Awards for Excellence in Health Care Journalism: 2010 winners
The story chronicles how the author's father's last years were unnaturally prolonged by a pacemaker, and the perverse financial incentives within medicine that promoted his overtreatment. It wove together the personal story of the author's parents' lives and deaths with medical studies and investigation of Medicare reimbursement policies, cardiology treatment guidelines, and lobbying by the medical industry. It shows the sometimes intense personal costs of the technological imperative at the end of life, and it publicized the under-recognized risks of "living too long" thanks to a modern cardiac device.
Katy Butler's moving examination of the final agonizing years of her father's life - prolonged by a pacemaker - is both a compelling first-person account of her struggle to come to grips with her grief and a striking indictment of what is wrong with the American health care system.
In unflinching candor, Butler takes the reader into the world of end-of-life medical care, lending flesh-and-blood realism to the ongoing national debate on health care reform. Butler's piece is by turns touching and distubing, insightful and biting, compassionate and clear-eyed. She traces how a decision made in just a few minutes after a hurried exchange with a surgeon set her father on a course that Butler, her mother -- and least of all her father -- wanted. Even as his mind deteriorated, the pacemaker relentlessly kept him alive.
She delivers the story with an investigative reporter's eye for detail, a novelist's sense of pacing and a consumer advocate's talent for providing useful information to the reader. Many reporters have spotlighted gaps and flaws in the U.S. health-care system, but rarely with such eloquence and high-minded conviction.
The piece forces the reader to confront, compare and contrast the two end-of-life experiences of her parents - one good, one bad. Without overstatement or melodrama, she makes clear that the health-care industry should place a higher priority on quality over quantity of life in such cases. She artfully tracks the soft-money stream and financial interests that drive many medical and health-care decisions.
A winning combination of personal memoir, narrative storytelling and deep consumer reporting, "My Father's Broken Heart" should be required reading for any member of Congress who will weigh in on health care issues and Medicare this year. We feel certain Butler's mother and father would have been proud of the way she has nobly and ably characterized their struggles with their own declining health and the health care system.
In 2009 an unprecedented number of baseball players quietly went on MLB's disabled list for a publicly disclosed mental illness. This story not only asked why so many "injuries" occurred but provided an in-depth look at the sport's unique relationship with psychiatry and psychology from the men – doctors, players, coaches, executives, researchers – directly impacted and involved. One active player, Ian Snell, described struggle with mental illness and thoughts of suicide; another, the retired Bill Pulsipher, opened up about the maltreatment by his former employer, the Mets; and the sport's leading authority on psychology, Harvey Dorfman, admitted to not having any actual academic or professional training in the field.
Pablo Torre's inside glimpse into the ways Major League Baseball is changing its approach - and culture - in responding to athletes with mental health issues is a compelling fly-on-the-wall report on a topic rarely discussed inside or outside the locker room
Solid reporting. Insightful commentary. Inspiring human stories. They're all here in Torre's tale of the difficult struggles faced -- and overcome -- by the pro athletes at the center of the issue.
What distinguishes the piece is Torre's ability to provide a rare glimpse into one of the most exclusive Boys Club cultures in America: the MLB. He shines a light on a topic that, for decades, was kept hidden in the dark corners of pro ball. He chronicles how the few athletes who've been open about their struggles have coped, if not conquered, their demons. He also shows how league officials have accepted and addressed mental health issues.
"A Light in the Darkness" offers a candid account of the moving stories of human tragedy and triumph. In so doing, Torre paints a portrait of the new face of the American Sports Hero. Nice work.
Kotler's piece looks at the underground world of psychedelic medicines, which have reappeared in the mainstream after a 30-year absence. It reports on the use of MDMA (ecstasy) to treat post-traumatic stress disorder, as well as the use of mushrooms to treat what is known as "fear of death" (i.e., life) anxiety.
Steven Kotler artfully weaves the story of a dying cancer patient's experimentation with ecstasy and other illegal psychedelic drugs to relieve her pain and anxiety with an account of researchers who are conducting clinical trials of these drugs in an effort to provide an evidence base for them to be used legally for cancer patients and veterans with PTSD.
