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Why Bolstering Trust in Journalism Could Help Strengthen Trust in Medicine | Vaccination | JAMA | JAMA Network



Declines in public trust in US institutions has been widespread and well documented.1 Neither journalism nor medicine is immune from this trend, although the combination has the potential to adversely affect both population and individual health. Individuals are inundated with health information from news media, with news stories ranging from the latest trends in health and wellness to breaking news about new treatments or technologies that have the potential to revolutionize health care.
The relationship that medicine and journalism have with the people they serve relies fundamentally on trust. Yet, that trust can be jeopardized by the way in which news about medical research and health care interventions is often disseminated to the public. While science is incremental, journalists are faced with trying to break through a cacophony of information using attention-getting headlines. As a result, media messages often convey scientific certainty when that certainty does not exist. In a review of more than 2600 news stories over 12 years that included claims about interventions, approximately two-thirds received unsatisfactory grades on quantifying benefits, harms, and costs.3 When an earlier version of these data was published, an editorial commenting on this study noted this “alarming report card of the trouble with medical news stories is thus a wake-up call for all of us involved in disseminating health research—researchers, academic institutions, journal editors, reporters, and media organizations…”4 Reviews of public relations news releases—from government agencies, medical journals, academic institutions, and industry—demonstrate an even greater likelihood of an unsatisfactory grade.3

The Problem

The problem is not limited to authors of news releases and news stories. Authors of the research studies and the peer-reviewed journal enterprise are partially responsible through the use of “spin” in the abstracts of peer-reviewed research papers, ie, emphasizing or exaggerating beneficial findings while minimizing or ignoring limitations in the research or potential harms.5 This becomes compounded by spin in promotional public relations news releases and then in the eventual media news coverage. Some patients who see these exaggerated claims may come to their physicians with false hope, while physicians may be frustrated with having to debunk claims that have raised false hope in the minds of their patients.

Moreover, undue weight is often placed on celebrity health news that often has no relevance in readers’ lives. For example, a celebrity parent can amplify a harmful message that vaccines cause autism through her lack of knowledge.  While celebrity health endorsements have always existed, the rise of social media as a way to disseminate traditional news media has changed the pace with which such news is spread.

Efforts to repair trust in the news media that also promote fair, accurate and unbiased coverage of health care stories could contribute to restoring trust in medicine. The medical community could have an important role in these efforts by engaging in the following activities.
Possible Solutions
Support High-Quality Health Care Journalism

High-quality health care journalism often appropriately raises questions about the trustworthiness and integrity of research and clinical care. Investigative data-driven news stories can focus on conflicts of interest, scientific fraud and retractions, overdiagnosis, overtreatment, and nonevidence-based recommendations. When science does not self-correct, a vibrant health care journalism sector can play a vital role in pointing to needed improvement and perhaps even in helping to restore public trust.  However, the health care journalism sector in 2018 is far from vibrant, particularly at the local level where news organizations are smaller and less well staffed than ever before if they continue to exist at all.  Local health news has always been more trusted by communities, featuring individuals and institutions readers know, written by journalists and produced by publishers who are their neighbors.  
At the national level, alternative models are aiming to fill this void. Such examples include STAT News or the nonprofit Kaiser Health News, which cover a range of health and health policy topics. Likewise, nonprofit investigative newsrooms, such as ProPublica and the Center for Public Integrity, have published excellent investigations in the health and medical spheres that many legacy newsrooms now lack the staff and resources to produce. The reporting of these organizations benefits from engagement with those in the medical community who work with journalists to inform the public and investigate problems in the health care system. Clinicians and health care executives should work with local media to highlight stories of interest to their communities. For example, the University of Chicago has partnered with a local radio station to feature a community health focus hour to highlight the most pressing health issues the community reported in a needs assessment.7
Hopefully, this article can serve as a point of embarkation to find credible information. All of the aforementioned sources are non-profit and hold no allegiance to any hospital, health plan or other principals.
Engage Media to Amplify and Share Truthful Stories
As traditional news media struggle to reach people in an era of information overload and changing revenue models, it is even more important for clinicians to be involved to amplify, share, and help create truthful news stories. While social media is often dismissed as a way “fake news” is spread, it serves as an important conduit for the medical establishment to engage with news media and amplify truthful stories. Examples of recent ways in which clinicians have amplified stories to advance public health include pediatricians joining Twitter (dubbed “Tweetiatricians”) and working in consort to advocate on vaccine effectiveness (ie, #VaccinesWork). Another example is the weekly #BCSM Tweetchats moderated by an academic breast surgeon and a leading advocate of patients with breast cancer that offers evidence-based discussions that debunk hype each week and hopefully lead to an increasingly well-informed group of women with breast cancer who are active on social media. Likewise, clinicians can offer to serve as key informants for news media about health and wellness stories so that truthful messages are communicated. For instance, Seattle Mama Doc is a pediatrician-authored blog for a major children’s hospital and frequently serves as a reputable source for news media on stories regarding children.
Actively Correct Stories That Are Not Accurate
To rebuild trust in both medicine and health care news, the response of clinicians to health care news stories that are not accurate is as important as their response to those that are truthful. It is easy for physicians to dismiss a news story with a patient in the privacy of their offices. It is more difficult to do so on a public-facing comment forum. However, journalism benefits from these corrections and feedback. In the race to put out a headline first, the headline may not always be correct. Physicians have an important role in correcting the record both through comments and through social media. Likewise, it is equally important for clinicians to challenge celebrities who may be given a platform to spread misinformation in traditional news media or on social media. For example, an obstetrician has spoken out on her blog to explain why the jade eggs promoted for vaginal health not only lacked evidence but could cause harm8 and an oncologist actively uses Twitter to address hyped cancer treatments based on insufficient medical evidence.9
Article Information
Corresponding Author: Vineet M. Arora, MD, MAPP, Department of Medicine, University of Chicago Medicine, 5841 S Maryland Ave, MC 2007 AMB W216, Chicago, IL 60637 (varora@uchicago.edu).
Published Online: May 13, 2019. doi:10.1001/jama.2019.0636




Why Bolstering Trust in Journalism Could Help Strengthen Trust in Medicine | Vaccination | JAMA | JAMA Network: This Viewpoint discusses how proliferation of health misinformation to the public undermines trust in science and medicine, and proposes ways the medical community and media might work together to make medical professionals better producers and consumers of accurate health information and to make...

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