By Debra Kaufman
Special to TelevisionWeek
Health care is one of the fastest-growing sectors of the U.S. economy, currently at 14 to 15 percent of the gross domestic product and, by 2015, predicted to rise to 20 percent. No wonder, then, that health care journalism has become an increasingly important beat on local and network news.
“You have millions of people who work in the industry, not just concerned with how it affects their health but how it affects their job,” said Andrew Holtz, an independent journalist and board member of the Association of Health Care Journalists. “You have life, death, money and politics all wrapped up, and there’s a human angle to every story.”
As the AHCJ prepares for its annual convention this week in Houston, Mr. Holtz, who has been a full-time health care reporter since 1987 at CNN, talked about how the health beat has changed. He has seen it evolve, he said, from something out of the ordinary into a commonplace component of a newscast.
“It’s astonishing how many new pills, devices and procedures there are,” he said. “And the demographic for TV news has been getting older, as has the nation, and as baby boomers move through middle age, they get interested in health in a way younger viewers wouldn’t.”
For the local TV station and network, health care reporting can equal a healthy bottom line. “It’s no secret that health news sells,” said Dr. Maria Simbra, a medical reporter for KDKA-TV, a CBS owned-and-operated station in Pittsburgh and an assistant professor of neurology at the University of Pittsburgh Medical Center. “In a ratings-driven industry, producers and news directors take advantage of this to attract an audience for their newscasts. And viewers respond. In a 1998 survey by Rodale Press, 39 percent of respondents said they turn to TV for health and medical information.”
At the same time that health care exhibits all the qualities of a winning beat, the field of TV health care journalism itself is ailing. Dr. Simbra noted that a “dedicated health and medical reporter is a luxury at many stations,” and many medical reporters double as anchors or general assignment reporters.
“If the station’s goals aren’t met and if covering this beat requires too many resources, a manager will easily make the decision: Cut here,” she said.
That’s exactly what happened to Christine Miles, an eight-year health care journalist. She covered the health care/medical beat at KOIN-TV in Portland, Ore., for the past five years, until the station was bought out and her contract was not renewed. She recently signed with WECT-TV in Wilmington, N.C., where she will be the morning show news anchor-and she hopes to cover health as a sideline.
In Tampa, Fla., on ABC affiliate WFTS-TV, Linda Hurtado also does double duty, as a news anchor and a medical reporter, the latter a beat she has had for nearly six years. She tries to do a health segment every day at 5 p.m., she said, and relies on the ABC Network’s medical unit, which provides daily and weekly information about breaking health care stories.
All journalists who cover health care, either full time or part time, face twin obstacles in reporting the often complicated stories that make up today’s medical landscape. First, staying on top of the immense amount of health care news generated on a daily basis is a near impossibility-especially for those with part-time or occasional health care beats. Second, TV station managers want the kind of unequivocal, flashy headlines that are often at odds with the multilayered, complex nature of medical news.
“Medical reporters are challenged by the mountain of health and medical information they need to digest and quickly sift through every day,” Dr. Simbra said. “And they need to deliver their reports in less than 90 seconds-perhaps enough time to be sensational, but not enough time to explain all the caveats.”
More Harm Than Good
That’s a problem that concerns many in the health care journalism field. “It’s almost to the point where I think that the viewing public would be better served if there were no health news,” said Gary Schwitzer, director of the health journalism graduate program at the University of Minnesota School of Journalism and Mass Communications. “I think more harm is being done than good by the skewed and imbalanced and incomplete and commercial-like presentation of news that tends to focus on new ideas, new drugs, new devices, new procedures. Many of the stories rely on a single source, many of which have a vested financial conflict of interest that can do harm to the receiving public.”
Health care journalists are often hard-pressed to vet all the information thrown their way, much of it by sources whose interests or biases aren’t patently evident. Ms. Miles said she tried to stick with local experts whose credentials she knew were valid. “If someone was touting that they were from Duke University, I’d call Duke to make sure,” she said. “Sometimes their credentials were blown way out of proportion.”
Adding another challenging twist, the beat is often covered by reporters with little experience in the complex health care field. Mr. Schwitzer conducted a four-month, four-station analysis in the Minneapolis-St. Paul area two years ago that revealed that 58 people worked on health news stories, none of them assigned to the beat full time.
ABC News created a dedicated medical unit 10 years ago to improve this situation. “When I created it, I believed that what we needed was a way of making sure we were evaluating medical information by getting a range of views of varying experts,” said Managing Editor Roger Sergel. “I approached medical centers to request permission to have direct e-mail access to their top experts, and we now boast a network of over 12,000 experts in over 200 different specialty areas.”
