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Ever wondered why health professionals don’t want to work with the media and the public are misinformed on medical issues?

February 7th, 2009

Dr Petra

This is a long post as I’ll be quoting from a radio programme within it, but if you’re a journalist, healthcare worker, scientist, academic or member of the public with an interest in your own health and/or how the media works please go get yourself a nice cup of tea then come back and read on.

Over at Ben Goldacre’s Bad Science a real hornet’s nest has been stirred up after Ben posted a clip of a recent radio talk show for independent station LBC where host Jeni Barnett discussed the MMR (Measles, Mumps and Rubella) vaccine in a way that’s best described as uninformed, alarmist and unprofessional.

Ben originally posted a clip from the programme and invited comment on it, only to be threatened with legal action by LBC who have asked him to remove the clip of the programme from his blog.

This raises a number of legal and ethical issues about blogging, as well as the wider concern of public debates around healthcare and science. If you read Ben’s most recent blog on this topic you’ll find links to a host of other sites now exploring this issue including Jeni Barnett’s site where she responds to her critics.

There are major problems within journalism currently about the level of understanding of health and science issues by presenters, researchers and other media staff. While a minority appear to have a good grasp of what’s going on and take time to read evidence and seek professional input, the majority of reporters are often poorly placed to understand and discuss complex and emotive health issues and lack the time, training and/or enthusiasm to get to grips with health or science evidence.

The result is a lot of opinion expressed as fact; endless hard-to-argue-with-rhetoric (for example the favourite ‘well I’m a mother so I should have the right to decide what happens to my child’); dismissal of those who may be informed but whose views don’t fit with the angle/belief of the journalist, their editor or producer; and a systematically inconsistent approach to understanding science and healthcare (so journalists are eager to highlight the evils of the pharmaceutical industry in relation to MMR but don’t question their role in medicalising other areas such as female sexual dysfunction).

Ignoring the MMR aspect for a second, let’s just look at this exchange between Jeni Barnett and a nurse called Yasmin who tried to tackle the presenter during the programme (courtesy of HolfordWatch).

