In Depth

AHCJ Award Winners for 2010

By Elizabeth Jensen

The first-place winners of this year’s Awards for Excellence in Health Care Journalism exposed questions surrounding the safety of generic drugs, documented how industry distorted the science surrounding the plastics compound BPA and uncovered a pattern of claims denials by disability insurers.

There was a report on a questionable treatment for autism, another on global cigarette smuggling and an examination of the practice of end-of-life care in the U.S. But some of the winning stories also highlighted more positive aspects in the field, including advances in understanding Alzheimer’s disease and groundbreaking hospital-based programs designed to cut down on urban violence. Marshall Allen, of the Las Vegas Sun, received the award for beat reporting.

The awards from the Association of Health Care Journalists are meant to recognize the best health reporting in nine categories, from print to broadcast and online media, at a time when the organization is concerned that “special-interest groups may seek to sway media coverage by awarding large prizes for coverage of specific medical and health issues.”

More than 250 entries were received this year for the association’s sixth contest. Entries were judged by 36 journalists or journalism professors. Winners receive $500 and have their convention registration and hotel fees covered.

Links to the winning entries are available here.

1. Beat Reporting

First: Marshall Allen, Las Vegas Sun

Las Vegas Sun reporter Marshall Allen was a latecomer to journalism and a reluctant convert to health care journalism. As he was finishing up a master’s degree in theology from Fuller Seminary, he moved into daily journalism and discovered the two have “a ton in common: What we do is stand up for what’s right and stand up for what’s true.”

When he landed at the Sun, an editor convinced him within months to switch from general assignment to health care. He says he’s “no science expert” and at first, “it didn’t sound interesting at all,” but once he got going — he’s been doing it 3 1/2 years — he realized how much “it really affects people’s lives in real and intimate ways.” The stories for which he won covered a hospital privacy leak, doctor pay fraud, hidden obesity surgery costs and a surgery to cure epilepsy. The judges cited his “doggedness,” which “created stories that get the attention of authorities and results.”

He covers national issues from a local perspective, and “I write every story from the point of view of the patient,” he said, because in the world of health care, he finds that “there’s no one to advocate for the patient.” He tries not to take anything from a press release and still maintains good relations with those he covers: “I’m fair and accurate and not out to get anybody.”

2. Trade

First: Joe Carlson, Modern Healthcare, “The Cost of Murder”

The judges had high praise for Joe Carlson’s story about how a few tax-exempt hospitals are reducing gunshot violence with outreach programs to victims. The judges said, “Among the hundreds of stories that have been written on ways to reduce health care costs while making Americans healthier, Joe Carlson’s is probably the most original and certainly one of the most compelling.”

Carlson’s beat is not-for-profit hospitals and the story started last summer when Chicago was being rocked by gun violence. “I got to thinking, isn’t there some connection here,” said Carlson, a former daily newspaper federal courts reporter who joined the trade in 2008. “Hospitals many times are located in communities being besieged by this violence,” and furthermore, he said, the nonprofit ones are “mandated by law to reach out to communities to improve them.” But many limit those activities to anti-obesity, blood pressure or CPR classes and vaccination programs, he said.

When he probed he found a few programs that were working with violence victims from their first visit — to keep them from coming back. He said he learned that “the best predictor of a violent incident is another violent incident.”

[Note: Modern Healthcare, like and NewsPro, is owned by Crain Communications.]

3. Large magazine

First: Katherine Eban, Self, “Bad Bargain“

Freelance health care reporter Katherine Eban had been hearing from sources that the generics market “was the new wild west,” but that, she said, while intriguing, didn’t give her a way into the story. Then when she heard that there was an investigation into generics producer Ranbaxy, she began poking around in earnest. But still, there was “no data, no studies, no head-to-head comparisons, or any obvious way in to a story.”

