Shared Wisdom

Sometimes all we need is a quick suggestion from our peers to zero in on a good story. Here we turn to front-line journalists for advice, some simple insight to add to our repository of “shared wisdom.”

Did you have any tricks to get health providers to talk with you? They’re not bureaucrats and don’t have to talk with a journalist.

It’s a hard dance, not wanting to be so pushy that you turn everyone off, and no one wants to talk with you, to being pushy enough that you just have to insert yourself. Maybe you’re willing to stay into the evening until this person has 15 minutes at the end of the day.

I had the luxury, and didn’t have a newsroom to report back to. You have to truly believe you’re giving someone an opportunity. You have to believe that in your gut, otherwise you will constantly feel like you are bothering someone.

Joanne Faryon (@JoanneFaryon) is an award-winning journalist and producer specializing in investigative multi-media projects. She has reported in Canada and the U.S. for regional and national news programs. She wrote a series of stories and produced a six-part podcast on her two-year pursuit of the identity of 66 Garage, a man kept on life support for nearly two decades and whose consciousness was questionable.

Health journalists often get calls from patients who want us to write their story of how someone medically harmed them. They often aren’t sophisticated enough to know what records to ask for or have the money to spend to get them. How would you advise journalists to get those stories without wasting time?

It is tricky. Patients often have trouble getting their records, and when they do, sometimes the information about harm is not even included. I’ve met many people who perseverate on the same thing, and never move beyond that. But I’ve also worked with many who then to go the next step. They dig forever and go to the next level of seeking accountability. It can be years before they put the pieces together. As a patient advocate, a consumer activist, when I make a statement, I better damn well have facts backing me up because some elected official or journalist is going to ask me where that came from. But doctors are rarely asked for evidence to back up their statements. I think verification should be the responsibility on all sides, not just patients.

I also tell patients to file complaints with state and federal regulators, even though most of the time nothing is going to happen. It helps to establish an official record, because everyone they speak to will ask them whether they did so and they will have a report they can provide as evidence. I told this to a group of advocates from an underserved community in Washington, D.C., years ago and they looked at me incredulously. They asked, “Why would we recommend that if nothing’s going to happen? Why would we waste our time or risk our reputation with the people we work with?” There’s a widespread feeling among harmed patients that if their complaints just go into a black hole, it is not worth doing. I disagree and think it has value.

Lisa McGiffert led Consumer Reports’ Safe Patient Project for 15 years, and after 27 years with the advocacy arm of the organization, she retired and co-founded a nonprofit coalition called the Patient Safety Action Network (PSAN), to continue her work on patient safety.

How can journalists tell these stories [about technology in health care] better?

Be really skeptical of hype. Now that there’s a lot of money in this you’re seeing the entry of traditional digital companies and a lot of startups. They’ll sell you a bill of goods and they’ll sell others a bill of goods and they may be well meaning; they’ve got to try and create a business or those initiatives will flame out. The questions aren’t so much about whether the technology is working but what are the deeper implications of this? What’s the workflow?  What happens when the patient gets really anxious about this? Who does the information go to?

It’s technical vs. adaptive change. It’s easy to cover the technical change – here’s the new bell and whistle – and does it do the thing they say it’s going to do accurately. It’s a little harder to cover adaptive change, which is how does this actually fit into the lives of patients and the health systems and health organizations and doctors and nurses? I think those are going to be the more interesting stories.

Robert Wachter, M.D., chair of the Department of Medicine at the University of California, San Francisco, is considered the “father” of the hospitalist field and a leader in the patient safety field. He’s written six books, including “The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age,” which took a detailed look at the role of technology in health care. Wachter is married to journalist Katie Hafner.

What are key questions that journalists should ask themselves (and their sources) when reporting on hospital scorecards?

• Who is releasing the hospital ratings and why?

• What data are they using and how is that data gathered?

• How did the measures get combined to inform the rating?

• What counts for or against the hospital?

• What are the limitations of the data?

• Does my story make statements that are not supported by the data?

It’s never as black and white as anyone would wish.

Marshall Allen covers patient safety for ProPublica. He is one of the creators of ProPublica’s Surgeon Scorecard, which published the complication rates for about 17,000 surgeons who perform eight common elective procedures.