October 3rd, 2009 by David Kroll, Ph.D. in Better Health Network, Expert Interviews
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This morning, I once again get to join in with a group of noted journalists, authors, educators, and all-around people-who-do-things-I-can’t for the annual advisory board meeting of the M.S. in Medical and Science Journalism Program at the University of North Carolina at Chapel Hill’s School of Journalism and Mass Communication.
Program founder and current director, Tom Linden, MD, is a Yale- and UCSF-trained physician-journalist with extensive broadcast experience across a series of California television stations. Dr Linden also recognized very early the potential value and pitfalls of the web for communicating health information and published in 1995, with Michelle Kienholz, one of the first consumer guides to medical information on the internet. I also featured Tom here in December 2007 when he launched his own blog.
So today, Dr Linden has asked me to speak to about science and medical blogging but with respect to how it has augmented my own professional career. Read more »
*This blog post was originally published at Terra Sigillata*
June 25th, 2009 by DrRob in Better Health Network, Opinion
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I was looking through an article in Time Magazine recently and came across an article about healthcare reform. It spoke of the daunting task ahead and went through a list of the people at the table in the process of creating change. The list included politicians, hospital corporations, pharmaceutical companies, insurance companies, and lobbyists from certain large special-interest groups. Notably absent from the list was physicians and “normal” patients. I commented about this in a conversation with Val Jones, MD, and she said: “If you aren’t at the table, then you’re on the menu.”
She’s right. Up to now, the interests of the people who matter most – the doctor and patient in the exam room – were largely unheard. Folks said they knew our needs, but they all had their own agendas and so often got it wrong (either out of ignorance or out of self-interest). Even the organizations that are supposed to represent my needs, the AMA and the specialty societies to which I belong, are not composed of folks who spend most of their time in the exam room; they are people who have either retired to spend their time in Washington, or are full-time smart people (they know lots about other people’s business). There are very few people at the table who regularly see patients. There are also very few who represent patients without a particular axe to grind (elderly, people with chronic disease or disabilities).
But healthcare is about what goes on in the exam room. The entire point of healthcare is health care; it is about the care of the patient. It isn’t about the business, the drugs, the delivery system, or the insurance industry; it’s about optimizing how the system makes sick people better and keeps better people from becoming sick. Everything else is a means, not an end.
But those of use who are in the exam room are soon to be served up on the menu for the sake of political gain and special interest clout. They may or may not have a good plan, and they may or may not have good intentions. But they definitely do not have an understanding of what really goes on and won’t be affected much by the decisions they make. They are serving up a dinner of food they don’t know about and they won’t have to eat what they cook. How can they make good decisions?
A step in the right direction would be to listen to bloggers. As opposed to the lobbyists and pundits inundating Washington, we actually do healthcare. The doctor and patient blogs on the web represent the interests of the people who are in the middle of the healthcare universe. This universe doesn’t have Washington DC at its center, it has the patient and those who care for him or her.
A good parallel is the crisis in Iran. There are reporters and politicians who say they know what it’s all about – and in some ways they do – but the voice of the people living in Iran are crucial to understanding what is going on. Why are there riots? Ask a rioter. Was there rigging of the election? Ask someone who was there to witness the process. The people who are on the ground should always be listened to. They don’t give the entire perspective, but getting a true perspective is impossible without talking to them.
Don’t just listen to me; I represent a specific point of view, and don’t represent that of patients or specialists fully. Don’t just listen to patient blogs, as they often don’t have a clear understanding of the business of medicine or the complex medical realities (although I know some of them do know an awful lot). We need to force ourselves to the table. We need to give perspective that has previously been invisible.
Blogging matters because it gives perspective that could never come from anywhere else. Blogging is the journalistic equivalent of democracy, giving the average person a chance to make their voice heard.
In July, a group of us medical bloggers will be going to Washington to do what we can to make our voice heard (thanks to Val Jones’ hard work). Maybe it won’t make a difference; but at least we won’t be invisible any more.
*This blog post was originally published at Musings of a Distractible Mind*
June 17th, 2009 by Peter Lipson, M.D. in Better Health Network, Quackery Exposed
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It might seem a bit undemocratic, but science, like medicine or dentistry, is a profession. One doesn’t become a scientist by fiat but by education and training. I am not a scientist. I apply science. My colleague Dr. Gorski is a scientist (as well as physician). He understands in a way that I never will the practical process of science—funding, experimental design, statistics. While I can read and understand scientific studies in my field, I cannot design and run them (but I probably could in a limited way with some additional training). Even reading and understanding journal articles is difficult, and actually takes training (which can be terribly boring, but I sometimes teach it anyway).
So when I read a newspaper article about science or medicine, I usually end up disappointed—sometimes with the science, and sometimes with the reporting. A recent newspaper article made me weep for both. Local newspapers serve an important role in covering news in smaller communities, and are often jumping off points for young, talented journalists. Or sometimes, not so much.
The article was in the Darien (CT) Times. The headline reads, in part, “surveys refute national Lyme disease findings.” Epidemiologic studies, such as surveys, are very tricky. They require a firm grounding in statistics, among other things. You must know what kind of question to ask, how many people to ask, how to choose these people, etc, etc, etc. So what institution conducted this groundbreaking survey on Lyme disease?
Actually, they are quoting the famous work of one Kent Haydock, chairman of the Deer Management Committee. But I’m sure he outlined his methods carefully. Or not.
