Tip Sheets

Plunging into health care: Tips for beginners

How to find “real people” for your stories, by Tony Leys of the Des Moines Register:

• Introduce yourself to folks in the audience at forums or public meetings. Many shy away from the microphone, but they often have compelling reasons for showing up.

• Post a box with your stories, online or in print, saying you’d like to talk to people who have experiences with the subject you’re covering. Don’t be too specific about what you want to discuss. The most valuable responses will come from people who will tell you things you’ve never heard about.

• Post a box saying you’ll help readers find answers to their questions about a subject. (The Affordable Care Act is a great one.) This can lead to decent Q&A columns, but more importantly, it can draw in tips about complications and concerns that are just coming to light.

• Read letters to the editor religiously. Also, ask the editorial-page staff to send you copies of all letters about the subject you’re covering. Many letters go unpublished because of space constraints or because they’re poorly written. But the authors are people who are interested in the subject and are willing to talk publicly about their experiences. Bonus: Letters-to-the-editor submissions include phone numbers and e-mail addresses.

• Respond to commenters on your stories if they appear to have personal experience. Even the ones who portray you as a doofus in the comments section can wind up being valuable sources if they realize you’ll hear them out.

• Try to build a reputation in your newsroom as someone who will talk to nutty-sounding callers. Three-quarters of them will, in fact, be nuts. Okay, 90 percent. But there’s gold to be panned from that stream.

• Seek out local volunteers for patient advocacy groups. Skeptics doubt the credibility of many of these groups nationally, because the groups are heavily financed by drug companies. But the local volunteers tend to be motivated patients or family members, and they often know many other families.

• Try not to rely solely on doctors or hospitals to identify patients to talk to. It can be hard to get around this on deadline, but recognize that if you go this way, you’re inevitably going to get the patients who had the best outcomes. At the very least, you should highlight this fact high in the story, and explain what the average outcomes are.

• Always ask patients about the cost of their care. Even ones who rave about a treatment are likely to acknowledge if it cost them a fortune or if they had trouble getting an insurer to cover it.

Dos and Don’ts from Martha Bebinger, WBUR radio, Boston

Do:

• Determine the top three people in the area of health care you plan to cover and persuade them to talk to you on background once a month or so.

• Find the journal and the blog that focus on the area you want to cover.

• Find the patient network, association, or meet-up that will be most useful when you are looking for the consumer perspective.

• Track the hashtags on Tumblr or Twitter that are most relevant.

Don't:

• Let jargon slip into your stories. Make sure you convert health care speak into plain English.

• Hesitate to ask for proof. As reporters, we sometimes behave like patients and forget to question a doctor's orders.

• Accept the POV of one specialty group without contacting another that is relevant.  Don't let a family doctor say that a test cardiologists order all the time is a waste of money without hearing from the cardiologists as well.

• Be put off by stories that seem difficult or dense.  If they are hard for you to understand, they are even harder for the general audience, but that doesn't mean they aren't important.

Tips when starting out on the beat, from Lola Butcher, freelance:

• Record interviews and get a complete transcription, including the parts that you think are not important for the assignment at hand. Read through transcripts to learn how a source is redirecting conversation in nuanced ways, facts you did not know, or connections that were not previously clear.

• Identify the professional organizations that are pertinent to your beat. Study their websites to identify good sources, what’s hot for their members, or what leaders are lobbying Congress for.

• Identify the professional meetings that your best sources attend. Even if you can’t go to the meetings, scour the agendas (almost always available online) to find out what the sessions are and who is presenting. That may be a source of story ideas and will definitely help you understand what should be top of mind in beat coverage.

Advice and cautions for reporters new to health care from Felice Freyer, Providence Journal

• Be prepared for complexity. No health-care story is ever as simple as it looks when you start out.

• Don’t be cowed by impressive academic titles. No matter how brilliant or how well-meaning your sources, ask for evidence for their assertions and seek out people who may disagree.

• Don’t be dazzled by technology. Each new machine and new technique comes with new risks. Make sure you find out about the downsides, including the risk of unnecessary treatment or high costs.

• Remember that medical care is not always a good thing. Often, it does harm and too much care can be worse than too little.

• There are few health stories that don’t involve money. No matter what you’re covering, ask: What does this cost? Who’s paying for this? Who’s making money from it?  

• Health care is also rife with conflicts of interest. Be sure to find out what the person you’ve interviewed has to gain and who funded the research you’re writing about. Let your readers know.

• Ask anyone who makes a health claim to provide evidence (this treatment/product/procedure saves lives/saves money/is safe). For help in evaluating the evidence, see AHCJ’s guide, “Covering Medical Research.”

• Be wary of anything billed as “natural” or “alternative.” Aside from being ill-defined, “natural” does not equate to safe. Some of the deadliest substances on earth are totally natural (foxglove, botulinum). When you hear about “alternative” medicine, ask, “Alternative to what?” “Alternative” can signal anything from quackery to a worthy challenge to common practice. Don’t use the word without making clear what it stands for.

• If you expect to be covering health care on a regular basis, be visible. Cover minor events just to get a chance to meet people and have them notice your byline. Go to meetings that you don’t plan to write about, just to hear what’s going on and meet the players.  

• As people get to know you, they will inundate you with story proposals and press releases. Set consistent standards for selecting among them. What most matters to your readers (not your sources)?

• Learn the regulatory structures of your community. Is there is a Certificate of Need program? Which facilities and professions are licensed, and by whom? Who would be in charge of handling a disease outbreak? Which state agency runs the Medicaid program? Do your state and county health agencies post inspection reports or quality ratings online?

• Don’t get sucked into disease awareness campaigns. The mere fact that it’s “Polycystic Fibrosis Awareness Month” does not justify a story and writing about it can really put you in a bind when “Hallux Abducto Valgus Awareness Week” rolls around. If the only purpose offered to write about an illness is “to raise awareness,” or if the only local angle is a local doctor or patient, that’s probably not good enough. But there are always exceptions, so listen to these pitches and keep your ears perked for the new and surprising.

• Explore the broader context if you’re going to write a story about a family holding a fundraiser for medical treatment. These are rarely just the heart-rending human interest features they appear to be on the surface. They can point to problems that should be explored. Why does the family need to charity from strangers? Is their insurance company being unfair or is the treatment bogus or unlikely to work? Do they have no insurance or inadequate insurance, and what are the implications of that for the rest of us?

• Beware of rankings and “report cards.” They have no absolute meaning. The selected criteria reflect the particular concerns of the organization doing the ranking. If you’re going to write about this, find out exactly what was measured, what wasn’t measured, and why.