News

Is health news - on TV, on radio, in newspapers, in magazines, on the Internet - fit to print and broadcast?

That is the provocative question asked in the most recent edition of the venerable New England Journal of Medicine.

Susan Dentzer, editor-in-chief of Health Affairs and a health correspondent for the PBS program NewsHour with Jim Lehrer, offers up a stinging critique of the quality of health journalism.

She argues that health and medical reporters routinely get the facts wrong, fail to provide context about new research, and misstate the benefits and risks of treatments (and prescription drugs in particular).

As a result, Ms. Dentzer concludes, the media, with few exceptions, are providing the public with inadequate and distorted news instead of informative and educational news.

But why is this happening?

Some oft-stated reasons are cited, like the rush to publish in which speed trumps quality, a lack of beat reporters (those who specialize in a specific area such as medicine or health policy), the reluctance of media outlets to invest in training, and widespread scientific illiteracy and innumeracy among reporters and editors.

There is also the stubborn insistence of media outlets on sticking to tried-and-true formulas, such as the "he said, she said" style of stories that emphasize conflict and paint every issue in a stark black-and-white manner. Not to mention the media predilection for contrariness that draws them to offbeat, counterintuitive findings.

And, of course, there is nothing the media like more than simple truths and stark conclusions.

Unfortunately, health research (and science generally) has a culture that is virtually the polar opposite to that of the media.

Science tends to progress in an incremental fashion. Research papers feature copious footnotes and references to past work, whereas journalists focus almost exclusively on "newness," and context be damned.

Most frustrating of all for reporters, scientific researchers long for precision, not generality, to the point where they hesitate even to draw conclusions.

In fact, anyone who has read medical journals will know that the conclusion of every research project - virtually without exception - is that more research is required.

In her commentary, Ms. Dentzer makes only passing mention of the role that scientists and clinicians (not to mention the medical journals that publish their work and the public relations people who promote it) play in distorting the way scientific findings are presented to the public.

But that's fine. Those critiques can be left to the introspectives in the scientific community.

Ms. Dentzer has zeroed in on the foibles of the media and posed some questions that are asked too rarely in newsrooms.

Among other things, she asks: What is the proper role of health journalists?

"Is our job to describe the bigger picture, or simply report what is 'new'? Should we present black-and-white versions of reality that lend themselves to stark headlines, rather than the greyer complexities that are harder to distill into simple truths?"

Ms. Dentzer comes down on the side of more thoughtfulness: "The news media need to become more knowledgeable and to embrace more fully our role in delivering to the public accurate, complete, and balanced messages about health," she writes. "With some additional skills, care and introspection - and a change of priorities - we can produce coverage more in line with our responsibilities."

She argues that health and medical reporters have a duty to readers and viewers that is greater than that of other journalists, because what they write influences behaviour in a concrete manner.

"We in the news media have a responsibility to hold ourselves to higher standards if there is any chance that doctors and patients will act on the basis of our reporting," Ms. Dentzer writes.

It is hard to take issue with any of those criticisms, though health reporters tend to riposte that the failings are not individual, but institutional. Put another way, reporters feel that there is little appetite among editors for more balanced, contextual stories because they are perceived as boring.

Regardless, one of the most intriguing observations that Ms. Dentzer makes in her commentary is that, in our increasingly wired world, health coverage is worse than ever.

In short, she argues that the 24/7 news cycle pushes journalists to crank out a lot of crap (not her exact words), to produce an ever-growing volume of stories of ever-diminishing quality: McHealth stories that are the journalistic equivalent of fast food.

What reporters need to do to stand out in this swamp is produce stories that help readers and viewers make sense of all the nonsense out there.

Or, as Ms. Dentzer states: "We must be more than carnival barkers; we must be credible health communicators ... conveying clear, actionable health information."

But, for that to happen, the public will have to demand it.