Haydock conducted:
[T]wo surveys — which polled 41 Darien households after a showing of the Lyme Disease film, Under Our Skin, at the Darien Library last month… . In the 41 households that completed the questionnaire, 47 total Lyme disease cases were reported. In 64 percent of those cases, the patient had relapses after an initial Lyme treatment, which required additional treatment for a chronic or long-term conditions.
So, Haydock showed the agitprop chronic Lyme advocacy film Under Our Skin to local families, presumably not selected at random, and then asked them if they had signs of Lyme disease and if it was ruining their lives. Not surprisingly, the answers to both questions were “yes” a remarkably high percentage of the time.
His conclusion: the surveys “show that Lyme not only exists in great numbers, but also in debilitating, chronic and long-term cases.”
This is not epidemiology. This is not science. This is an uninformed opinion dressed up with meaningless numbers. If you get together a group of people who are interested in Lyme disease, show them a propaganda film, and query them about it, the only thing you’ve “measured” is your ability to count people who come to a movie and hold a certain belief. If there were any valid conclusions to be drawn (and with these numbers, there probably aren’t) it’s that many people in this small group think they have Lyme disease—and even that’s over-reaching.
It’s bad enough that the deer commissioner did this. But arguably, it’s much worse that the reporter and editor published it. The only thing this accomplishes is fanning the fears of the readers.
*This blog post was originally published at Science-Based Medicine*
August 4th, 2008 by Dr. Val Jones in Announcements, News
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I was welcomed as a new member of Washington, DC’s 100-year-old National Press Club (NPC) today. My credentials for membership? I’m a blogger.
The Internet has revolutionized information sharing and news reporting. Not only has it democratized the process, but it has harnessed the power of the common man and woman to bring a new depth and breadth of insight to the news. Just as medicine is becoming “personalized,” one could say that blogging is making journalism “personalized.”
Mainstream media outlets like the Los Angeles Times, the New York Times, and the Wall Street Journal have recognized blogging as a legitimate platform for information sharing. Bloggers like me, KevinMD, Gene Ostrovsky, Dr. Rob Lamberts, and many others are openly recommended sources for further reading. In the span of 5 years, medical blogging has become a respected part of the new media landscape.
When I told my parents that I was becoming a member of the National Press Club, my dad asked if they were going to give me a press credentialling card for my fedora (hat). For him, the NPC clearly conjured up images of 1920s news reporters crowded into small, smoke filled rooms to interview foreign dignitaries.
There was a hint of truth to my dad’s vision – the NPC retains a relatively austere interior, with large flags and club seals prominently displayed in regal blue conference rooms. But beyond the C-SPAN aesthetic, the club is undergoing substantial modernization. The restrooms feature Dyson airblades, the old library’s bookshelves are being torn down to expose bay window views of DC, and the fourth floor studios are constructed with glass and clean-line architecture.
The NPC’s new member luncheon was hosted by two staff and an NPC member who joined the club in 1971. I was astonished to learn that my new membership entitled me to a free daily breakfast and unlimited access to: their librarian for my fact-checking needs, a gym with a full-time personal trainer, meeting rooms that I could book in advance for my convenience, and a Friday night taco bar. Who knew?
Near our table was a portrait of Will Rogers who, among other things, was a nationally syndicated columnist featured in over 4000 different newspapers. Our member-host pointed at the portrait and said, “Back in Will’s day – everyone wanted to know what he thought of current events, so they’d purchase their daily newspaper to find out.”
As I considered Will Rogers’ smiling face, it suddenly struck me that blogs offer today’s readers a filter through which to view current events. And thanks to the abundance of blogs, there is an ever expanding array of personal editorial. Finding a good blog is like finding a voice you can relate to – a living commentator on events. No longer is there one voice like Will Rogers who dominates the national consciousness.
But citizen journalism has its downside, as does Karaoke. Karaoke offers everyone a microphone, but not everyone is a talented singer. In the same way, blog quality varies considerably, and so now more than ever we must cling to the old news addage, “consider the source.” The danger of blogs is that readers may ascribe more authority to their authors than they deserve. When it comes to medicine – and your health is hanging in the balance – it’s important to get the facts straight. So I believe that professional medical bloggers should work extra hard to uphold the ideals of medicine, and respect patient privacy.
Just as the NPC is welcoming bloggers like me into their midst, I hope that new media gurus will welcome what the NPC has to offer them: a rich history of journalistic integrity. I think that a fusion of old and new media might actually produce a hybrid product that will bring us the best of both worlds – a broad array of trusted voices in online journalism.
With this blog I add my “voice of reason” to the choir and look forward to all that the NPC can teach me. At the very least, I’ll enjoy Friday night taco fests with my peers in Washington.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
March 13th, 2008 by Dr. Val Jones in Humor
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In case any of you aren’t familiar with The Onion, it’s a spoof newspaper whose articles range from hilarious to irreverent. Here are some recent health headlines that struck me as funny:
Depressed Cow Eats Entire Haystack
Nation’s Bachelors Demand Health Care Coverage For All Their Buddies
Pharmaceutical Company Says Its New Anti-Depressant Is ‘Worthless And Dumb’
Very Specific Food Pyramid Recommends Two To Three Shrimp Scampis Per Year
Disease-Free Water Tops List Of World’s Most Popular Beverages
Half Of 26-Year-Old’s Memories Nintendo-Related
Swanson Foods Launches Hungry Man Line Of Apparel
Area Man Thinks He Can Save Relationship With Pancakes
American Cancer Society Unveils 1.2-Megaton Anti-Cancer Missile
New Product Can Do All That, More
Barky Dog Just Going Bark, Bark, Bark
And for you scientists in the audience, here’s an Onion classic, mocking the medical peer review process. Enjoy!This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