It took one year, and numerous FOIA requests for records, but she was eventually able to put together what the judges called “a first-rate piece of investigative reporting” for Self, which had previously published a story of hers about counterfeit drugs that led to the book “Dangerous Doses.” “Bad Bargain” raises the warning about lax oversight of generic drugs — by far the majority of the medicine taken today — and the consequences for patients when they don’t get the drugs they think they have been prescribed. The story has had an impact: The Federal Drug Administration, she said, has now agreed to do a head-to-head study of one drug and its generic equivalent that caused so many of the problems documented in Eban’s story.

4. Television

First: HBO, “The Alzheimer’s Project”
Maria Shriver, Sheila Nevins and John Hoffman

“The Alzheimer’s Project” was HBO’s third major multiplatform foray into a public service health campaign, following “Addiction” and “Cancer: Evolution to Revolution.” Its five hours, and companion book and Web content, blended serious science with personal stories of the burdens of the disease for patients and caregivers.

John Hoffman, the series producer, said the program, which was co-presented by the National Institute on Aging, part of the National Institutes of Health, stemmed from conversations with the NIH about where advances had been made in diseases of concern to the public and where “the public might not be aware.”

Alzheimer’s turned out to be “the most-feared illness after cancer,” and yet, he said, “increasingly, there are things you can do in middle age to mitigate your chances of developing Alzheimer’s in older age.” The network “felt that we can use this platform that we have to help people understand advances that, if they knew about them, would reduce their anxiety about Alzheimer’s.”

The judges were impressed with how HBO “took a complex disease and really dissected it in a unique way.”

Next up, for 2012, is the topic of obesity, which will be a project of HBO and the Institute of Medicine, in association with the NIH and the Centers for Disease Control. It’s the first time the three medical bodies have worked together, Hoffman said.

5. Small magazine

First: David Case, Fast Company, “Warning: This Bottle May Contain Toxic Chemicals. Or Not.”

David Case, a veteran freelancer who is now the editor of Passport, the membership service of international news Web site GlobalPost, first started reporting his story on the possible dangers of the plastic compound BPA, or bisphenol A, a decade ago. He pitched the story “many times to editors over the years, but it wasn’t ripe yet.”

So he took his box of notes and cassette tapes with him on every move — to San Francisco, Washington, Philadelphia and New York, each time debating whether to toss it. In mid-2008, his diligence paid off with an assignment, but it took another nine months to pull it together.

“The story involves several very determined groups of people trying to keep BPA on the market, one of the biggest industrial chemicals out there,” said Case of the challenges. The other, he said, was making sure everyone understood the science.

For the judges’ part, they found that “our trust in science was shaken after reading Fast Company’s investigation,” which argued that manufacturers had funded scientific studies that exonerated BPA, muddying the debate when independent studies turned up evidence it caused health problems. The article was cited by BPA researcher Fred vom Saal, of the University of Missouri, in an e-mail to Case, as helping shift the reporting, such that “on January 15, 2010, the FDA announced that it was reversing the decision it had reached in 2008 that it considered BPA safe, and instead identified concern about exposure to BPA and recommending approaches to reduce exposure while it worked with industry to eliminate BPA from a number of current uses.”

6. Community papers/regional wire and Web sites

First: Evan George, Los Angeles Daily Journal, “Disabled and Denied”

This series of articles began, writer Evan George said, when he was having lunch with a source, trolling for ideas, and “she mentioned it in passing,” but it took eight months to pull the pieces together.

He first thought he might find a few cases in which insurance companies were denying disability benefits to people even though they had already been deemed disabled by the government and approved for Social Security. George eventually reviewed 576 cases, and found that the practice was widespread. “The general rule is you find three cases and that’s a trend,” he said, but this story turned out to be “more compelling than we had expected.” The AHCJ judges cited his “thorough reporting and exhaustive analysis.”

One challenge, he said was “wrapping my head around, and my editor’s head around, exactly what was at issue. Whenever a story idea or case comes from a law professor, you know you’re about to delve into something not too flashy or easily understood.” He also spent time confirming that the victims really were victims, and not scammers. And he ran into frustrations dealing with the state Department of Insurance and federal regulators, “everybody pointing fingers in a different direction.”

