Tag Archives: propublica

Health stories win at ONA for investigations, multimedia

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

The Online News Association has honored two of this year’s bumper crop of excellent health pieces with top honors in their respective categories at the 2011 Online Journalism Awards, with nods going to pioneering work by both ProPublica and The Washington Post.

For ProPublica, AHCJ member Robin Field’s examination of the nation’s Medicare-funded dialysis system and what this oft-overlooked federal budget item tells us about the implementation of “socialized medicine” in America earned the Gannett Foundation Award for Innovative Investigative Journalism in the Small Site category. Since its publication, Fields’ award-winning piece has continued to evolve, adding data and updates as they become available.

Also nominated in the category were ProPublica’s Dollars for Docs and Investigative West’s Livesaving Drugs, Deadly Consequences.

The other prominent health winner was The Washington Post‘s video-heavy “Traumatic Brain Injury: Coming home a different person,” which beat out another multimedia piece, the Los Angeles TimesDylan’s Brain, in the large site category of the Multimedia Feature Presentation award.

Earlier: Health journalists poised for strong showing at 2011 ONA Awards

Pharma discloses free meals, ProPublica expands database

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

In his latest report, ProPublica senior reporter and AHCJ board president Charles Ornstein explains exactly how, since its founding last October, ProPublica’s Dollars for Docs database of pharma payments to physicians has mushroomed from 30,000 entries to more than half a million. They answer, he writes, has a lot to do with free meals and other perks that pharmaceutical companies are starting to publish ahead of strict federal disclosure regulations which will go into effect in 2013.

Pharmaceutical company representatives say the meals serve an important educational purpose, and they have adopted their own set of rules for such interactions.

A voluntary code of conduct adopted by the Pharmaceutical Researchers and Manufacturers of America says that “it is appropriate for occasional meals to be offered as a business courtesy” to doctors and members of their staffs attending information presentations by sales reps.

In such cases, the guidelines say, the presentations have to “provide scientific or educational value,” and the meals should be “modest” by local standards and not part of an entertainment or recreational event. Meals for spouses and take-out meals are not appropriate, the guide says.

To put it all into perspective, Ornstein demonstrates with numbers from Pfizer that, while the meal numbers have certainly increased the number of entries in their database, they haven’t had as significant an impact upon the overall dollar amounts in question.

Relatively, the meals didn’t add up to much money. Pfizer’s meals amounted to only $18 million last year, compared to $34 million for promotional speakers and $108 million for research.

As with previous installments, Ornstein, Tracy Weber and Dan Nguyen’s database work has spawned follow-up reports around the country. In fact, the response was such that Ornstein and Weber even took the step of re-nationalizing the localizations of their story, with the follow-up “News Reports Cite Drop in Physician Speaking Fees.” Below, I’ve linked to a few notable localizations and follow-up stories. If you’ve got another one to point out, add it in the comments.

ProPublica’s Allen opens window into screening business

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

In an investigation co-published with his old friends at the Las Vegas Sun, ProPublica’s Marshall Allen offers a revealing investigation into Heart Check America, a company whose high-pressure sales tactics and dubious quality record have earned it reams of consumer complaints and attention from state authorities.

Allen’s first-person anecdotal opener alone is enough to make the story worth reading, and the fact that he backs it up with thorough investigative work that appears to have already launched probes in two states is just the icing on the cake.

Heart Check America’s business model is eerily similar to that of the time-share industry, which is exactly where manager David Haddad earned his business stripes before being forced out by a state attorney general. Patients are lured in with the promise of free tests, then subjected to high-pressure sales tactics until they fork over thousands of dollars for long-term medical screening packages which they likely didn’t need in the first place.

It’s a classic investigation with evidence unearthed from a legion of sources; here’s just a sample of what Allen has assembled:

Colorado regulators checked Heart Check America’s Denver center. They found a litany of deficiencies, including no proof that staffers operating the scanner were qualified, no controls to ensure patients received as little radiation as possible, and that tests were being conducted without doctors’ orders.

Inspectors also found that the clinic was not supervised by a physician licensed in Colorado and that test results weren’t being read by a qualified radiologist or delivered to patients in a timely manner.

Allen’s work plays right into the debate over the efficacy of various screening procedures, especially those applied to low-risk patients, which makes one paragraph at the end of the story particularly ominous.

Haddad said he is continuing to look for opportunities in the imaging business. He has formed a new company, Cancer Check America, in Hilton Head, S.C, to focus on cancer screening.

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ProPublica investigates ties between doc groups, industry

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

With an assist from Sen. Chuck Grassley, ProPublica senior reporters Tracy Weber and Charles Ornstein, AHCJ’s board president, have published their latest data-heavy investigation (USA Today version). This time, their journey into the myriad avenues pharmaceutical companies pursue to influence physicians has taken them into the world of professional societies and annual conferences. The duo writes that despite the power of these groups, their dependence upon millions and millions of dollars in industry funding has often slipped under the radar.