Kotler's reporting is impressive, most notably his ability to gain the trust of Mara Howell and her mother, who allowed him to be a fly on the wall in her last days as she was treated by an underground psychedelic therapist. He demonstrates a keen eye for detail and comprehensively traces the colorful history of psychedelic drugs in medicine, providing the context for the current wave of interest.
While he writes with a strong point of view, Kotler is careful to point out that the trials are still ongoing and to not cross over into advocacy.
New York Magazine's Mark Levine examines the systemic financial crisis facing the New York City hospital system. Levine documents the crisis, unravels its causes, and makes plain its implications. Millions of people use the New York City hospital system, and tens of thousands – a disproportionate number of them old, sick, or poor – are likely to lose access to quality health care if action isn't taken to address the system's fiscal instability.
A smartly written, meticulously reported account of how and why the bankruptcy and closing of an iconic New York hospital is an alarming reflection of the broader ills of the city's hospital system. A self-described novice to covering the intricacies of health policy and the hospital business, the author nevertheless weaves in plenty of perceptive insight around the economic, political and medical forces that drive the dysfunctional health-care system far beyond the five boroughs of New York.
This article is a journalistic examination, through one person's personal story, of the costs of end-of-life care.
With courage and candor, a reporter uses a daunting compilation of medical records, interviews with doctors and other caregivers and her own recollection to take readers on a compelling, bittersweet narrative of her and her husband's seven-year battle with his cancer. End-of-life is often held up as a huge bucket of waste in the U.S. health-care system, and perhaps it is. But as the author and her husband rely on generous health-insurance, the hope of technology advances and the strength of their relationship to negotiate their "series of expensive last chances," few easy choices are in sight.
The story covers the rise and fall of an Indian kidney trafficking ring, illuminating the anatomy of the global kidney trade.
From the first sentence, readers are propelled on a chilling journey where a dying woman's desperate gambit for a new kidney leads to a thriving, global black market, centered in the outcast slums of India, where poor workers were tricked or forced to sell their organs. The author crafted a vivid, intimate narrative that dug beneath the headlines of a high-profile investigation to illuminate the many victims of transplant profiteers.
First Place: Rationing Health: Who Lives? Who Decides?; David Baron, Patrick Cox, Sheri Fink, PRI's The World, WGBH-Boston
In 2010, PRI's The World reported from South Africa, Great Britain, Zambia and India to examine how other governments manage the costs of delivering health services to the public. Each country, with its unique economic and cultural environment, provided an opportunity to spotlight different approaches to the challenge of rationing scarce health care resources: explicit rationing by committee, rationing by cost effectiveness, unintentional rationing, and innovation to avoid rationing altogether. The series, the result of a more than half-year reporting and editing effort, was presented along with a website and opportunities for interaction via Twitter and online discussions. See the story on the web.
The terrific series addressed one of the hottest 2010 election topics in a different and fascinating way by looking at the realities faced in other parts of the world.
I was hooked by the first characters – doctors deciding who will get life-saving dialysis in South Africa.
It was clever to not start with the obvious – the much demonized British system – but smart not to wait beyond part 2 to address this country as well. Parts 3 & 4 were also very intriguing and the analysis in the final part was a nice way to button up the series without belaboring the points already made in the previous episodes. Great job.
Second Place: A Scientist's Saga: Give Son the Gift of Speech; Mary Beth Kirchner, National Public Radio
This radio documentary profiles a neuroscientist who has advanced treatment and research on autism, primarily because of his extraordinary devotion as a parent. Dr. Barry Gordon is a neurologist and a psychologist at Johns Hopkins University and a leading expert on memory and learning. When Gordon became interested in how human beings develop language, he never dreamed he'd have to confront it head on. His youngest son, Alex (age 18) is severely autistic and unable to speak. A dozen years ago, Gordon took an extended sabbatical from Hopkins to devote himself to research into his son's condition. With the help of an anonymous donor (who also has a similarly severely autistic child), Gordon has developed a full-time home based education program for his donor's child - resulting in some speech never thought possible in a severely autistic adolescent.
