In Depth

Doctor On Call for NBC News

Snyderman Works Across Media Platforms to Explain, Interpret Health Care Stories

As NBC News’ chief medical editor, surgeon Dr. Nancy Snyderman is literally on call for whatever medical or health issues need to be discussed on the air. Since joining NBC News in September 2006, after a 17-year tenure at ABC on “20/20” as well as “Good Morning America” and the network’s other news shows, she has been seen regularly on “Today,” “NBC Nightly News With Brian Williams,” “Dateline NBC,” MSNBC and MSNBC.com. In anticipation of the Association of Health Care Journalists conference in Washington that opens March 27, Dr. Snyderman spoke with TelevisionWeek correspondent Allison J. Waldman about the current state of medical journalism at the network level.

TelevisionWeek: How do you see your position with NBC News?
Dr. Nancy Snyderman: My title is chief medical editor. I have the great fortune of stepping into the arena where Bob Bazell has done some fabulous work for 25 years covering science, and what we’re trying to do right now is the science and the medicine including health and wellness. We’re dealing with issues of the marginally insured, breaking news, news you can use, all that stuff, so we at least have our eye on it. The challenge is every day what to cover and what not to. There are times when there may be medical studies that are fascinating to me as a surgeon, but I’m not sure they’re applicable to my audience. There are times when things cross my desk that I feel I’ve known forever, but I have to ask myself if my viewing audience sees it the same way. Each day I’m making those decisions.

TVWeek: When it comes to choosing what to cover, where do you start?
Dr. Snyderman: Fortunately, for me, I have an extraordinary, helpful group of senior producers to bounce ideas off of. I try to get a view of the landscape out of the big journals the week before; for instance, today I’m reading the Journal of the American Medical Association so I can get an idea of what might be a big story in the week ahead. Then, every morning, I try to figure out if we should react to breaking news. It’s a combination of doing real reporting on stories that matter to me, like right now I’m doing a story about public hospitals and how they’re in crisis in this country. Then I have the journals and the breaking news of the day. It’s trying to find what to do in the constant mix.

TVWeek: The way you describe it, you have quite a balancing act.
Dr. Snyderman: It’s all a balancing act, a phenomenal balancing act, and hoping that I don’t let any of the crystal balls fall through the cracks. There are times when I disagree with my team. Yesterday was a perfect example of what I chose not to cover, but the New York Times did. There was a story on polyps and colonoscopies, flat ones versus regular ones.

TVWeek: CBS did that story with Dr. Jon LaPook …
Dr. Snyderman: Yes, on Katie Couric’s broadcast. I chose to pass. I looked at that and thought, “Interesting story, but what’s the take-home message for the patient?” You know, like watch the video while your doctor is doing the colonoscopy? Are you supposed to say, “Oops, I think you missed one”? So to me it was a fascinating report for doctors and [gastroenterology] people, but I thought there were more important things than that for our “Nightly News” audience. We decided to cover, instead, the 40,000 people who got notifications letters in Las Vegas that they may have been exposed to infected needles. That was my decision for the day. We went with the Las Vegas story, and the next morning, as I said, [the colonoscopy story] was on the front page of the New York Times. And I still didn’t believe that it was a story for me to cover the night before. So there’s always a lot of soul searching: “Did we make the right choice or not?” And, of course, there are times when we just miss it. But this last week was a classic example of trying to figure out if it was important news, and if so, is there something of importance for my patient/viewing audience? Is there something for them to learn?

TVWeek: Do you have a limit on what you can cover each week and on how much airtime you’re given?
Dr. Snyderman: I have sort of a wacky schedule, more than maybe other medical correspondents. I’m always on deck for the “Today” show. There was a time we did a series on cancer, maybe a month or so ago, so I know that’s coming and I can make it a rich series and plan. But I’m always around for breaking news. Yesterday, it was Patrick Swayze’s pancreatic cancer. That’s when I have to put on my doctor hat, because I’m very sensitive to not making conjectures when I don’t know all the information, but at the same time, you have to see it as a basis for explaining pancreatic cancer to people.

