By Debra Kaufman
It’s impossible to talk about the state of health care journalism in the U.S. today without noticing the elephant — and the donkey — in the room: the debate over health care reform that dominated headlines, sound bites and Internet posts in 2009 and early 2010.
“It’s the best of times and the worst of times in health care journalism,” said Gary Schwitzer, who is leaving his post as associate professor at University of Minnesota School of Journalism and Mass Communication to devote full-time efforts to publish HealthNewsReview.org. “We’re talking about a spectrum of fantastic efforts by hard-working journalists who clarified the confusing picture out of Washington.
“At the other end of the spectrum, others chose to focus on the horse race of politics and did as great a disservice as any that I’ve seen,” continued Schwitzer, “because journalists allowed such a polarized view to be presented — absolutely nonfactually based, ridiculous assertions, such as the ‘death panels’ — without questioning them.”
Trudy Lieberman, immediate past president of the Association of Healthcare Journalists (AHCJ) and a contributing editor to the Columbia Journalism Review, notes the irony that “we’ve lost capacity in health care reporting at a time when its need is really great. What I’ve seen is a lot less local reporting on the health care reform issues,” she said. “A lot of local news outlets rely on AP and other wire organizations.”
The launch of two nonprofit newsrooms that distribute stories to other news organizations was a serendipitous turn of events to ameliorate some of this loss of capacity: ProPublica, which began publishing in June 2008, and Kaiser Health News (KHN), which debuted June 2009, are continuing to build their relationships with major news organizations and in-depth stories.
Laura McGinley, KHN executive editor, pointed out some of the upsides of the focus on health care reform for health care journalism. “This is a time of intense interest in health care and even things that are incredibly wonky are getting attention,” she said. “I wouldn’t be surprised if there was some health care fatigue for awhile. But I also think people are paying attention and have learned a lot about how the health care system works or doesn’t. I would hope there would be continued interest.”
Schwitzer is concerned that the political skew in covering the health care reform debate has impacted coverage of other health care topics, in particular that of screenings and tests. When, in November 2009, the U.S. Preventive Services Task Force raised the recommended age for beginning mammograms from 40 to 50, based on the low risk of breast cancer between ages 40 to 50 and the risk of false positives and complications from biopsies, much of the coverage focused on the emotional reaction rather than the evidence-based results of the task force. “This was a nonpolitical story that was made to look political and allowed this polarized frenzy to be whipped up,” said Schwitzer. “It’s a bad harbinger of things to come.”
Not everything is bleak when it comes to health care journalism. This past year also saw the Internet establish itself as a more important new medium for serious health care journalism, and not simply on the Web sites of ProPublica and KHN. “The blogosphere is growing, much more than five years ago,” said Lieberman.
Andrew Holtz, a former CNN medical reporter who is now senior news editor at startup MDiTV.com, said he agrees. “Everybody is trying to make sense of how you do journalism using the new technologies and also taking into account how those technologies have changed the business,” he said. “It’s sometimes happening by choice, other times by necessity as the old news organizations shrink.”
MDiTV.com is a for-profit venture that is video-based. “It’s like watching on-demand TV,” explained Holtz. “Health has always been big on the Internet, and video is catching on as more people have broadband.”
Online sites and blogs also allow for niche journalism and stories unhampered by the need to adhere to time or word limitations. Dr. Ivan Oransky, executive editor of Reuters Health at Thomson Reuters and AHCJ treasurer, also notes the rise of “people doing things that are clearly journalistic who are not full-time journalists. This is an increasing trend partly because the barrier to entry for publishing is much lower,” he said. “And because of the shortfall in the number of health care reporters due to layoffs.”
Although the quality of coverage varies, Oransky (who has his own blog) is enthusiastic about several bloggers, singling out Schwitzer’s HealthNewsReview.org site, as well as Dr. Daniel Carlat, who is also an associate clinical professor of psychiatry at Tufts University School of Medicine, and Dr. Val Jones who, in addition to her own blog, The Voice of Reason, also brought together a network of health care bloggers. Lieberman also blogs about health care for the Columbia Journalism Review at CJR.org.
Currently, most serious bloggers have a day job, although other health care journalists are doing their best to create a business model that will replace jobs lost in traditional media. For now, however, the irony persists that, at a time that health care issues take center stage, the economy and the sea change in journalism both conspire to limit coverage.
“It’s still tough out there,” said Holtz. “Health journalism isn’t really different than what’s happening in newsrooms in every part of journalism and the economy. We have to hope this is close to the bottom, and we’ll climb on up from here.”