This was a great piece. It wasn't the first time I heard of an autism researcher pursuing this field because his own child was locked inside the world of these neurologic disorders. But it was the first time I heard a story, where researchers found the key to unlock one child's silence. As I'm sure many listeners were, I was hoping this method would help the doctor's son as well. I've covered a lot of autism stories, and this was a refreshing new angle, told in a very engaging way.
It was one of my favorites. Good use of sound bed and "nat" (natural) sound. Powerful use of words to draw pictures in the listener's head. This narrator knows how to use radio. This is a finely crafted story that took a lot of research (author's notes say it was years in the making).This is an amazing story and deserves an award.
Current national debate around end-of-life care is focused on elderly Medicare patients. Arguments are rife around what the government will pay for at the end of life and how policies affect patients' medical decisions. But what about when children die? Federal reimbursement rules are no different for 5 year-olds than they are for 85 year-olds. Children cannot receive in-home palliative and hospice care unless they forego any life-prolonging treatment and agree to a doctor's prognosis that they have less than six months to live. In California, Medi-Cal, the state's public insurance, began testing a new reimbursement model in a pilot project that allows children in select counties to receive both hospice and curative treatments concurrently. This story looks at the project and the state of pediatric palliative care in California.
This is a topic that is almost never discussed. Kudos for tackling this heart-breaking topic in the first place. The story came to life with the children. It was sad and the little boy who was dying sounded so mature for his age. The story tugged at your heart without being sappy. Despite being such a sad topic - it's a reality some families have to face and I was not changing the channel until it was over.
Ground-breaking, insightful story. Excellent sound bites. Well-organized narrative, easy to follow and grasp. Fact-filled and well-researched, but emotionally moving as well. Poignant punch line (boy interviewed at length died before story aired).
Rural hospitals across the nation have struggled to stay afloat. There are, of course, fewer patients in rural areas, and many of them are on public health insurance programs that pay far less than private insurers. Residents in Modoc County, in the remote northeastern corner of California, will soon vote on whether to tax themselves to save their local hospital. The county has gone broke trying to keep the hospital open, and a fractious debate has erupted in this proudly conservative, frontier community over the best way forward.
First-class job on weaving-together all the threads connecting a hospital to a community. Presented in a way that is easy for the listener to grasp. Good grass-roots explanation of economics and politics! of health care; unusual, clever and well-researched approach to the subject. Held my interest to the very end (hard to do for 8 minutes on radio).
Honorable mention: The Economics of End-of-Life Care: Part I & II; Caitlan Carroll and Betsy Streisand, Marketplace Radio
This series that aired on the national business show "Marketplace" looked at the reasons behind the growing costs of end-of-life care and how patients' options may change in the future. The first story explained why the "best" care at the end of life is not always the most expensive care. The story described how the breakneck pace of technological development has led to an over reliance on expensive interventions. The second story looked at how the conversation surrounding end-of-life care may change. A number of hospitals and other health care providers are creating palliative care teams to treat chronically and terminally ill patients. The hope is that palliative care may increase quality of life and decrease costs for the terminally ill. See the stories online:
Another hot election topic - this one explained in a very rational and clear and compassionate way. It was the kind of crisp reporting that I would sit in garage for, listening to the end of the report.
Lazar's entry included stories about:
- Antipsychotic medications given to patients in nursing homes and the risks for patients that have dementia
- The impact of earlier coverage of this issue: state regulators and industry leaders formed a task force and launched an educational campaign to reduce the inappropriate use of the medications.
- An unintended consequence of Massachusetts' pioneering health care reform law
- The widespread practice of no-bid contracts in the Massachusetts Medicaid procurement system and the $400,000-plus salaries of officials involved in the contracting process.
See the stories on the Web:
- Nursing home drug use puts many at risk
- Short-term customers boosting health costs
- Feeling him slipping away
- Medicaid contracts with UMass Medical School unit scrutinized
- Mass. aims to cut drug overuse for dementia
Kay Lazar of the Boston Globe, for the range and depth of her health policy coverage, and its measurable impact. Her reporting on no-bid contracts for Medicaid and on "gamers" who exploited a loophole in Massachusetts' universal health coverage law exposed costly problems and drew responses from state regulators and lawmakers. Her reporting on excessive use of antipsychotic drugs in state nursing homes prompted regulatory review and new training. Her news feature story about a storeowner with early-onset Alzheimer illustrated the impact of a devastating disease and the genetic testing quandary facing family members.