TVWeek: Is that an example of where you don’t want to exploit the subject but you have to cover it because people are curious about it?
Dr. Snyderman: There’s always the “Oh my God, could this happen to me?” There’s the voyeuristic aspect of it—a celebrity got something bad. Then there’s the “Tell me it won’t happen to me,” and with that, I think it’s important that people like Dr. LaPook and me do a little bit of hand-holding. You get to say to your audience, “It’s OK. This is rare. It’s probably not going to happen to you. These are the things to watch out for just in case.” That’s important. I’m also responsible to MSNBC during the day, maybe for little drop-ins or hits to explain something. Of course, there’s “Nightly News,” which is a different audience, so I tell a slightly different story with regard to Patrick Swayze. If you go back to that big spinach contamination case, that was a classic story that was on MSNBC and “Nightly News,” and I told it differently for each audience, but there was an urgency and newsiness to it that wove all of NBC News together. I’m very lucky, too, because Ami Schmitz, who was my medical producer for “Good Morning America,” came with me to NBC. I have a really well-oiled machine.

TVWeek: You’re basically available whenever NBC needs you, is that it?
Dr. Snyderman: I’m no longer on call in the hospital, I’m on call for NBC.

TVWeek: What’s the most difficult part of being a medical journalist once you’ve decided which story you’re going to do?
Dr. Snyderman: That’s a two-fold question. I’m very wary about the “mouse” science that isn’t necessarily relevant to the person sitting at the kitchen table. I think you always have to say, “Look, this is a really cool breakthrough and here’s what’s coming,” but always let people know it’s not going to be in your doctor’s office tomorrow. You have to let them know what’s coming down the pike because that’s what makes science interesting. Then the other part, I think something happens to physicians as they go through medical school and residency. The more letters and credentials we get to put after our names, the less able we are to speak English and just converse. I’m constantly saying to doctors, “You have to talk plain.” That doesn’t mean you talk down to somebody. It means there are times you use medical jargon and there are times you don’t. For me, a television camera is really no different than sitting down at a patient’s bedside. If I sit down at a patient’s bedside to explain a surgery for the next day, I speak very differently than I do if I were speaking to one of my colleagues at Penn. But never do I talk down to a patient. It’s the same when I’m talking to a television audience. You take the complicated words and the complicated concepts and you simplify them, but never in a condescending way.

TVWeek: Are there situations now where you’re finding that people are diagnosing themselves on the Internet and have too much information?
Dr. Snyderman: I call it the Internet Syndrome. The Internet Syndrome hits me when I’m seeing patients, and I definitely see it when viewers write in. Sometimes they’ll criticize me, sometimes they have story ideas, but there is a lot of erroneous information out there, so what I hope I’m doing is laying a road map between what we know is truth and what we know are myths, and—just as important—admit what we don’t know.

TVWeek: Do you use new media to help tell your health care stories on MSNBC and the NBC Web sites?
Dr. Snyderman: Yes, yes, every day. For instance, on the hospital story that I’m doing now, I will not only post interviews in the long format, but we will re-cut stories. We will do blogs and vlogs, video logs, when appropriate to the story, and I also want the audience to know that I’m receptive to hearing from them and we will try to even answer viewer e-mail. I can’t answer everybody, but I constantly check to see what his or her feedback is. There are times when people will say, “Hey, you got this wrong.” I may not have the luxury of going back on the “Nightly News” and saying, “Oh, by the way, I got this statistic wrong,” but I will address it at least electronically. There’s no doubt in my mind that when I came to NBC a year and a half ago, I came here because I believed it was the best place for me to blend new media and old. I don’t even think the Web today is emerging—it’s here. My work must be integrated across all platforms, and in a perfect world we’d be doing radio, too. I am very, very, very sensitive to viewers who write in. A lot of times on “Today”—yesterday was a good example—I did an 8 o’clock segment and said, write me your questions or comments. I came back two hours later and addressed some of them. I think that using television and the Web as a basis for a conversation is a way to explain, teach and, frankly, respect my audience.

