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Using evidence, FDA reports and legal documents to explore robotic surgery’s risks and benefits Date: 07/23/15

Robotic surgery has exploded in popularity in recent years, but is that because it actually improves patient outcomes over traditional surgery methods or because of marketing campaigns? That is one of the questions Laura Beil dove into in her award-winning story for Men’s Health, “What’s Wrong With Robotic Surgery?

In a story that involved months of reporting, Beil “used FDA and legal documents to explore concerns over the safety” of a prostate robotic surgery procedure and wove together her findings “into one concise narrative that engaged and informed Men's Health readers.” The reporting required FOI requests for adverse events from surgery (along with documents related to recent inspections and findings), legal documents from malpractice lawsuits and a class action suit against the manufacturer, and dozens of scientific studies to determine whether robotic surgery represented an advance in treatment.

Beil also describes the pushback after publication, adding that posting corporate responses online is a powerful way to expose unjustified pushback.

Laura Beil

By Laura Beil

A few years ago I did a story for Men’s Health on proton beam radiation. If I learned one thing, it was that if you want to promote a new technology, sell it to men worried about bladder and sexual function after prostate surgery. So the first time I saw a billboard for robotic surgery making just those claims, I had to wonder whether I was seeing an advancement in marketing but not medicine.

It also helped that about the time I started paying attention to robotic surgery, notices from the FDA were raising concerns about the safety of the technology, the first large malpractice suit was coming to trial, and the manufacturer had a class action suit filed against them. But even though pieces of the story were being reported, nothing I read pulled everything together, or tried to answer the overarching question that a man would want to know: Is robotic surgery better? So I set out to write the most definitive story I could, with the patient in mind.

The reporting was time consuming, but without major roadblocks (aside from the usual FDA difficulties). The real challenge was writing and story construction. I had hours of interviews and stacks of documents that encompassed every aspect of robotic surgery – medical studies, legal filings, the history of the surgery and more. I was in real danger of overwhelming a reader with a notebook dump, or meandering around from topic to topic in a confusing way. Plus, it had to fit into the magazine, so I had to distill everything I had down to about 2,500 words. I had set out to write the definitive story on robotic surgery, but it was in danger of collapsing under its own weight.

The real grief for me came after the article was published. I took pains to make sure the story was fair and accurate, but Intuitive Surgical, the manufacturer, didn’t see it that way. After publication, I received an email from a reputation management firm (I didn’t even know such a thing existed), saying I had errors in my story. They wouldn’t tell me what the errors were, but asked for the contact information for my editor. I walked around with a knot in my stomach for days, agonizing over what I could have gotten wrong. So did Jaclyn Colletti, the head researcher for Men’s Health, and one of the finest fact checkers I have every worked with.

They finally sent a letter to my editor that was almost three pages long, single-spaced. There were no errors; they simply took exception to opinions they didn’t agree with. It’s not necessary for me to rehash it here, because in a brilliant move, my editor decided to put their objections and his responses online.

The only thing I will highlight is one of the objections they had related to my paraphrasing an FDA action against them. I’ve sat in on a lot of debates over whether journalists should actually show any of their copy to sources prior to publication. I see both sides, but generally don’t consider this a problem as long as you make it clear that you are only checking for errors of fact and that editorial control remains with you and your editor. In this case, showing my copy to a source ahead of time proved to be an extremely valuable move. In their request for “corrections,” the company said my characterization of the FDA action was “misleading at best.” However, I had emailed this exact wording to their corporate PR person – and I had her response, in writing, saying that what I had written was an accurate summary. Had I not sent her the copy, or had I just read it over the phone, I would not have had the proof I needed to show that their after-the-fact protest was just an attempt to discredit a story they didn’t like.

Working in magazines, I usually don’t have the luxury of space for my stories—I can’t write multi-part series or 10,000 word features. I used to long for this kind of space, but over the years I’ve learned that it’s possible to deliver a concise, complex, information-packed story that serves readers. The only problem is that in the freelance world you’re paid for published length, even when, as in this case, writing short proves to be a lot more work than writing long. But that’s a discussion for another day.

Laura Beil is a freelance health and science journalist, contributing editor at Men’s Health and correspondent for Science News magazine. Follow her on Twitter at @ljbeil.