What medical journalism is, and how it differs from medical writing
Medical journalism informs patients and the public about health, disease, research and healthcare, bridging the gap between scientists and lay readers. It differs from medical writing in its investigation, its storytelling, its pace and its readiness to criticise science as well as explain it.
What the field covers and its legal status
Health and medicine are favourite topics for newspapers and magazines, because people are increasingly interested in how to stay healthy, prevent illness, understand a disease they have, how the health system works, why things go wrong and what to expect of healthcare professionals. Any newspaper or magazine is likely to carry at least one article or piece of news about health, disease, medicine, healthcare systems or healthcare professionals. In surveys of where people get their information about health, the media are often more popular than health professionals, so a health professional can potentially influence people's knowledge of and decisions about their health more as a writer than in practice.
In 2012 most medical writers, whether in the pharmaceutical industry, in contract research organisations or freelance, provided documents for regulatory authorities, and a smaller proportion wrote medical and health communications for specialised audiences such as doctors or broader audiences such as patients and other lay people. Increasing demand for medical and health information in print and on the web had created a new niche for medical writers, medical journalism, in an era called Health 2.0, in which information empowered patients to become active and responsible partners in their own health and care.
Medical journalists strive to inform patients and the public about diseases and treatment options through newspapers, magazines, journals, brochures, leaflets and pamphlets, and through healthcare portals, newsletters, blogs and e-learning. In 2012 medical journalism aimed at scientific journals was also growing, and its requirements are quite different from those of writing for the general public. The work requires understanding complex data, filtering them by subjective and objective relevance, and presenting them in a format and language suited to the target audience and the medium, online or print.
In 2012 the profession was not yet legally regulated in most countries, which may be a reason why the quality of medical journalism varied greatly.
In 2021, growing public interest in scientific and medical advances was making medical journalism more important to medical writers, although few of them were familiar with it. Writing effectively for the public requires understanding its needs and how to reach it efficiently.
The gap between research and the public it bridges
Medical journalism aims to give the public an insight into scientists' research, which lay readers may find difficult to understand from scientific journals. Data need to be simplified while still letting readers understand the research as closely as possible. A medical journalist has to write reports carefully and cannot go ahead without understanding the research well. Scientists who explain studies technically in journals may find it difficult to explain them simply to a general audience, and this is where a medical writer or medical journalist comes in, formulating an articulate report that keeps the research's essence intact.
How the work differs from medical writing
Medical journalism demands an investigative nature, critical evaluation of evidence and the rapid production of engaging pieces of wide interest, and its world is stimulating and sometimes fast-moving.
Headlines about health appear in the media daily, designed to engage, inform or potentially shock a reader. Michael Kenward, a former editor of New Scientist, distinguishes science writing, which explains complex ideas that nobody wants kept secret, from science journalism, which explains things everyone can understand but some would prefer kept buried. The essential features of medical journalism are subject-matter research and understandable, impactful content. Medical writers produce primarily informative or regulatory text on topics set by a client or institution, while the priority for medical journalists is to tell a story that holds interest until its last paragraph. That involves examining context, seeking comments, speaking to independent experts, and highlighting negative as well as positive aspects.
One independent journalist expected medical journalism to be dry, heartless and devoid of storytelling and poetry, but found that the stories of real people affected by the science could hook readers and verbal pictures could explain hard-to-grasp concepts. That requires a high-level understanding of the science behind each piece. Audiences range from healthcare professionals, providers and governing bodies to newspaper readers and television audiences, so targeting the narrative is important. Some scientists and healthcare professionals may be uncomfortable with a popular approach or with a metaphor such as comparing parts of a cell to a fried egg, and the same journalist answers them with the words of the chair of a master's programme in health and medical journalism: a good health story makes readers feel smart. One of the biggest differences is the human angle: journalists almost always cover how changes affect particular communities, families and individuals, and journalism always has elements of storytelling, while medical writers tend to focus more on the science.
Both medical writers and journalists work under time pressure, but it can be particularly intense in newspapers and broadcasting, where a story may be asked for at a few hours' notice. Medical journalists need to cover climate conferences and accords, sustainable development meetings, pandemics, epidemics, ecological changes and the latest research, which involves background research, talking to experts and unbiased reporting, so they work in a much more fast-paced and deadline-driven environment than medical writers. Medical writers write science publications or online pieces about the latest research or a topic but do not report current events, so they have more time to research and develop a story.
