Reporting a health story beyond the first convenient source
A health story is reported by going past the press release and the first convenient source: investigating who says what and why, gathering material from experience, places, libraries and the literature, checking what a study can establish, negotiating access to an institution and what may be recorded inside it, and finding on the ground what the prevailing account misses.
Independent sources beyond the press release
Medical journalism requires the evaluation of numerous sources to deliver what should be a balanced and unbiased story. When a newspaper or broadcast story is wanted at a few hours' notice, the temptation for the media is to accept material already written by a press officer working for industry, government or a lobbying group.
A checklist for investigating a story advises:
- Never take press releases, corporate publications or newspaper and magazine articles at face value.
- Get the background on the story.
- Ask searching questions when interviewing people.
- Always get an independent expert to comment.
- Be aware of people's motivations, agendas, conflicting interests and possible prejudices.
- Do not report statements as fact; use qualifying phrases such as “according to Kuritech” or “says Dr X”.
Background reading helps in understanding the impact or importance of the material a story has to cover. On a topic outside the writer's main expertise, other reading or an expert may help. Whenever possible, the writer should interview someone for the story, such as the authors of the study, ask searching questions or get an independent expert to comment. One former science news writer also used “the authors wrote in their study” as a qualifying phrase when quoting directly from a research paper.
Gathering and organising material
Researching an article for a magazine or newspaper is much the same as researching any piece of writing, and it can draw on the writer's own personal and professional experience, other people's experience, visits to relevant places, libraries and the internet. Personal experience is unique, so it helps bring a fresh angle, and an article may rest entirely on it, as in a personal journey through an illness. It should be presented in a way that is valuable to readers, not used for personal therapy or self-promotion. Other people's experience may come informally from family and friends, or from interviews with experts.
An article is livelier when the writer has visited the places it describes, such as hospitals, clinics, GP surgeries, pharmacies or pharmaceutical companies, rather than only speaking to someone on the telephone. The writer should note everything seen, heard and perhaps smelt, tasted and touched, and take photographs too, since detail may be easier to recall from a photograph than from notes.
Despite the internet, visiting a library can be beneficial and even necessary, and some big libraries, including the British Library, have online databases holding an enormous amount of information. Many writers begin their research on the internet, but it should not be the only source, because relevant information is easily missed and the article may end up superficial. Free entries may be only abstracts or summaries, so it may be best to buy entire papers, which can also be done online. Besides the factual content of an article, the internet can be used to search for the names and contact details of people who might offer personal expert quotes. Learning to use a search engine effectively is a good idea.
One freelance writer of explanatory reportage develops an article by reading journals and talking with physician colleagues, then interviewing physicians or researchers who are experts in their field and patients willing to share their experiences, and finally compiling all those perspectives into one narrative, accompanied by images of clinical interest.
Information-collecting and note-taking should be systematic, which is easier when an outline of the feature is developed first. For an article based entirely on written sources, the information collected should be divided into the subjects of the outline's sections, and written notes divided the same way, which a tear-off pad makes easier than a notebook. Interview notes are the exception: it may be more practical to extract their information while working than to separate it physically.
What a study can establish
Source material, often newly published research studies of varying quality, should be analysed critically with the writer's scientific skills rather than taken at face value. The message of a well-designed study should be delivered with clarity and accuracy, without exaggerating or forcing the impact of its results just because the study is scientifically sound or was published in a high-ranked journal. A significant drug-induced reduction in tumour burden in mice may be good news, but it cannot be extrapolated to humans as a new cancer treatment; a substantial amount of work remains before such a claim can be made, and writers need to make that very clear.
A news writer whose employer has a daily need to cover any new material may sometimes have to write about weaker studies too, such as those published in non-peer-reviewed journals, those with no control group, or case reports of a single patient. Their design and results make strong scientific conclusions hard to draw, let alone medical ones, and this must be part of the message: the article must make very clear that the results came from studies with certain limitations and must be interpreted with caution. One former science news writer holds that it is the writer's job to highlight the context in which results were obtained and, above all, their true contribution and value to research in the disease.
Access to an institution
Negotiating sustained access to a hospital team
In late 2007 a reporter at The Dallas Morning News proposed that she and a videographer follow the members of the palliative care staff at Baylor University Medical Center and tell their story. The first, unspoken reaction of the physician who had started the programme was refusal, but he then saw that an investigative reporter's story could spread awareness of the programme. Having overcome his own reaction, he still had to quell the discomfort of his team, who would have to take off their emotional armour and talk about something as personal as death while being followed by one woman with a notebook and another with a video camera.
After six months of negotiation, guidelines and rules were established that addressed the concerns of both the hospital and the newspaper. The partnership produced At the Edge of Life, a five-part series blending print and visual media.
Recording and photography at medical society meetings
In 2010 journalists were sometimes banned from recording or photographing the meetings of medical societies, and the Association of Health Care Journalists sent letters to medical societies asking them to reconsider. Four societies then known to have these policies were the American College of Obstetricians and Gynecologists, the American Society of Gene and Cell Therapy, the American Society of Nephrology and the Association for Research in Vision and Ophthalmology, and other groups had varying levels of restriction. The association cited the American Heart Association as an example of a society whose rules work.
Reporting on the ground
When AIDS began to spread and was still unnamed, even many experts believed it was a disease of a handful of gay men in New York, Los Angeles and San Francisco. A newly appointed lead medical reporter with virtually no experience could see in South Florida that they were wrong: many of the patients there were Haitian, and an elderly man in Broward County with haemophilia had given the disease to his wife of 50 years. The reporter's story of the couple in The Miami Herald was, by his account, the first recognised case of heterosexual AIDS in the United States. It went unnoticed for seven months, until The New York Times ran a story based on a case report about the couple in a medical journal.
Journalists felt uncertainty and unease reporting on a disease that no one really understood: nobody then knew what was happening or how large the epidemic would become. Looking back in 2007, the reporter judged that the epidemic in Miami had foreshadowed what AIDS became worldwide far better than the epidemic in San Francisco, New York and Los Angeles: AIDS had become a disease of the poor, the disenfranchised and the dispossessed, hitting women harder than men and people of colour harder than whites.
One physician honoured for communicating health care to the public advocates going on reporting the plight of underserved patients around the world, not only through television and the internet but also in writing. In her account, one story left untold after Haiti's January 2010 earthquake was that Haiti's medical society was apparently upset by the loss of paying patients to free foreign volunteers, a loss that had put many of the country's own doctors out of business and made the relative lack of medical infrastructure worse.