House call doctor daily work highlights health-care reform issues such as end-of-life decisions and rationing of care. Life-or-death coin toss shows the emotional terrain that genetic testing holds. Family's nightmare illustrates the lack of treatment available for people with brain injuries. Insurance cap story shows one family's experience with hitting a cap that health care reform recently eliminated for children.
See the stories on the Web:
- Huntington's disease a life-and-death coin toss for family
- He makes house calls - and provides a sympathetic ear
- Beach family battles a disease - and an insurance cap
- A family's worst nightmare: Child with traumatic brain injury
Elizabeth Simpson of the Virginian-Pilot, for her engaging, compelling use of individual case studies to illustrate major health policy issues, from genetic testing and the dilemma it poses (a Huntington's disease family) to the impact that the new federal health care law may have on individuals and families, both in abolishing lifetime benefit limits and exclusions of pre-existing conditions, and through demonstration projects testing less expensive, more humane delivery of care (illustrated here by a doctor whose practice consists entirely of house calls.)
Helfand's entry included stories about how insurance giant WellPoint Inc. posted an eightfold increase in profit in just three months. He followed this initial reporting with stories about flaws in Anthem's rate application. The math errors were uncovered by an independent actuary hired by the state and Anthem was forced to cancel its hikes. In the end, Anthem wound up delaying for six months and settled for about half of what it had originally sought – saving California consumers about $150 million in premiums. Anthem's president lost her job as a result and state regulators decided to examine rate applications submitted by three other major insurers.
Duke Helfand of the Los Angeles Times, whose stories about the huge rate increases that Anthem Blue Cross sought to impose on individual policy holders in California in 2010 had an immediate impact on the national health care debate at a critical juncture, vividly illustrating the problems faced by Americans who lack employer-sponsored health insurance. They also had a measurable impact in California, helping produce rate reductions for policy holders as a result of the work done by an independent actuary whom Helfand profiled.
Seattle Times reporter Michael J. Berens discovered that thousands of vulnerable adults have been exploited by profiteers or harmed by amateur caregivers in Washington's 2,800-plus adult homes. Elderly victims were roped into their beds at night, strapped to chairs during the day, drugged into submission or left without proper medical treatment for weeks. Owners even listed elderly residents as commodities in the sales ads for such homes. Berens also uncovered at least 236 deaths that indicated neglect or abuse in these homes but were not reported to the state or investigated. Further, the state excused mistreatment even when it knew that home owners had lied to its investigators, provided falsified medical records, or contributed to preventable deaths. The state, Berens discovered, had a hidden agenda: To reduce the state's Medicaid burden, caseworkers had to meet monthly quotas and relocate thousands of nursing-home residents into less-expensive adult family homes. The state may have saved millions of dollars, but many seniors were placed in inappropriate homes where they suffered harm.
Michael Berens' searing reporting on slipshod, superficial licensing and oversight of adult care homes in Washington State skillfully blends accounts of human suffering, attempts by state regulators to dismiss the seriousness of his findings, and dogged data mining. A shocking reflection of the co modification of healthcare generally and of those who cannot defend themselves in particular.
Michael Berens connects the dots between state workers assigned quotas for moving the most fragile among us into shark-infested waters, and the tragic consequences that followed. A fine example of why newspapers still matter.
Amy Harmon takes a close-up look at the testing of a melanoma drug whose targeted approach to cancer treatment is widely seen as holding promise. Told through the eyes of the doctors and the dying patients involved in the drug's clinical testing, it illuminates the scientific and ethical challenges of drug development in the dawning era of personalized medicine. And it shows just how much dedication and loss it takes to make even a little headway against cancer. The series ran in five parts over the course of 2010.
Amy Harmon spins out a rich tale of medical science and how it gropes its way forward to develop drugs that might add weeks, then months and then years to life. At its heart, though, this is a story about ambitious, passionate researchers who cry when a patient relapses; about terribly ill people who manage to joke through their fears when told their illness has returned; and about the altruistic force that compels a dying patient to drive hundreds of miles so a researcher can take a sample of tumor tissue.