For one magazine editor, medical journalism is more fast-paced, reacting to stories emerging minute by minute, with a wider range of content: news, blogs, opinion pieces, webinars, advice and continuing professional development material. A freelance medical journalist would probably use the two terms interchangeably, but places getting expert comments, analysing information and uncovering a new story on the journalism side, and summarising or exploring a topic on the medical-writing side. By 2021, with print in decline and online content growing, the distinction had blurred between medical journalists and medical writers interested in writing media articles and blogs and creating other media content.
From translating science to criticising it
The writer and medical ethicist Harriet A. Washington first saw medical writing as a mission of translating science for ordinary people and helping them make the best decisions for their health and welfare, their families and society. She came to see science as appropriating every human endeavour and as shaped by human values and limitations, including, as she draws from Thomas Kuhn's The Structure of Scientific Revolutions, politics and racial and gender concerns. Medical journalists, in her view, write the first draft of science's history, and that history reflects those who dominate and tell it: in the words she attributes to Churchill, history is written by the victors, and in those of Felix Okoye, a professor of African history, do not let the lion tell the giraffe's story. Her mission became not simply translating science but analysing it and, where appropriate, criticising it.
At her first reporting job, on her college newspaper during the racial tension of the 1960s, editors asked Washington how, as an African American, she could be an objective journalist. She later understood the question as a judgment about who could be a scientist or a journalist, and quotes Donna Haraway's observation that objectivity had come to stand for the requisite tone of the White male scientist, assumed objective by nature; objectivity itself, she adds, is an elusive goal. Washington tried for a time to demonstrate objectivity by avoiding race, social friction and women's concerns, a goal shared by many she wrote for and worked with. In the 1970s, at 16, she was told her ambition to become a doctor was unrealistic because there were no Black women doctors, regardless of her grades. She never again let anyone tell her what she could and could not do in that way.
Criticising science seemed to Washington to evoke hubris, although she had seen racial bias in the hospital she worked in during the 1980s and in medical and science reporting. She saw no examples of how to criticise while adhering to scientific rigour until a 1992 journalism fellowship at Harvard School of Public Health, which selected three medical journalists a year. Those years inspired her to seek medical truth by navigating conflicts of interest, financial bias, and sexist and racist assumptions. The programme director, Bob Meyers, put her in touch with public-health and ethics leaders, including Jonathan Mann, Larry Gostin and Allan Brandt. Marcia Angell, then editor of The New England Journal of Medicine, pointed out to her the corporate influence behind conflicts of interest. Patricia Thomas, then editor of the Harvard Health Letter, took her to her first AMWA meeting in 1993 and helped her see unsupported assumptions, subtle and missing data, and unasked questions. An example was treating women as inappropriate research participants because of hormonal fluctuations, pregnancies and monthly cycles, which excluded more than half the population and produced an inaccurate picture.
Two outcomes of that work stand out for Washington. The American Medical Association's 2008 apology to the nation's Black doctors was based on a paper she coauthored in JAMA in July 2008. What matters about an apology, she argues, is what happens afterward, and here the lasting results were projects the AMA and the National Medical Association worked on together, such as a committee to end health care disparities. In 2018, the statue of James Marion Sims was removed from Central Park after she had detailed his unethical research on enslaved Black women who could not consent, and after mostly Black and Hispanic women living nearby, assisted by mostly White medical students, had pressed City Hall and the Parks Department. Her book Medical Apartheid, written after a medical ethics research fellowship at Harvard Medical School, corrected, in her account, a history of medicine that systematically excluded people of color's experience.
Washington argues that writers' role in the development of medical thought and practice has been exaggerated and, at crucial points, effaced, and that writers are blamed for failings they share with and inherit from scientists. Medical news, she adds, has been a catalyst for change when it revealed events such as “Mississippi appendectomies”, abuses at Willowbrook and the Public Health Service study at Tuskegee.
In Washington's view, medical journalists should write more often about research in the developing world, perhaps departing from much of the ethical literature. She holds that medical journalists will play a key role in analysing what is happening to the people there who test medications and then end up without access to them, and what the various people's rights and needs are. Their mission, she concludes, is to look thoroughly at all the issues and publicise them, whether or not doctors and ethicists are discussing them, to help people make the best decisions.