TVWeek: What do you say to people who cannot afford health care?
Dr. Snyderman: Did you see the “60 Minutes” piece the other night? They took it from a front-page article in the New York Times over the summer or last fall. When you see people being treated in a fairgrounds in this country, every American should take pause and say, “What’s wrong?” I find this terribly, terribly painful. It was a crime seeing that on “60 Minutes.” I have a very good friend whose politics are very Republican. He’s the head of the American College of Surgeons. He’s a big, brassy guy and he said to me, “I never thought I’d say this, but I think we’ve got to talk about a single-payer system. How can we not be taking care of people?” So I think you’re starting to see physicians, who wouldn’t have said this 20 years ago, because we ethically and morally know that we’ve got to do something.
When you have people who work for a living, they pay their taxes and they can’t afford insurance, something is wrong. When you have veterans being denied help at VA hospitals because something isn’t service-related, something’s wrong. I’ve heard someone say, “Yes, but I’m 23, blah, blah, blah. It doesn’t make sense for me to pay for insurance….” You know what I say to him: “When you get hit by a car, and you get taken to the hospital, every other person who has insurance will pay for that.” Premiums go up, there’s someone who won’t have food in the food bank that day, there’s a ripple effect throughout our economy. With my doctor’s soapbox hat on, we cannot be a strong economy globally if we aren’t a healthy nation.

TVWeek: What about people who know they are sick, but put off seeing a doctor because of insurance issues?
Dr. Snyderman: I had a patient see me. He had terrible, rotting teeth. I said to him, “I don’t want to be rude, but why have you let this go?” He said that he had to make a decision in November: Pay the heating bill or see the dentist. He needed to keep the heat on, so he paid the bill. We would be criticizing another country if we heard stories like this. I really hope, whoever is president, that we have a totally different dialogue this time about how to make this right. There needs to be recognition that everyone is going to have to give a little. It’s going to be a huge compromise. Everyone has to give a little and we’ll all come out better.

TVWeek: You have strong feelings about this, don’t you?
Dr. Snyderman: This whole thing tears at me. I saw a guy last week that has cancer of the neck. His referral letter didn’t get to me for two months because it was held up through some bureaucracy through the Veterans Administration. That’s not OK. Those are the things that make a difference between someone doing well and someone dying. And now, unfortunately, hospitals are a great place to get sick.

TVWeek: What are the health concerns that you hear about most from viewers?
Dr. Snyderman: Even though heart disease and stroke kill more people than cancer or anything else, it’ll be cancer. And people are sometimes fascinated by some of the lighter topics and myths. They love it when we dispel myths. They love it when we dispel urban myths. It comes down to the economics of how to handle health care, health care coverage, they’re worried about that, and then cancer stuff. Screening tests, how can I avoid it. That’s what they want to know.

TVWeek: Are you still practicing medicine?
Dr. Snyderman: Yes, at the University of Pennsylvania; I have a faculty appointment there. I have always seen patients. I fell into television, it was somewhat accidental. I always knew I was going to be a doctor since I was in third grade. Because the people I work for have recognized that, by seeing patients, it gives me a very different view of the world, I’ve always had support from the people at ABC News and now from NBC News to keep that part of my mind going. I stopped my private practice, but I see patients with residents. It allows me to teach young surgeons and humanists, but frankly, I need contact. I’m a doctor and I think being a physician makes me a better communicator on television. And I think being a journalist has opened my eyes and made me so much better read than I might normally be, and therefore a better physician. They really go back and forth. On a paranoid level, if someday an executive says, “I no longer like her face,” I can still put food on the table. And there’s a part of that, that Midwestern girl inside of me, that I’ve always needed to know that I’m still a physician.