%) mentioned potential harm to patients
• 63 (30%) mentioned costs
• 170 stories cited an expert or a scientific study
- 85 (50%) cited at least one source with disclosed financial ties
- 33 (39%) disclosed these ties
Moynihan R et al. Coverage by the news media of the
benefits and risks of medications. N Engl J Med 2000;
342:1645-1650
How Are The Media Doing?

7. 193 articles reporting at leastone benefit or harm of a drug
100% mentioned at least one benefit
132 (68%) did not mentionside effects or harms
119 (62%) did not quantify benefits or harms
– Of 510 mentions of benefits and harms, only 120 (24%) gave quantitative
information
– In 26% (31/120) the magnitude was presented in relative terms
37(19%) articles reported only surrogate benefits
7 (4%) mentioned contraindications
61 (32%) mentioned drug costs,
89 (46%) mentioned drug alternatives
30 (16%) mentioned nondrug options (such as exerciseor diet)
Cassels A. Drugs in the news: an analysis of Canadian
newspaper coverage of new prescription drugs. CMAJ,
April 29, 2003; 168 (9)
How Are The Media Doing?

8. 193 articles reporting at leastone benefit or harm of a drug
120 (62%) quotedat least one interviewee.
After exclusion of industry and governmentspokespeople, potential
financial conflicts of interest were reported for only 5 of 164
interviewees (3%)
Of 57 articles covering studies, only 15 (26%) includedinformation
on study funding Cassels A. Drugs in the news: an analysis of Canadian
newspaper coverage of new prescription drugs. CMAJ,
April 29, 2003; 168 (9)
How Are The Media Doing?

9. Why Is It So Bad?

10. In a national survey of U.S. health and medical journalists:
• Nearly 70% had at least a bachelor’s degree
• 19% reported having a master’s degree;
• 4.5% had a doctorate; about 3% were M.D.s
• Almost half had a degree in journalism
• 13% had a degree in communications
• 8% were ‘‘life sciences’’ majors
Viswanath K et al: Occupational practices and the making
of health news: A national survey of U.S. health and
medical science journalists. Journal of Health
Communication 2008; 13:759–777.
Why Is It So Bad?

11. The Problem
Fewer reporters are doing more stories, broadcasts,
and blog posts
• Sites chasing a smaller number of advertising
dollars
• Pressure to cover more and more, which places
heavy reliance on journals and meetings
• Doubles down on natural tendency to favor what’s
shiny and new

12. “He Said, She Said” Alive And Well

13. The Problem
Many health reporters feel it’s hard to find
independent experts willing to assist
journalists
They think editors need education in critical
appraisal of medical news
Larrson A. Medical messages in the media--barriers and
solutions to improving medical journalism. Health
Expectations 2003;6:323-31.

14. The Problem
Barriers to improving medical journalism
• Lack of time, space and knowledge (the most common
obstacles)
• Competition for space and audience
• Difficulties with terminology
• Problems finding and using sources
• Problems with editors and commercialism
Larrson A. Medical messages in the media--barriers and
solutions to improving medical journalism. Health
Expectations 2003;6:323-31.

15. The Tyranny of the Anecdote
• Make sure anecdotes are appropriately chosen to
serve the interests of fairness and balance. Avoid the
"tyranny of the anecdote." Personal stories used as
examples must be consistent with the larger body of
evidence. Whenever possible, individuals who had both
positive and negative outcomes should be included.
Statement of Principles of the Association of
Health Care Journalists
http://healthjournalism.org/secondarypage-details.php

16. Poor Risk Perception
• The same risk perception factors that trigger fear in
those who consume the news trigger interest in the
people who report it. For reporters, these “fear factors”
are characteristics of a story that has a better chance of
making the front page or the top of a news broadcast.
For editors and producers hungry to increase the
number of readers or viewers, these factors identify
stories that might grab more attention.
David Ropeik, Neiman Reports
http://www.nieman.harvard.edu/reports/article/10138

17. But It’s Not Just Journalists
Academic medical centers issue a mean of 49 press releases/year
Among 200 randomly selected releases
– 87 (44%) promoted animal or laboratory research, of which 64
(74%) explicitly claimed relevance to human health
– Among 95 releases about clinical research, 22 (23%) omitted study
size and 32 (34%) failed to quantify results
– 113 releases promoted human research
• 17% promoted randomized trials or meta-analyses
• 40% reported on uncontrolled interventions, small samples (<30
participants), surrogate primary outcomes, or unpublished data
—yet 58% lacked the relevant cautions
Woloshin S et al. Press releases by academic
medical centers: not so academic? Ann Intern
Med 2009;150:613-618

18. • Develop relationships
– Answer calls
– Don’t hype
– Don’t just call when you have a paper published
– Send newsworthy items and ideas from other
groups
– Be an reporter’s back pocket expert
• Help news offices write better press releases
What You Can Do

19. Pitch Less, Tip More

20. Use Twitter
• Follow reporters to see what they’re
interested in
• Don’t use it to send the same thing to
30 reporters

21. Avoid Jargon
• Talk to me like I’m your smart 14-year-
old nephew

22. Get to Know AHCJ

23. Get to Know AHCJ
• >1,500 members in 49 U.S. states, >25 countries
• Strict membership guidelines: Journalists only
• Annual conference with workshops, newsmakers,
more
• Website http://www.healthjournalism.org has
reporting guides, blog, tipsheets, other resources

24. Start Your Own Blog

25. ► University of Pennsylvania
Perelman School of Medicine
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THE #1 MEDICAL NEWS SITE FOR
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Credible Authoritative
► Vice President, Editor-in-Chief:
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– 25 Medical news
correspondents, journalists and
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► Vice President, Global Editorial
Director: Ivan Oransky
► Sanjay Gupta, MD, Editor, Gupta
Guide
► #1 Physician Blog: Kevin MD
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► 35 Therapeutic categories
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26

27. Let’s Work to Avoid This