When a medical study is coming out, Mr. Sergel’s unit sends the study to that field’s “thought leaders”-groups ranging in size from 25 to more than 300-and invites comment. “We certainly get enough response on most of the issues that we send out to feel very confident in where we are on a story,” he said.
The ABC medical unit also sends out a daily memo summarizing the most important upcoming health care stories for the next four to five days to key people at all the ABC news programs and more than 50 ABC-affiliated stations, medical producers and reporters. The responses of the experts are attached, and if video is available that information is included as well. “It’s a system designed to allow drilling down for increasing amounts of information,” Mr. Sergel said. “We’re regularly making decisions in how we handle information in the memo that will signal to our programs and affiliates what we think is important.”
Though ABC health care reporters have a leg up with vetted study information and sources, they still face the same kinds of tight time constraints found at other networks in putting the story together-and keeping it to 1:20. Ms. Miles recalls her difficulties in convincing local health care providers that it was possible to do justice to a story given so little airtime. “For me, it took time to build up trust with them that this wasn’t a drive-by medical report and that I truly do care about health care issues,” she said. “I really depend on the doctors never getting tired of my questions. I depend on them to break it down for me.”
But the potential for confusion-and viewer backlash-is always present. Dr. Simbra noted that some TV stations shy away from medical/health care stories because viewers get confused-and then angry-about reports “claiming something is good for you one week and then bad for you two weeks later.”
“I believe this reflects how inadequately television news understands and communicates the scientific method,” she said. “The media-and perhaps the public-want definitive, sensational health news. But the slow, methodical and sometimes equivocal nature of medicine and science just doesn’t work that way.”
Are health care issues simply too complex to be handled in 1:20? “Yes and no,” Ms. Miles said. “There are so many layers to a story. But sometimes the 1:20 is better than a 3:20 because if you gave all the information at once, you’d confuse people. By taking it topic by topic, it helps to make it easier [to understand].”
Mr. Schwitzer would like to see hard-hitting health care reporting that focuses on the big issues in the field. “TV news seems to have a real avoidance of the important policy issues,” he said. “But why is it during sweeps season that we see an explosion of health stories that run from between four to nine minutes? You can’t hide behind the shield of saying you don’t have enough time.”
“There’s the old line that consultants tell news directors that if their numbers are down, add a health story-and if your numbers are really down, add two,” he said. “Yet consultants don’t take the next step and tell stations how to do health care reporting in a quality manner.”
Mr. Schwitzer doesn’t point the finger at individual TV health care journalists. “The management and corporations squeezing them have to take responsibility for the product we’re getting,” he said. “Polls consistently show that many if not most Americans get their health care news and information from TV. And at the same time, a 2002 Gallup survey showed [TV] is the least trusted source.”
The local station Web site is another potential resource for health information, but Mr. Schwitzer said he hasn’t seen it used effectively yet. “The potential is great,” he said, ‘but the experts on these Web sites are cash-and-carry propositions. They aren’t independently derived. This is nothing but another advertising vehicle; these people pay to be experts on the Web sites.” The same lack of time to create longer, more hard-hitting, multisource articles on local news is behind the inability to create Web sites that archive information from a wide variety of reliable sources.
On the ground, local TV reporters now face another obstacle to putting stories together in a timely fashion: HIPAA, the 2000 Health Insurance Portability and Accountability Act, which took effect in 2003. The Act was implemented to improve the privacy of people’s health information, but it creates a sizable roadblock for reporters building health care stories with a human angle. “It used to be easy. I used to be able to shoot in emergency rooms,” Ms. Hurtado said. “But now, no way they’ll let you in the door. There’s more paperwork and it takes longer to do my job.”
Ms. Miles added that if she’s pursuing a contentious issue, the hospital can “hide behind HIPAA or use it as a reason why we can’t do something.”
Despite the challenges, health care journalists are enthusiastic about their specialty beat.
“I’ve never gotten an e-mail on a crime story, and I can’t tell you how many e-mails I’ve gotten on a health story,” Ms. Miles said. “Health care is an issue that touches everyone’s lives.”
“I love this beat,” Ms. Hurtado said. “Even if it’s a difficult subject to talk about, people are happy to see you. They know that the information will help someone.”
And even the industry watchdogs balance their criticisms with guarded optimism. “Journalists on the beat have an increasing sense that this isn’t only a wonderful beat with important stories but one that requires us to look beyond the surface level to understand the facts of medicine and health care policy and the health care business that shape the stories we’re telling to our audiences,” Mr. Holtz said. “That’s the most hopeful thing that I see.”
Health Journalism 2006
What: Annual convention of the Association of Health Care Journalists
When: March 16-19
Where: Texas Medical Center, Houston