A gem of a series. Ms. Harmon expertly reduced complex science into a compelling and moving narrative of resolve and suffering.
This series details the use of anabolic steroids and human growth hormone by hundreds of New Jersey law enforcement officers and firefighters, who in most cases used their taxpayer-funded health benefits to pay for the substances, running up a bill in the millions of dollars. The series shows how deeply the substances have infiltrated law enforcement agencies and fire departments, endangering the users and, potentially, the public. Separately, the stories show how easily the substances can be obtained when a doctor chooses to abandon medical protocol, illegally churning out prescriptions based on phony diagnoses.
Amy Brittain and Mark Mueller's series about a physician who seemingly injected steroids into every cop and firefighter in Newark with a Rambo wish is a great read, original and deeply researched. But it is also worrisome. How many of our cops and firefighters in other towns and cities similarly put themselves, and those they are sworn to protect, at risk so they can muscle up? How many other physicians and pharmacists are happy to cooperate?
An original angle, good shoe-leather reporting and crisp writing add up to an eye-popping series of stories that impressed the judges.
Reporters examined more than 550 SIDS cases over five years, finding that about two-thirds of SIDS babies were sleeping in risky situations that suggested the cause could have been suffocation. SIDS babies in North Carolina, the newspaper found, were often sleeping face down in a pillow, or in an adult bed piled with blankets, or with two or three other people who could have rolled over on the baby. Sometimes the infants were face down on sofas, or on their own parents' chests in a recliner. At least one baby died face down in the arms of a parent who had lost another infant in a risky sleep situation. And though the SIDS diagnosis isn't recommended unless doctors can exclude all other causes of death, reporters found 50 SIDS autopsies where the pathologists wrote notes saying they couldn't exclude overlying by an adult or other potential cause of suffocation.
If the message of this powerful ensemble series could somehow capture the attention of public health officials not just in North Carolina, as it did, but around the nation, hundreds, perhaps thousands, of infant deaths might be prevented.
A well-researched, well-written and nuanced series of stories that will no doubt save lives.
Making use of data never before obtained by a news organization, The Wall Street Journal was able to demonstrate how mining Medicare claims can expose waste and potential fraud in the $500 billion government health program for the elderly and disabled. A computerized record of every billing claim submitted to Medicare and every dollar paid out, the Medicare databases the Journal gained access to are regarded as the single best key to understanding the American health care system. The Journal showed how they can be used to contain the country's spiraling medical costs. In particular, the series turned the spotlight on the secrecy that cloaks information about individual doctors – a restriction that results from a little-known, 30-year-old court ruling – and how that secrecy allows physicians to abuse the taxpayer free from public scrutiny.
Mark Schoofs, John Carreyrou, Maurice Tamman, Tom McGinty, Anna Wilde Mathews and Barbara Martinez spent almost a year and a half prying Medicare payment data out of the federal government and digging through it, finding thousands of physicians enriching themselves at taxpayer expense through ineffective and even dangerous treatments, self-referrals, and kickbacks. But old-fashioned shoe leather-staking out two doctors' homes, for instance-played a part. And the series set off investigations by the SEC, the Justice Department, and the Senate Finance Committee.
Shining a light on a huge and largely hidden slice of the federal budget, the Wall St. Journal provides a public service and some troubling examples of abuse.
First Place: A Burning Issue; Deborah Schoch, Steve Schoonover, Larry Mitchell, California HealthCare Foundation Center for Health Reporting & Chico Enterprise-Record
As they've done each winter for generations, residents of Chico, Calif., fire up their wood-burning stoves to stave off the cold. The stoves, and the smoke they produce, have come under fire from local air quality officials, doctors and pollution experts. They say the smoke can have serious health consequences for children, the elderly and those with respiratory conditions, pointing to statistics showing the county with among the state's worst rankings in lung cancer deaths and death from chronic lower respiratory disease. Many residents dispute the health evidence and insist that any attempt to limit their freedom to heat with wood is an unwarranted intrusion by government. The Center partnered with a group of Chico Enterprise-Record reporters to produce a four-day series that examined the fiery mix of politics, economics, local culture and science behind the debate.
