Practicing in the Public Eye continued
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Because of this omnipresent threat—and because typical malpractice insurance doesn’t cover against advice dispensed in public—Peeke recommends that all doctors who are working in the public arena take
precautions.
“You have to be careful about this,” she says. “What if someone listens to me and I say, ‘Take XYZ,’ and they take it and get sick. They might sue me. It’s never happened to me, but I’ve seen it happen.”
Peeke says that a doctor should call his malpractice insurer to see what it
recommends and maybe even have a conversation with an entertainment lawyer “about your precise role and how you’re identified on TV.”
However, not all physicians who work in the public eye agree. Even though
malpractice doesn’t cover their work, both Prewitt and Donohue see no threat in dispensing medical
information in public forums.
“I don’t make diagnoses by mail,” says Donohue, “And I truly hedge on my advice. I say you should confirm everything with your
own doctor. I’m not telling anyone to do anything dangerous.”
Indeed, the information usually dispensed by doctors is often available from
government agencies. There are, however, interesting situations that might
arise whenever a doctor interacts with the public.
In the course of answering one letter, Donohue casually remarked that he
considered the knee “an evolutionary mistake.” He was surprised to find out that his comment generated significant backlash
among people who do not believe in evolution, and letters poured into his
office.
“They were really ranting at me,” he says. “It was such an innocent remark, but people were really up in arms.”
Where ethics are concerned
Donohue’s brush with controversy may have been innocent, but it serves to highlight a
larger truth: The practice of journalism has rules and patterns unique to itself, and when it
comes to health-care reporting, ethics are exceedingly important. Because of
their education and experience, doctors are trusted figures, and having a
public audience magnifies the impact of their words many times over.
According to specialists in health-care journalism, doctors who transition into
the media—even in small ways—will suddenly confront a new set of ethical challenges. Among the most obvious
are companies that want to cash in on your credibility by paying you to promote
a product. This is the kind of thing that, while tempting, leads to the
perception that you can’t be trusted.
In fact, any appearance of impropriety can cause serious damage to your
credibility. The larger the audience, the greater the damage. For a physician
like Peeke, with a national following, it’s a bad idea to even hold stock in pharmaceutical and medical device companies
because these are the same companies she might someday report on.
Outside of financial relationships, there are other issues that must be
confronted. In clinical practice, physicians generally learn treatment
protocols that work best for them. Similarly, many doctors prefer certain
surgical techniques to others and are unabashed supporters of these techniques.
One obvious example is the interventional cardiologist who favors angioplasty
and stenting over bypass surgery.
However, quality health-care journalism requires that these
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Learning from
Michael Moore
Forget the question of politics for a second and consider the possibility that
shock documentarian Michael Moore has proved an important point when it comes
to health-care reporting: There is a hunger for information about health-care policy.
Sadly, this need is going largely unfulfilled throughout the media. Instead,
newspapers, magazines, and broadcast outlets focus on the newest gizmo or
procedure, while virtually ignoring an issue that is threatening to overwhelm
the American middle class.
“Why are people plunking down $8 to see Michael Moore’s Sicko?” asks Gary Schwitzer, an associate professor and director of graduate studies
for the masters program of health journalism at the University of Minnesota. “I think it shows that people want a discussion of health-policy issues.”
But these stories are the “broccoli” of health-care reporting, not the “hot fudge.”
“They’re tough, and they can be dull, and they’re deep,” Schwitzer says. “But we’ve got 45 million people without health insurance. We’re one of only two countries in the world that allows direct-to-consumer drug
advertising. And how meaningful is the national conversation we’re having on health care? I think journalism has an agenda-setting
responsibility.”
This may pose a special challenge to physicians, says Schwitzer, who are
probably better equipped to tell the story—but may not want to.
“I’m concerned that these are the kinds of stories that a member of the ‘club’ isn’t going to want to tell, even though they know that stuff better,” Schwitzer says. g
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sorts of biases do not seep into the reporting.
“The transition from clinical practice to being a reporter should not be a smooth
transition,” says Gary Schwitzer, an associate professor and director of graduate studies
for the masters program of health journalism at the University of Minnesota. “A physician is trained in an entirely different area, and there is not an
automatic overlap.”
According to Schwitzer, there are two major areas where physician journalists
tend to have problems. The first is known as “advocacy journalism.” This occurs when a doctor goes into a story with an agenda and ignores evidence
that might contradict an original bias.
“In the last few years, it’s been very fashionable for doctors to go into television or write columns in
newspapers, but a lot of it is promotional and the public doesn’t know that,” says Trudy Lieberman, the president of the board of the Association for Health
Care Journalists.
This includes physicians who have financial relationships with pharmaceutical
companies or hospitals. To be a responsible member of the media, it is
important that these ties are either disclosed or you sever your ties with any
health-care corporations.
Peeke says, “I have a rule that I’ll never be a spokesperson for anything. You’ve got to know the consequences.”
The second challenge facing doctors in the media is the medical equivalent of “gotcha!” reporting. This happens when news stories are based on single studies or
inadequate evidence and heavily hyped. The vast majority of the public has no
idea how medical practices and standards are developed. They don’t understand how clinical trials work or why it often takes years for the
medical establishment to adjust to new information.
“A lot of physician journalists become enamored of the newest, brightest thing in
health care without reporting important questions of cost and benefit,” says Schwitzer. “A lot of the folks I see on TV fall into a trap of things that seem to make good
TV but don’t do the important grunt work of, ‘Where is the evidence? Is it going to work? Who has access?’”
This situation is perhaps worst in broadcast, where the average network news
health story runs 90 seconds. At the local level, the average story runs only
75 seconds.
Ultimately, it’s about passion
The decision to pursue a sideline career, or even a career change, in media
might be driven by a lot of things, but money shouldn’t be the leading one.
It’s hard to find salary reports for medical correspondents, but it’s safe to say that for every multimillion-dollar, national network contract,
there are many relatively poorly paid positions.
“Never, ever, ever do media for the money,” Peeke says. “People are misinformed when it comes to this. You’ll get paid well if you’re doing well and if you’re national. But the bottom line is you don’t do this to get rich. You do it to augment who you are. You’ve got to do a passion check. If there’s no passion, it’s going to be a hard sell.”
At least in the beginning, it’s going to require some selling. Media is not an easy industry to break into,
even for physicians. At first, this means you will likely be offering
information for free to television stations or writing articles without the
guarantee of publication or pay.
Donohue says: “If you want to break into syndication, start with a local newspaper and see how
your work is reviewed. Then market it to one of the larger newspaper
syndicates.”
If, however, you are the type of doctor who thrives on public exposure and who
is sensitive to the unique demands of the media, being a “media doc” can be richly rewarding.
“When it comes to the media, you have to think on your feet because you never
know what’s going to happen,” Peeke says. “The bottom line is, is it fun and can you fit it in with being a physician?” c
Jon VanZile is a medical writer and editor living in South Florida. His writing
has appeared in many magazines, newspapers, and Web sites.