The Department of Insurance, Wood said, maintains “they still do everything they can,” and they “felt very slighted by the stories.” They threatened never to talk to him again, he said, but have since relented, although “they have not been warm.”

7. Radio

First: Rachel Gotbaum, Anna Bensted, George Hicks
WBUR, “Quality of Death- End of Life Care: Inside Out”

Independent public broadcast reporter/producer Rachel Gotbaum, a special correspondent for Boston public radio station WBUR, got interested in the topic of end-of-life care because she and her colleagues “all have elderly loved ones and we know that we’re in a region where we have the highest cost per capita of health care in the country.”

Statistics showed that different regions of the country spent different amounts of money on end-of-life care “and I wanted to find out why,” Gotbaum said.

The result was what judges called “an insightful look into costs, ethics and real-life accounts that are bound to make listeners ponder some serious questions.” Gotbaum found that the attitudes of patients, as well as doctors, accounted for some differences.

The reporting, in which Gotbaum was in some cases brought to people’s death beds, was a bit like war reporting. “I could think I was going to go in and make a plan to get something, and I never knew what was going to happen,” she said.

Gotbaum, who specializes in reporting on the “the culture of medicine,” noted that “this kind of reporting is very expensive and very important, and we hope to continue to fund it and find money for it.”

8. Multimedia

First: International Consortium of Investigative Journalists, Center for Public Integrity, “Tobacco Underground”

A decade ago the nonprofit International Consortium of Investigative Journalists, part of the Center for Public Integrity, exposed how big tobacco companies were colluding with organized crime worldwide to evade taxes and get market share. But much about the multibillion-dollar global trade in cigarettes had changed in subsequent years, said David Kaplan, the editor and project director of “Tobacco Underground.”

With funding from the Johns Hopkins Bloomberg School of Public Health, ICIJ looked at the new money, smuggling routes, technology, globalization, revolutionized communications and emergence of significant counterfeiting powerhouses that had changed the equation, Kaplan said.

“What was fascinating to us was these massive black markets that arose to meet the demand, and as investigative journalists that brought us in and was a great way to tell the story, which at bottom line is a health story about increasing addiction and dumping low-cost cigarettes on unsuspecting subjects.”

The multilingual, multinational project was compiled by 22 reporters in 14 countries over 18 months. As the judges noted, the reporting led to “tougher controls adopted by the World Health Organization, an investigation by Serbian authorities, and exposure of Paraguay’s largest tobacco company,” which tried to stop publication with a bribe. As Kaplan noted, “we’re one of the few news organizations that can field a team like this and take on very difficult targets like multinational corporations and organized crime and smuggling routes and black markets around the world.”

9. Metro papers/national wire and Web sites

First: Trine Tsouderos and Patricia Callahan, Chicago Tribune, “Dubious Medicine”

Trine Tsouderos and Patricia Callahan’s reporting on controversial treatments for autism got plenty of attention, and not all of it good. A quick Web search turns up plenty of vitriol from parents — one called it a “trash series” — who disagreed with the reporters’ conclusions that the treatments are “uncontrolled experiments on vulnerable children.”

The judges, however, called the series “first-rate medical writing and rigorous investigative reporting,” written with “total command of the material.” The reporters vetted each of the alternative treatments with recognized medical experts to conclude that they were ineffective.

Tsouderos, a former entertainment and features reporter, had just been named to her “dream job” as the paper’s science and medical writer and had never tackled autism before this series. Although as a mom, she says, “autism is always in the back of your head,” she hadn’t thought about the topic much, noting, “I definitely didn’t come in with any preconceived ideas.”

Tsouderos and Callahan, a Pulitzer-winning investigative reporter for the paper, produced five major pieces for the series. They had expected some backlash, Tsouderos said, “but we didn’t really expect the amount of positive response we got. We heard from far more people who were happy we wrote the stories than the negative.”