This wasn't necessarily the most sophisticated entry we read, but it was so beautifully conceived and executed that we quickly decided to make it our winner. The writers had a clear mission – help local people understand that wood-burning stoves pollute the air – and were smart enough to know that their readers would be more likely to absorb that message in small chunks than in the lengthy pieces that usually win contests. All the key information was there, but in easily digestible form. This is local journalism at its best. (The series was so compelling, in fact, that when I remodel my California home I'm going to remove the fireplace. Honestly.)
InvestigateWest showed that the federal Occupational Safety and Health Administration does not regulate exposure to chemotherapy in the workplace, despite multiple studies documenting ongoing contamination and exposures and their potentially lethal implications for human health. When nurses, pharmacists, technicians and, increasingly, even veterinarians, mix and deliver the drugs, accidental spills, sprays and punctures put them in close, frequent contact with hazardous drugs. These are drugs that can save lives of cancer patients, but ironically, are also human carcinogens themselves. The report documented, through FOIA's, that the federal government had cited a workplace for lax handling of chemotherapy agents only once in 10 years, despite ongoing and repeated studies that revealed workplace contamination was pervasive throughout the health care industry.
This series achieved the perfect balance of human emotion and investigative findings. Carol Smith grabbed us with the personal tale of a nurse whose death was likely caused by the chemotherapy drugs she gave to her patients, then shocked us with the news that the government does not regulate the administration of these drugs or monitor the health problems they can cause. Each piece was so clear and well organized that the message became a drumbeat: This shocking situation must be remedied.
This is a four-part series about a neurosurgeon from Charleston, S.C., and his quest to teach brain surgery in the Tanzanian bush. The series examines the brain surgeon's motivations as a vehicle to explore the issue of how overseas medical missions create a culture of dependency in the very countries these missions are trying to help.
The writing in this series was just beautiful – anyone who aspires to do narrative journalism should definitely study this one. But more important than the writing was the deep thinking that went into this piece. While readers were surely beguiled by the tale of a brilliant, young neurosurgeon, they also came away with valuable insight into the difficulty of providing health care in developing countries.
This series examined challenges and possible solutions to providing health care in rural communities, mostly in Wisconsin but also in Kentucky, Montana, New Mexico and Tennessee. Critical access hospitals, the National Health Service Corps, J-1 visa waivers and other programs have helped ease rural health problems, but many obstacles remain.
The problems with rural healthcare have been written about for decades. What made this series special, however, is the way it segmented those problems and then offered solutions. The information was clear and accessible, and the series already appears to be triggering some action. Hopefully David Wahlberg will continue pursing this topic – he's providing an important service for his readers.
This series looked at tobacco usage and obesity in China. In China 350 million people, including a significant number of medical professionals, light up on a regular basis. The country is facing staggering short-term and long-term health consequences. But as the country's sole manufacturer and seller of cigarettes, the Chinese government is reluctant to wage antismoking campaigns. Similarly, many Americans know obesity is a problem here, but few realize it's a growing concern in a number of countries where incomes, and Western fast food joints, are on the rise. The NewsHour's Global Health team went to China to report on the economic and cultural factors that are causing a surprising number of Chinese to become overweight. See the tobacco and obesity parts to this series on the web.
We loved this series- particularly the tobacco story, which had great visuals (the jewelry-store like settings where cigarettes are sold) that helped tell the story and lively writing (more smokers in China than PEOPLE in the U.S.) . It was also notable for what it didn t say but rather let the viewer recognize for him/herself: that China, with its government control over tobacco is today where the U.S. was not all that long ago.
This series unfolds across three two-hour episodes and explores the human desire and struggle for happiness and the ways we can ultimately attain it. The first episode probes the nature of the social relationships that are the key to human happiness. The second looks at the obstacles to happiness – negative emotions such as fear, anger, anxiety and depression – and what we can do to cope with them. The final program uncovers new scientific research that is transforming our understanding of this most elusive of emotions.