JB: And I think that the reason you fill up my telephone-there are no calls being able to come in at the minute- is because you’re phoning is because there isn’t a definitive answer. There is no absolute answer.
As a parent, whether you are male or female, you have to make a decision based on your family history. I took my daughter who kept getting ear infections when she was a kid and one of the doctors said to me, “If you do not give her an asthma spray, and do not do this, that and the other, she will die within a week”. You don’t say that to a young mum, well, I was an old mum but she was only a little person.
Since I had asthma and my mother in law died of asthma and I’ve told you this before, that doctor didn’t take into account where I was coming from. I required him to look in my child’s ear and give me some indication of what was going on so I could make an informed decision.
I, however, am not like Yasmin in Chelsea. You would – what would you have done in that situation?
Yasmin: I’m just wondering how much longer your programme is on air. Because I give hundreds of MMR vaccines
and all the work that we do in general practice is probably being undone by your programme in 15 minutes and I think it’s very irresponsible.
JB: Why. [Indistinct]
Yasmin: It doesn’t seem to be based on any facts. I’m very sorry to hear that your child had autism but if you…
JB: My child. Yasmin – [not] my child – somebody else’s child had autism.
Yasmin: Somebody else’s child, I’m very sorry to hear that. But if they read the Wakefield study in the Lancet in 1998, Dr Wakefield actually said that he didn’t prove an association between MMR and…
JB: Well he wasn’t really allowed to have his say, was he, Yasmin. He was kinda…
Yasmin: I think he was. I think he said it recently in court.
JB: But you’re not…
Yasmin: I think he’s being tried for medical negligence. I think that your programme is extremely irresponsible. You’re talking…
JB: Ah, let me just ask this…Let me ask you this before you go on with that.
How, if you are so certain that your MMR jab is correct, how can 15 minutes on LBC 97.3 rock what people are thinking?
Yasmin: Well, you’d be surprised. And at the moment we are expecting a measles epidemic and it’s because of people like Ken Livingstone and people like yourself.
You talk about young mothers who have a very difficult decision to make and, I agree, they do, and I spend a lot of time talking to them. But people like you don’t really make it any easier for them.
And you were just talking about somebody with an ear infection. I’ve been talking to somebody I know who had a child who woke up with the contents of their ear on the pillow and that was down to the rubella virus.
So you really need to think about what you’re doing here and why you’re doing it.
JB: Well, you see, I could argue, Yasmin, that you have to think about it, too. I’m allowed…
Yasmin: I do, every day.
JB: And so do I, as a parent, and that’s what I’m saying.
Yasmin: I’m a parent. And one of my children has had 3 doses of measles [sic. Possibly meant MMR] and there’s no problem with it. You could have a hundred doses of measles [sic. Possibly meant MMR] and it would do nothing.
[Yasmin and JB talk over each other]
JB: But why give them the vaccine if they get the measles? I never can understand that.
Yasmin: We don’t give vaccines to children who have had measles. They need a combined vaccine of measles, mumps and rubella.
If they have one dose the studies show that they possibly need to be revaccinated within a couple of years to make sure that that protection carries on for life.
JB: Do you not think, though, that as a parent, I am allowed to make a decision about what I put in my kid’s body?
Yasmin: Yes. And do you not think that a parent whose child has cancer and is having chemotherapy and has a much lower resistance to things like measles, mumps and rubella, has a right for their child to go to normal Primary…
JB: Absolutely, absolutely.
Yasmin: A normal Primary School. But because there may be one child in the class, such as yours, who is lucky to have the immunity, that child might get measles, mumps or rubella and die.
JB: Yasmin, my daughter did not have decent immunity which is exactly why I did not have her inoculated.
Yasmin: We don’t. We wait until your child is well and fit enough to give the MMR.
JB: But I don’t want my child to be fiddled with with all sorts of stuff that’s in a vaccine. Now why…
[JB and Yasmin talk over each other]
Let me finish.
Yasmin: Could you tell me what’s in the vaccine? What do you think is in the vaccine?
JB: No, I can’t.
Yasmin: Then how can you make a decision for your child? You’re taking about parents having to make decisions for the child but if you go into any secondary school, which I have done, we’ve been asked to vaccinate kids against MMR, they all say they want it.
If you’re deny immunisation then you’re denying health to your child and other children.
JB: No, no, no. My child is absolutely strong and healthy in many ways…
Yasmin: Then you’re one of the lucky ones aren’t you? If your kid had chemotherapy…
JB: Listen, listen, listen. Yasmin will you stop…Stop.
Yasmin: You’d want your child to be protected, wouldn’t you?
JB: Stop being so dramatic about it. If you
[JB and Yasmin talk over each other.]
Yasmin: You should think about what you’re doing in this programme. You’re doing a lot of damage. A lot of damage.
JB: Well, maybe. I don’t think so.
Yasmin: You don’t know what you’re talking about. You can’t even tell me what’s in an MMR vaccine so you shouldn’t be talking about it.
JB: Well, I can get it…Shall I get it off the internet, Yasmin?
Yasmin: Yeah, get it off the internet, from a reliable source, the such as the Department of Health
JB: Really?
Yasmin: and then I might listen to you, yeah.
JB: The Department of Health frightens people.
Thanks, Yasmin, for your call.
I think it’s quite interesting. When I was told I had a high blood sugar, I was told in that room I had diabetes. I don’t have diabetes, I have high blood sugar. My blood sugar’s normal now but they frightened me. Which is what people like Yasmin does.
This is LBC 97.3.

I don’t know about you, but I’m pretty shocked at this transcript. Here’s a professional calling in to share an opinion that’s different to the majority allowed on the programme. A caller whose daily job involves counselling parents and treating children. A caller who is interrupted, accused of ‘frightening people’, accused of being ‘dramatic’ when she raises the real issue of child health and vulnerable patient groups, and who later is described in Jeni’s blog as ‘vicious’.

Time and again myself and colleagues are invited onto TV or radio programmes or interviewed by print media journalists where we are interrupted, ignored, misunderstood, misquoted, ridiculed and quite often (as in the case of Yasmin above) deliberately insulted.

It’s because of this so many professionals are wary of the media – and with good reason. You need to be particularly gutsy to have a go like Yasmin did, but if you’re taking on poor journalism on a regular basis it does start to wear you down.

Yet all of our media training really sets us up to consistently play patsy to this kind of shoddy reporting. We are trained to be helpful and available, to give soundbites and responses to build a journalist’s story. We’re not trained to cope when we’re ignored, misconstrued, bullied or when we find after giving an accurate account it’s replaced by someone who’s not as qualified but whose opinion fits the angle the journalist or their editor/producer is taking. We’re also not trained how to cope when faced with someone whose interview techniques are poor (see above).

