Photo: Pia ChristensenA Health Journalism 2014 panel about hospital rankings included (left to right) Evan Marks of Healthgrades, Marshall Allen of ProPublica and John Santa, M.D., of Consumer Reports.
If you were at Health Journalism 2014, you might have heard that things got interesting on Saturday when journalists questioned panelists who represented hospital ranking services about their business practices.
Tony Leys, a reporter for the Des Moines Register, was in the audience for “Hospital grading: Reporting on quality report cards” and asked Evan Marks, the executive vice president of informatics and strategy for Healthgrades, how much hospitals pay his organization to be allowed to advertise their ratings. Marks refused to answer the question.
After the panel, Leys pursued the question and got some details that all reporters should be aware of when they consider writing about hospital rankings, including some concrete data on how much hospitals are paying in “licensing fees” to ratings services. You might use his technique to find out how much some of your local hospitals are paying.
Read this tip sheet to find out more.
When writing about medical studies, reporters should always ask researchers about any financial relationships with drug companies or device manufacturers. That was one of the main lessons from a panel on conflicts of interest on Saturday at Health Journalism 2014.
Starting in September, sunshine provisions in the Affordable Care Act will require drug companies to disclose most payments to doctors. Some companies have already started to publicize their financial relationships with doctors. But most medical journal articles do not give accurate information on researchers’ potential conflicts of interest, said panelist Susan Chimonas of the Institute of Medicine as a Profession at Columbia University.
“You shouldn’t be uncomfortable asking these questions,” Chimonas said. “They owe you this information. They owe everyone this information.” Continue reading
Reporters curious about the financial relationship between physicians and pharmaceutical companies can use publicly available data as a starting point – although that comes with some caveats, journalists and industry leaders say.
During the workshop “Covering prescription drug data,” Charles Ornstein, ProPublica senior reporter, pointed out resources that ProPublica has created that reporters can use to write stories about doctors in their communities. Continue reading
Six years ago, a clinic in Oregon made the decision to ban representatives from the pharmaceutical companies. The doctors and staff say goodbye to free samples of expensive drugs, lavish lunches, pens, notebooks, mugs, toys for children and other “benefits.”
Markian Hawryluk, a health reporter with The Bend (Ore.) Bulletin, picked up on a recent journal article about the transformation and used that as his inspiration to write about how the clinic made its decision and how it changed the way doctors there practice medicine, as well as how the move impacted the community.
As data is collected under the Physician Payments Sunshine Act, a part of the Affordable Care Act that will require pharmaceutical companies to disclose the money and gifts given to physicians, reporters may start noting similar changes in their area.
Read more about how Hawryluk reported the story and what he learned about the influence drug reps and samples have on prescribing.
Efforts to correct biased and dangerous medical studies are making more headlines.
Shortly after I posted about a new idea to correct missing and misreported research, I got an email from AHCJ member John Fauber, an investigative reporter at the Milwaukee Journal Sentinel.
His latest story for the Journal Sentinel and MedPage Today involves an extensive undertaking coordinated by Yale University to correct the record on a product made by Medtronic called Infuse. The project is called YODA, for Yale Open Data Access. (Read more..)
Infuse — officially a device — consists of a metal cage fitted around a sponge that is soaked in a genetically engineered protein. The protein is supposed to promote bone growth and healing. It works, but perhaps too well. Side effects linked to its use include bone overgrowth that can trap and irritate nerve roots causing chronic pain. It has also been tied to a complication called retrograde ejaculation, which leads to sterility in men. Patients who receive infuse also experienced more problems with wound healing and more cancer.
All in all, pretty devastating outcomes for patients who were hoping to feel better after their back surgeries. Continue reading
A few weeks ago, I reached out to a disease charity for comment on a story I was working on. Disease charities are nonprofits like the American Heart Association, the Cystic Fibrosis Foundation, etc., that raise money to support the research, care and awareness of people who live with a given condition.
The story was about a rare but very dangerous side effect that was tied to new drug. The side effect is considered so serious that other drugs that cause it have been yanked off the market because of the risk.