This three-part documentary is a beautiful, watchable, ambitious look at the spectrum of human emotion and its scientific underpinnings. It s well-organized and well-explained, and lives up to the proud tradition of top-notch PBS NOVA episodes.
Third Place: A Crisis in Caring: California's School Nursing Shortage; Kelly Peterson, Martin Christian, Tim Walton, KVIE Public Television
If your child becomes sick or injured at school, legally there might be no one who can help them. In one Northern California school district, there is only one nurse for 14,800 students, 20 times more than the recommended national standard. This entry examines this growing concern by taking an in-depth look at some of the daily challenges facing school nurses, faculty and students. The program follows a credentialed school nurse over the course of an exhausting day visiting a dozen schools. It also looks at how telemedicine research from leading medical institutions is helping address this critical problem.
This is a vivid look at a too-rarely-covered topic: The shortage of school nurses. As the program points out, with more and more children in the nation s public schools with more and more serious medical needs, there are fewer and fewer school nurses to look after them. And that is a prescription for trouble. We particularly liked that this came from a local station, which took the time to produce this well-researched and thought-provoking entry.
First Place: Dialysis - High Costs & Hidden Perils of a Treatment Guaranteed to All; Robin Fields, ProPublica
Dialysis is a lifeline for almost 400,000 Americans, yet they endure some of the worst results for dialysis care in the industrialized world. One in four patients dies within 12 months of starting treatment. Those who survive often suffer high rates of hospitalization and poor quality of life. These stories showed that patients commonly received care in settings that were unsanitary and unsafe. Many incidents in which patients died or were injured in the course of treatment were never reported to – or investigated by – any outside authority. ProPublica came across another stunning fact: For years, the federal government had collected a rich store of data about the performance of each of the nation's thousands of individual dialysis facilities. Yet it had kept nearly all this information secret from those it might benefit most: patients. After pursuing this vital database for more than 27 months through reporting and Freedom of Information Act requests, Robin Fields succeeded in getting the government to release the clinic-by-clinic data. In December, it was posted in searchable form on ProPublica's web site, where already thousands of patients have used it to see how their providers compare to others.
See the story on the web and some of the data and graphics that accompany the investigation:
Dialysis Facility Tracker
Inside a Dialysis Treatment
Compare Dialysis Facilities
A stellar piece of journalism. The series reveals that the results of dialysis care in this country are atrocious, despite enormous outlays by U.S. taxpayers. Great multimedia features, including one that lets readers check the quality of care at dialysis centers in their area.
Second Place: Do No Harm: Hospital Care in Las Vegas; Marshall Allen and Alex Richards, Las Vegas Sun
This piece used investigative journalism, computer-assisted reporting, statistical analysis and new media tools to break through a wall of bureaucracy and complicated data to tap meaningful information about local hospital care. The Sun's analysis of 2008 and 2009 hospital records identified cases of preventable harm, infections from lethal superbugs and accidental surgical injuries. In 356 of the cases, the patient died in the hospital. This information has never before been made public by any organization and is hidden from consumers throughout the United States. The Sun also exposed that hospitals have lobbied to keep this information hidden from consumers, and are not employing best practices to prevent the injuries and infections.
In a two year examination of every in-patient hospital admission in Nevada going back a decade, 2.9 million in all, the Las Vegas Sun uncovered almost 4,000 cases of preventable harm. In 350 cases, the patient died. Over a week-long series, readers learned the personal stories of many of these injured patients and the hospitals where they had been treated. The result of this gripping series? Within weeks of publication, Nevada hospitals began sharing internal quality information with the public. With user-friendly interactive tools available on the Sun's website, consumers can now see how their own hospital fares on many fronts--from hospital-acquired infections to preventable injuries. An outstanding combination of computer-assisted reporting and quality story telling.