I think this particular case is about more than MMR. It’s a rallying cry for any of us working with the media to start radically rethinking our position. We used to need journalists to enable us to speak to the public, but nowadays with blogs, podcasts and other social media we don’t need journalists anymore. We can create our own materials and disseminate it any way we like.

This gives us the freedom to work with the media in a completely different way than in the past. Rather than waiting to be called, to contribute our quote, and wait for the next contact we can write our own copy, and more importantly we can challenge poor practice publicly. That means when we have a good or a bad experience we detail what that was and what happened. We may do this by showing an email exchange, clips or transcripts from radio or TV interviews, or from our notes from a telephone call or other interaction with a journalist. A good example of this is Violet Blue’s take on her experiences on the Tyra Banks show.

We need more transparency in media, and we are in a great position to provide this. The public need to know how people were chosen for a particular story/programme. They need to be told when qualified folk were overlooked or ignored and how and why that happened. They need to hear about bullying type behaviour and bad practice (e.g. Jeni Barnett’s response to Yasmin), and to understand that rather than evidence being shared that particular forms of ‘truth’ are created – more often supported by rhetoric and opinion masquerading as ‘fact’.

This doesn’t all have to be combative or reactionary. Good practice can and should also be praised

Presenters and journalists evidently need better training to understand evidence from health and social care. There also needs to be support for those hosting chat shows to enable them to fully explain their role, so they speak as a presenter with an opinion not an expert. I’ve worked in talk radio (not LBC) for several years and have had the privilege of working alongside some excellent presenters who can set up a controversial issue as a foil for you to come in and give the evidence. But sadly many journalists don’t have those skills (or can’t be bothered to apply them) which does a disservice to their listeners.

We also need to challenge empirically the idea many talk radio and television shows have – that if enough callers ring in with opposing views (possibly accompanied by an expert voice) – that the listener will be able to identify the accurate information within the discussion and act upon it. This received wisdom may underpin a lot of media but I’d like to see the evidence it actually works, because in my experience talk radio becomes a lot of noise for the listener to filter and without any clear guidance it’s virtually impossible to do so. And it’s made completely impossible if the host has an agenda and won’t allow dissenting views to be heard.

So how do we move forward? Well, there’s a lot of things we can do. In the short term we can share this story with others working in social/healthcare and media. We can support Ben Goldacre’s case. We can complain to LBC and Offcom (details on how to do this on Ben’s blog). We can also approach our governing bodies – people like the Royal Institution, British Association and others working towards increasing the public understanding of science and encourage them to boycott LBC until they address problems in their broadcasting.

We can speak to the media offices at our university and tell them not to deal with LBC. We can share within blogs, websites, listserves and research/professional groups individual journalists or particular publications/production companies who behave badly to discourage cooperation with them – and encourage cooperation with any competitors who can show commitment to good journalism and ethical practice.

I’ll be doing this with my office and with the British Psychological Society on Monday. And I’ll be showing them the transcript between Jeni Barnett and Yasmin to support my reasoning for the suggested boycott. Why should any qualified person volunteer their time for free to a radio station that treats professionals so shabbily and operates a system of censorship that denies their listeners access to evidence and reliable advice.

I’d also encourage journalists to take a stand on this. If you seriously think that Jeni Barnett showed us an example of exemplary journalism in this recent case then feel free to argue that position. But my feeling is most journalists will be cringing when they hear the audio or read the exchange between Jeni and Yasmin above. Ethical journalists need to be speaking out against poor media coverage and unprofessional activity, otherwise we’ll just assume you’re okay with things as they are. In case you needed any further incentive after reading the exchange and Jeni’s previous blog, here’s her second response to criticism from all us ‘bad scientists’ out there.

As scientists, educators and healthcare professionals we should continue to offer our support and advice to those who listen, and we should begin to name and shame those who don’t want to know – and where appropriate advise our governing bodies to boycott particular problem programmes/production companies/papers or websites. What’s the point in wasting time and effort on battles we’re set up never to win? Experts are the lifeblood of the media. But if we’re not listened to we can take our discussions elsewhere where they can be held calmly, clearly, and actually do some good.

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