Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Article Comments

Mainstream Media’s Sub-Par Health Coverage, Part 2

I recently wrote about an experience that I had with a reporter (Erica Mitrano) who interviewed me about energy healing at Calvert Memorial Hospital in southern Maryland. Erica was very friendly and inquisitive, and we had a nice conversation about the lack of scientific evidence supporting any energy healing modality. I thought it would be fun to post what we had discussed at SBM, and then wait to see what trickled down into the finished piece.

When the final article appeared I was very disappointed. Not only was I not quoted, but there was no skeptical counterpoint at all. The story read like an unquestioning endorsement of junk science, and I wondered if it was worth it to continue speaking to journalists to offer expert advice. It seemed to me that this experience was emblematic of all that’s wrong with health reporting these days. (Just ask Gary Schwitzer, who has recently given up on reviewing TV health stories in mainstream media since they are generally so inaccurate.)

But I want to apologize to Erica, because part of the problem in this case was her editors. The online version of her story was substantially different from her printed version –- and in this case the printed version was much more balanced. About one-third of an entire newspaper page (The Enterprise, Friday, February 19, 2010, St. Mary’s County, Maryland) was devoted to my counter arguments. Here’s a short excerpt:

“I’m honestly not aware of any scientific evidence that supports anything beyond the placebo effect with the energy healing modalities, including Reiki,” Jones said. “There is nothing we can measure that suggests there is a special force that needs to be balanced…”

Success stories are anecdotal and can generally be accounted for by a person getting better from something like an infection on his own. Patients tend to report success from energy work more often for subjective ailments, especially pain and emotional problems, she said…

Jones opposes untested therapies’ inclusion in hospitals.

“I think it’s misleading to the patients because they’re going to a hospital, they’re trusting the hospital will offer them treatments that have proof that they work and they don’t realize that these nurses are offering nonscientific therapies,” Jones said.

“I would rather that the nurses be given time to sit and talk to patients, go into the room and say, ‘Mrs. Smith, I’m sure you feel completely stressed out right now, and I don’t blame you.’ That would be more effective than concocting this pseudoscientific excuse for having nurses lay hands on people when really the patient needs a listening ear and a compassionate soul to talk to.”

But I think this case still serves as a reminder that traditional media’s approach to health story coverage can be flawed. Specifically, my concerns are these:

1. “Balance” – While I recognize the importance of impartiality in news reporting, the quest for balance can go too far. Some facts are incontrovertible, so regularly insisting that the truth is “somewhere in between” can be both misleading and dangerous.

2. Editing – Reporters can write an excellent piece of journalism that becomes nearly unrecognizable after their editors are finished with it.

3. Inability to crowd source – The advantage of blogs is that readers can correct the original article or add their valuable views. Without a community of virtual editors/contributors, any one news article is limited by the point of view and skills of the journalist.

4. Sensationalism – Mainstream media outlets are slaves to ratings and traffic. This means that they are under constant pressure to exaggerate the truth or misrepresent scientific research. Attention-grabbing headlines sell papers, and “good science makes bad television.” So readers must take what they read with a grain of salt.

5. Author credentials – Sadly, highly trained science journalists are being laid off in record numbers due to the economic realities of the failing newspaper business. Remaining writers often do not have the depth of experience to handle complicated health topics and do not represent important scientific nuances correctly.

In conclusion, I’d like to thank Erica for the opportunity to weigh in on energy healing and apologize for any distress that my blog post (expressing my frustration with the apparent bias revealed in the final online article) may have caused her. I know that Erica received a pointed letter of complaint regarding the story because of my post. I think it’s a good thing that people care enough about bias and misinformation to send formal complaints because when those cease, we’ll be in serious trouble!

*This blog post was originally published at Science-Based Medicine*

You may also like these posts

Read comments »

Comments are closed.

Return to article »

Latest Interviews

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

How To Make Inpatient Medical Practice Fun Again: Try Locum Tenens Work

It s no secret that most physicians are unhappy with the way things are going in healthcare. Surveys report high levels of job dissatisfaction burn out and even suicide. In fact some believe that up to a third of the US physician work force is planning to leave the profession…

Read more »

See all interviews »

Latest Cartoon

Richmond, VA – In an effort to simplify inpatient medical billing, one area hospitalist group has determined that “altered mental status” (ICD-9 780.97) is the most efficient code for use in any patient work up.