Third Place: Sexual Assault on Campus: A Frustrating Search for Justice; Kristen Lombardi, Kristin Jones, David Donald, The Center for Public Integrity
According to a report funded by the Department of Justice, roughly one in five women who attend college will become the victim of a rape or an attempted rape by the time she graduates. Many times, victims drop out of school, while students found culpable go on to graduate. The Center's investigation discovered that "responsible" findings rarely lead to tough punishment like expulsion – even in cases involving alleged repeat offenders. This piece examines internal campus proceedings that grow from two federal laws which require schools to respond to claims of sexual assault on campus and to offer key rights to victims. The Education Department enforces both laws, yet its Office for Civil Rights rarely investigates student allegations of botched school proceedings by students, largely because students don't realize they have a right to complain. When cases do go forward, the civil rights office rarely rules against schools, the Center's probe has found, and virtually never issues sanctions against institutions.
An issue that many thought had been dealt with decades ago. Instead, the Center for Public Integrity found that students found "responsible" for sexual assaults on campus face little or no punishment. Even more astonishing, research shows that repeat offenders account for a significant number of sexual assaults on campus, a fact contrary to what many collegiate administrators had believed. In a lengthy series, with numerous journalistic partners, this series outlines how many women suffer a lack of justice. The series has spurred reform both on Capitol Hill and college campuses nationwide. In addition, the Center includes an online toolkit so other journalists, especially reporters at college papers, can investigate on their own campuses. A stellar work of journalism leading to policy reform.
This entry looks at long-term survivors of cancer who are at risk for late effects as a result of treatment received 10, 20, or 40 years ago. New research on long- term cancer survivors who received radiation as part of their treatment shows that radiation damages the cells in a way that creates the perfect conditions for heart attacks and strokes by clogging arteries. In addition, radiation can cause second cancers, and, for women who received radiation in the chest area for Hodgkin Lymphoma, there is a high probability they will be diagnosed with breast cancer.
When the diagnosis is cancer, a patient can count on receiving the full attention of medical staff, family, and the most powerful tools in medicine. The all are bent to one purpose: eradicating the tumor and and the deadly threat within. If the cancer wins, the patient dies. But what happens when the patient wins? Cure's winter issue answers that question brilliantly, and hauntingly. In "The Cost of Living," writer Kathy LaTour explores the little known, dangerous after-effects of radiation therapy, some of which don't come to light until years after the cancer is declared in remission. The irony here: Many of these side effects wouldn't affect a patient unless he or she lived to a ripe old age, so a successful cure might mean a painful afterlife of health woes. Is the cure worse than the disease? The Cure helps us explore that vexing possibility.
This briskly told story manages to tackle a little-known topic – 'late effects' of radiation – with thorough, detailed reporting and compelling storytelling. And it deftly underscores a central irony – that radiation can save lives but also shorten them. The piece also includes valuable information on what doctors and patients should be doing to minimize 'late effects; it doesn't t just lay out the problem but also solutions.
The fourth in a series on epilepsy in cultural context, this entry looks at the state of epilepsy care among Native Americans, focusing on the often significant geographic and access-related barriers to care that affect Native Americans living in rural areas.
This story delved into one narrow problem – epilepsy among Native Americans – as a lens into the much broader issue of health disparities, and it showed us how multiple factors – from cultural bias to economics – can lead the health care system to fail certain populations. The story is well-written and includes thorough research and numbers so it doesn't rely on emotion for its impact, and yet there's still a palpable sense of outrage.
Third Place: The Duke Debacle: Misadventures in Personalized Medicine; Paul Goldberg, The Cancer Letter
This entry reported that a widely published, influential researcher at Duke University had misrepresented his credentials, claiming falsely to have won a Rhodes scholarship and a number of lesser awards. These falsified stellar credentials helped the researcher in questions – Dr. Anil Potti – obtain millions of dollars in grants from the National Cancer Institute and the American Cancer Society. Other researchers were relying on his work and cancer patients were being treated based on his technology.
An extremely thorough and dogged accomplishment of reporting with a remarkable outcome – the downfall of a well-established and regarded researcher, as well as the retraction of his major research. It also raised significant questions about the integrity among top brass at Duke University. It's clear the reporter's knowledge base and access to sources were critical in the success of this investigation.
Traumatic brain injury affects thousands per day, yet has no treatment, and receives only a small fraction of the funding allocated to much less common diseases. This is the story of TBI researchers who are making a last-ditch effort to transform the field, and the treatment that may be their last, best hope.
An important and timely topic, thoroughly reported with a nice narrative structure.