Medical journalism: triumphs and pitfalls

Geoff Watts, presenter of Radio Four's Medicine Now, is the recipient of the first annual HealthWatch Award. Here is a shortened version of the talk he gave to HealthWatch members.

The medium I work in - radio - has strengths and weaknesses. TV relies on pictures: the words are subsidiary. Print journalism does rely on words but they are mostly those of the journalists themselves, fleshed out with quotes from people whose views and ideas are being reported, disputed or analysed. But in radio this 'fleshing out with quotes' actually forms the greater part of what is broadcast. This is both the strength and the weakness of radio journalism.

It is a strength because radio journalists have the authority that comes from using a contributor's own words and voice. It also reduces the likelihood of distortion.

It is a weakness because radio journalists are more reliant on the fluency and articulacy of their interviewees. This can be a problem when dealing with complicated technical matters.

Broadcaster vs. medic

Doctors can't ignore their patients' prejudices or advocate therapies that patients don't want. Nor can broadcasters survive by making programmes that people don't want to watch or listen to. Compromises have to be made by both.

But there is a fundamental difference: doctors don't have to entertain their audiences, which are largely captive. The media do have to entertain -using that word in the sense of 'amuse and intrigue': to hold the attention.

One result is that the media do not necessarily emphasise what doctors think are the most important issues or angles. The 'responsible' journalist tempers the presentation of pure truth with enough entertainment to woo the audience; the less responsible provides nothing but entertainment - from sob stories to horror stories. But, when criticising the serious media, recall that they too have to make themselves attractive to audiences. No audience means, ultimately, no programme.

Doctors and broadcasters can fall out over the question of language, particularly when talking about matters that are technically difficult. Doctors are generally better than scientists at speaking in plain English but there is the danger of patronising the audience with talk of 'germs' and 'tummies.

Are doctors and scientists afraid to talk in ordinary language? Do they fear they won't sound important enough? Some can't seem to get away from the idea that they're talking to their peers. They're not. To talk simply and directly is not to trivialise.

Disasters and triumphs

Developments that would have been impossible without the cooperation of the media include the reduction in cot death following changes in the recommended sleeping position and the spread of knowledge about safe sex. People are now better informed about health.

Things go wrong for many reasons. There is genuine misunderstanding of the facts. Sometimes those providing the facts don't help. There is conflicting propaganda, for example, over the role of animal fats in heart disease.

Journalists occasionally decide their conclusions before they write the story. One TV production company and one particular journalist seek to champion the unorthodox ideas of Stanford University's Peter Duesberg about HIV. Provided no violence is done to the truth, and the competing claims are given a fair hearing, a partisan or unorthodox line of argument presents no problems - but it must be declared as such.

Anecdote

Anecdote is legitimately the basis of much journalism - to rule it out would be absurd. But, unaccompanied by the examination of more objective evidence it results in uncritical coverage of miracle cures and gee-whizz technology and a wide-eyed enthusiasm for every dubious idea dreamed up on the fringe from total allergy syndrome to the health benefits of sitting inside pyramids. It's an area in which journalists' natural scepticism can fall prey to the lure of a good story -and is a regular source of pitfalls.

Changes of points of view inside the medical establishment can lead to stories going wrong. The value of dietary fibre, the health benefits of moderate drinking and the violence induced by lowering blood cholesterol are just a few of the issues on which the research establishment has been, or is in the process of, rethinking its ideas. Changes of understanding can't be avoided - but they do create problems.

Publicity-seeking by individual doctors can generate bogus, dubious or non-stories. Motives range from self-agrandisement to bringing in private work to shroud-waving for an institution.

The practice of medicine is nothing like as international as the science on which it is (supposed to be) based. There are transatlantic differences which can be subtle and create further pitfalls for the unwary.

Finally, should medical reporters working for the lay media try to behave like editors of peer-reviewed journals? This is not practicable or desirable. The periodic failures of journalism are not so much a problem to be solved as a (sometimes unavoidable) phenomenon to be monitored, noted and kept within bounds of acceptability.