“When you enter a hospital, you’re bound to have some kind of mental status change,” said Dr. Fishbinder, co-partner of Area Hospitalists, PLLC. “Whether it’s confusion about where your room is located in relationship to the visitor’s parking structure, frustration with being woken up every hour or two to check your vital signs, or just plain old fatigue from being sick, you are not thinking as clearly as before you were admitted. And that’s all the justification we need to order anything from drug and toxin screens, to blood cultures, brain MRIs, tagged red blood cell nuclear scans, or cardiac Holter monitoring. There really is no limit to what we can pursue with our tests.”

Common causes of mental status changes in the elderly include medicine-induced cognitive side effects, disorientation due to disruption in daily routines, age-related memory impairment, and urinary tract infections.

“The urinalysis is not a very exciting medical test,” stated Dr. Fishbinder. “It doesn’t matter that it’s cheap, fast, and most likely to provide an explanation for strange behavior in hospitalized patients. It’s really not as elegant as the testing involved in a chronic anemia or metabolic encephalopathy work up. I keep it in my back pocket in case all other tests are negative, including brain MRIs and PET scans.”

Nursing staff at Richmond Medical Hospital report that efforts to inform hospitalists about foul smelling urine have generally fallen on deaf ears. “I have tried to tell the hospitalists about cloudy or bloody urine that I see in patients who are undergoing extensive work ups for mental status changes,” reports nurse Sandy Anderson. “But they insist that ‘all urine smells bad’ and it’s really more of a red herring.”

Another nurse reports that delay in diagnosing urinary tract infections (while patients are scheduled for brain MRIs, nuclear scans, and biopsies) can lead to worsening symptoms which accelerate and expand testing. “Some of my patients are transferred to the ICU during the altered mental status work up,” states nurse Anita Misra. “The doctors seem to be very excited about the additional technology available to them in the intensive care setting. Between the central line placement, arterial blood gasses, and vast array of IV fluid and medication options, urosepsis is really an excellent entré into a whole new level of care.”

“As far as medicine-induced mental status changes are concerned,” added Dr. Fishbinder, “We’ve never seen a single case in the past 10 years. Today’s patients are incredibly resilient and can tolerate mixes of opioids, anti-depressants, anti-histamines, and benzodiazepines without any difficulty. We know this because most patients have been prescribed these cocktails and have been taking them for years.”

Patient family members have expressed gratitude for Dr. Fishbinder’s diagnostic process, and report that they are very pleased that he is doing everything in his power to “get to the bottom” of why their loved one isn’t as sharp as they used to be.

“I thought my mom was acting strange ever since she started taking stronger pain medicine for her arthritis,” says Nelly Hurtong, the daughter of one of Dr. Fishbinder’s inpatients. “But now I see that there are deeper reasons for her ‘altered mental status’ thanks to the brain MRI that showed some mild generalized atrophy.”

Hospital administrators praise Dr. Fishbinder as one of their top physicians. “He will do whatever it takes to figure out the true cause of patients’ cognitive impairments.” Says CEO, Daniel Griffiths. “And not only is that good medicine, it is great for our Press Ganey scores and our bottom line.”

As for the nursing staff, Griffiths offered a less glowing review. “It’s unfortunate that our nurses seem preoccupied with urine testing and medication reconciliation. I think it might be time for us to mandate further training to help them appreciate more of the medical nuances inherent in quality patient care.”

Dr. Fishbinder is in the process of creating a half-day seminar on ‘altered mental status in the inpatient setting,’ offering CME credits to physicians who enroll. Richmond Medical Hospital intends to sponsor Dr. Fishbinder’s course, and franchise it to other hospitals in the state, and ultimately nationally.


Click here for a musical take on over-testing.

See all cartoons »

Latest Book Reviews

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

Unaccountable: A Book About The Underbelly Of Hospital Care

I met Dr. Marty Makary over lunch at Founding Farmers restaurant in DC about three years ago. We had an animated conversation about hospital safety the potential contribution of checklists to reducing medical errors and his upcoming book about the need for more transparency in the healthcare system. Marty was…

Read more »

See all book reviews »