- http://www.stltoday.com/news/local/woman-s–month-decline-highlights-end-of-life-care/article_d9310228-bd52-11e1-b34e-001a4bcf6878.html
- http://www.stltoday.com/business/local/mid-america-transplant-services-and-its-officials-move-into-for/article_f37bb65b-f000-5bf7-bc00-097b2f6341f5.html
- http://www.stltoday.com/lifestyles/health-med-fit/is-hospice-a-better-way-to-die/article_72b6ecf4-e7c5-11e1-ab65-001a4bcf6878.html
- http://www.stltoday.com/business/local/ascension-health-plans-billion-cayman-health-city-project/article_cbe07d56-8d91-11e1-85c9-001a4bcf6878.html
List date(s) this work was published or aired.
“The Care Quandary” — June 24, 2012 “The Business of Body Parts” — Nov. 4, 2012 “People’s Near Life’s End Choose Comfort, Control” — Aug. 19, 2012 “Ascension, partner mix message on ‘health city’ ” — April 24, 2012
Provide a brief synopsis of the story or stories, including any significant findings.
I cover the business of health care in St. Louis — a major medical community with two academic medical centers. My coverage includes Missouri-based hospitals, pharmaceutical firms, insurers and phsycian groups. I’ve chosen to focus mainly on the nexus between cost and quality of care, and constantly press for transparency when I write about non-profit and for-profit health systems. I specialize in telling the story behind the story, finding ways to explore and investigate business, ethical, legal and public policy issues in medicine. But I also try to humanize these stories to draw readers into the complexites of health care and help consumers become better informed decision-makers.
Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?
I rely on a broad range of documents and data in covering this beat. For the four submitted stories, these documents included hospital billing records; patient medical records; Form 990 tax filings; audited financial statements; conflict of interest policies; local property tax records; federal and state statutes; secretary of state filings; the federal tax code and filing instructions; litigation records; SEC records; medical journal and health policy journal articles; organ donation consent forms; Dept. of Health and Human Services inspection records and inspector general reports; land development proposals; studies by Dartmouth Atlas project, Centers for Medicare and Medicaid Services, Medicare Payment Advisory Commission, the Centers for Disease Control & Prevention, and trade associations; annual reports; US Census Bureau statistics; state of Missouri reports on hospice providers; CIA’s World Fact Book; web searches; and news clippings; . No FOI requests were made on these particular stories.
Explain types of human sources used.
Interviews with patients and their family members; providers including doctors, nurses and hospital and hospice administrators; state officials; Centers for Medicare & Medicaid Services officials; trade association representatives; medical tourism experts; insurance executives; experts on medical, business and legal ethics; authorities on palliative care; executives and board members at several transplant organizations; family members of organ donors and recipients; physicians involved in the organ transplant industry.
Results:
These front-page stories prompted public discussion about business and medical ethics and a strong response among the Post-Dispatch’s print edition and internet readers, many of whom posted online comments and submitted letters to the editor.
Follow-up (if any). Have you run a correction or clarification on the report or has anyone come forward to challenge its accuracy? If so, please explain.
Two of the submitted stories involved end-of-life care issues, and one naturally followed the other. The other two stories arose from the normal course of scouring my beat for new developments. The medical tourism story on Ascension, the nation’s largest nonprofit health system, followed a breaking news story I wrote on Ascension’s $2 billion project. The Body Parts story arose from my curousity about the organ and tissue business; I am working on a follow-up story. No corrections or clarifications have been issued on the four stories submitted.
Advice to other journalists planning a similar story or project.
Covering the health care industry is like peeling a giant onion — as complex a beat as I have pursued in many years of reporting. As you reach each level of partial understanding, there’s always another riddle to solve or a mystery to explore. That’s what makes the challenge and hunt so exciting. More specifically, look beyond the simplistic messages that company officials spin, and explore their motivations in structuring business relationships and deals. Trust your investigative instincts, and search for proof of your hunches. Use visual representations to chart out the inter-relationships of companies and their executives. Prepare exhaustively for big interviews so that you ‘re ready to ask the most telling questions. Listen closely to an interviewee’s responses so that you can ask the most specific follow-up questions. In trying to humanize these stories, approach family members gingerly, but also be sure to retain perspective so that you’re not too easily swayed by their point of view. Don’t settle for what you learn in a single interview with family members, physicians and other medical experts; go back repeatedly to learn more. Weed through your assumptions, bias, and suspicions to find the truth. In writing, look for ways to meld evocative details and policy perspectives.