I expected the scientific officer I spoke with to react to this news, which was published in a top-tier medical journal, with alarm and concern for patients who were taking the medication, which is poised to become a blockbuster. Instead, though, he was largely dismissive of the reports. He extolled the potential benefits of the newly approved medication for patients.
As reporters, we all have those moments when our spider senses tingle. You may not be able to put your finger on exactly why, but something just doesn’t feel right. Continue reading
Can a doctor’s prescription be bought for a tuna sandwich?
Whether it’s a tuna sandwich, steak dinner or a four-figure payment, there’s always the possibility of influence. And that’s how conflicts of interest begin in the medical field.
That was the message this morning from reporters Peter Whoriskey of The Washington Post and John Fauber of the Milwaukee Journal Sentinel during their panel on reporting on medical and financial conflicts of interest during AHCJ’s Health Journalism 2013 in Boston.
“Their job is to sell as much product as they can and maximize profits,” Fauber said of the pharmaceutical companies. “One of the ways they do that is by creating financial relationships with various stakeholders, which can be doctors, medical societies or medical schools. While this may be good for the bottom line of the drug companies, it may not work out for the patients.”
Fauber advised journalists to be on the watch for several things: promotional speaking gigs by physicians; participation in continuing medical education (CME) events; financial relationships between medical journal editors and drug companies; and royalties that come back to hospitals and physicians.
“It struck me very quickly that all the cynicism the media brings to politicians or companies, anybody, is held in abeyance for doctors and anybody that wants to heal you,” Fauber said. Continue reading
Photo by Pia ChristensenFred Trotter.
Going online is usually a great way to waste time or — for adventurous social media users — get in trouble.
For resourceful journalists, however, the Internet is a treasure trove of information that can be invaluable for reporting. These include providing access to open-source tools such as DocGraphs, which can provide crucial data that may not easily be available anywhere else.
A crowdfunded project from open source developer Not Only Dev, DocGraphs aims to shed light on the relationships between various medical providers, and make that information more accessible to the public. Examples include which doctors and medical centers a specific doctor refers patients to or which laboratories a physician group tends to use. Continue reading
AHCJ has just released a new trove of information from GuideStar on the finances of nonprofit U.S. hospitals. This information – from tax years 2009 and 2010 – contains carefully selected highlights from the hospital’s IRS 990 forms, which nonprofits must file to maintain their mostly tax-free status.
Reporters can use this AHCJ spreadsheet to get:
- detailed salary info on top executives
- the institution’s charity care and community benefit numbers
- a hospital’s lobbying expenses
- and the business relationships of board members, among other things.
This data will be discussed at the Health Journalism 2013 session, “Diving into documents: Using 990s and more to cover hospital finances,” on Sunday at 10:40 am. Howard Rivenson, senior lecturer on health management, Harvard School of Public Health, will join me to help demystify hospital finances.
The newest material from 2010 is here and here are last year’s data.
As part of the ongoing Milwaukee Journal Sentinel and MedPage Today series “Side Effects” John Fauber and Ellen Gabler “examined 20 clinical practice guidelines for conditions treated by the 25 top-selling drugs in the United States” and unearthed yet another tactic by which “pharmaceutical companies, with billions in sales at stake, exert a powerful but often unrecognized influence over the practice of American medicine.”
Issued by leading medical associations and government institutions, treatment guidelines are supposed to be based on rigorous science. But the committees that write them have been dominated by doctors who have worked as paid speakers, consultants or advisers for companies selling the recommended drugs.
In their investigation, the duo found:
- Nine guidelines were written by panels where more than 80 percent of doctors had financial ties to drug companies.
- Four panels did not require members to disclose any conflicts of interest. Of the 16 that did, 66 percent of doctors on the panels had ties to drug companies.
- Some guidelines written by conflicted panels recommend drugs that have not been scientifically proven to safely treat conditions, leading to inappropriate or over prescribing. Medical experts have raised such questions about guidelines for anemia, chronic pain and asthma.
For extensive anecdotes and examples, dig into the full piece.