Professional groups … are a logical target for the makers of drugs and medical devices. They set national guidelines for patient treatments, lobby Congress about Medicare reimbursement issues, research funding and disease awareness, and are important sources of treatment information for the public.

Their strongest anecdote comes from the Heart Rhythm Society, a group which, in 2010, pulled in about $8 million – half their total income – directly from manufacturers of the drugs and devices their members specialize in prescribing for, or implanting in, patients. The society has started to disclose these relationships, but perhaps not to limit them, the reporters write. “’This is our business,’ said Dr. Bruce Wilkoff, the incoming society president. ‘We either get out of the business or we manage these relationships. That’s what we’ve chosen to do.’”

The companies also pay two-thirds of the society’s board members speaking or consulting fees, a situation Weber and Ornstein found is far from unusual. In addition to these financial conflicts, the reporters gathered some fascinating examples of just how deep industry influence can run. My personal favorite comes from the conference of a well-known collection of cardiologists.

Last month, the American College of Cardiology attached tracking devices to doctors’ conference ID badges. Many physicians were unaware that exhibitors had paid to receive real-time data about who visited their booths, including names, job titles and how much time they spent.

For more examples, I recommend Robert Durrell’s photographs from the 2011 Heart Rhythm Society annual conference, which show dozens of industry-sponsored objects alongside the amount of money each company paid for that particular privilege. Dan Nguyen and Nicolas Rapp put together an infographic that expands upon a similar theme.

Much of the disclosure data the ProPublica team depended on for their reports was released in response to a request for informationGrassley sent out in late 2009. His investigation has started to yield some preliminary results.

There are fledgling efforts to push medical societies toward stricter limits on industry funding: 34 groups have signed a voluntary code of conduct calling for public disclosure of funding and limits on how many people on guideline-writing panels have industry ties.

“The general feeling is that the societies need to be independent of the influence of companies,” said Dr. Norman B. Kahn Jr., chief executive of the Council of Medical Specialty Societies, which helped draft the code.

Sponsored segments, hospital partnerships creep into news outlets

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

In the St. Louis Post-Dispatch, Blythe Bernhard takes a look at the fruits of the slow, steady advances hospitals and health providers have made into local television and print news. In recent years, sponsored segments and partnered content have insinuated themselves into broadcasts, columns and news-esque advertising spaces.

According to Stacey Woelfel, news director at KOMU-Columbia, Mo., partnership offers are more likely to come from medical institutions than from other sectors. There’s no denying that cash-strapped media outlets have welcomed the extra revenue, and the numbers show that providers have come out ahead as well.

tvnews

Photo by purple_onion via Flickr

Hospitals that promote their services during news broadcasts say the exposure is more effective than pure advertising. The Mayo Clinic in Minnesota launched its own news department a decade ago to distribute its “Medical Edge” stories to media outlets nationwide. A Mayo survey showed patients’ stated preference for the hospital increased about 60 percent within three years of the news service’s launch. Hospital executives said the business value of “Medical Edge” was more than 10 times the cost of producing it, according to the Columbia Journalism Review.

But media critics, including AHCJ member Gary Schwitzer, say that providing all that valuable exposure may involve ethical compromises on the part of news organizations. After all, they’re ceding some control over the content they air.

“It looks prestigious, it looks clean, it looks expert, but this is information that is coming from and being bought by one medical center source,” said Gary Schwitzer, publisher of Health News Review. “Who has vetted that to say that is the best information, and when are we going to hear from other players in town?”

And, by forming these partnerships, news organizations are allowing hospitals to become the gatekeepers for medical news, and thus indirectly allowing financial concerns to dictate what is considered newsworthy. To illustrate the quandry, Bernhard mentions a 10-month cancer prevention series that was created through a partnership between a St. Louis local hospital and a TV news station. It includes weekly news segments, regular two-minute paid ads during commercial breaks and even monthly phone banks and online chats. Cancer prevention is certainly news, but AHCJ’s president told Bernhard there may be other reasons why it’s driving this particular news and advertising blitz.

Cancer is big business for hospitals competing in a “medical arms race” to attract patients with insurance to fund hospital investments in MRI scanners and robotic surgical instruments, said Charles Ornstein, president of the Association of Health Care Journalists and senior reporter at ProPublica, a non-profit investigative newsroom based in New York.
“There’s a reason they chose cancer instead of diabetes care for the uninsured population,” he said.
Even a medical topic as seemingly straightforward as cancer prevention generates differing viewpoints and requires health reporters to reach out to multiple sources, Ornstein said.

For disclosures of the Post-Dispatch‘s own partnerships, see the final subheading, “Popular topic.”

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