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Tom Linden’s Postmortem on Physician Journalists In Haiti

Mike Magee

I’ve been involved in physician journalism for 30 years, at one point serving as president of the National Association of Physician Broadcasters (now the National Association of Medical Communicators) and authored a Health Professional Media Code of Ethics in 1992.  A great friend and first class journalist through those years has been Tom Linden, who heads up UNC’s Medical and Science Journalism program in Chapel Hill, NC. I draw your attention to his recent post on physician reporting in Haiti. It well captures the challenges and pitfalls when a single professional bridges two careers.

His report appears at http://weblogs.jomc.unc.edu/healthblog/ and is shared in full below:

“Since the earthquake in Haiti, television network news -– including ABC, CBS, NBC and CNN –- have featured their physician reporters in heavily promoted pieces. The reports raise questions about the role of physician reporters in covering disasters.

  • What’s the first duty of the physician reporter? To care for the injured or to report?
  • Can you do both? Can you do both well?
  • When does self-promotion get in the way of reporting?
  • Are shots and sound bites of injured Haitians being exploited for commercial purposes?
  • Are physician reporters requesting and getting consent of those whom they feature on camera?
  • Can a patient who is being treated by a physician journalist ever say “no” to being profiled when the reporter is the one providing care?
  • Are physician reporters and their production crews getting in the way of delivering care?
  • What about the journalist’s main job, namely, to tell the story without becoming the story?

Consider the following pieces that appeared on network news since the quake:

Dr. Richard Besser helps a woman deliver her child amid the chaos in Haiti(01/18/2010)
http://abcnews.go.com/video/playerIndex?id=9591907
Gupta treats injured baby (01/14/2010)
http://www.cnn.com/video/#/video/health/2010/01/14/sot.gupta.treating.baby.cnn
Dr. Nancy Snyderman describes the desperate struggle to save lives(01/19/2010)
http://www.msnbc.msn.com/id/34940404/

Lastly, consider a video clip showing CBS Evening News anchor Katie Couric at the bedside of an orphaned 13-year-old Haitian boy (The Face of Haitian Tragedy):
http://www.cbsnews.com/video/watch/?id=6108078n&tag=api

In the first piece Dr. RIchard Besser, ABC News medical editor and a pediatrician, assists a midwife in the birth of a child who he mistakenly thinks is presenting in a transverse position, perhaps requiring a Cesarean delivery.

By my count Besser used the first person “I” 11 times in the story. His apparent contribution to the mother’s care was that he aided her transfer to an Israeli field hospital. Did Besser ever ask the mother if she could be featured in the piece? We’re not told. And, in this situation would consent be voluntary when the only doctor apparently attending your birth is also a television reporter?

So, a story that Besser initially presents as an examination of the impact of the quake on pregnant women ends up being a story about an American TV doctor who assists a nurse midwife and then works his Blackberry to get consultations from obstetricians in the U.S. before riding with the pregnant woman in an ambulance to an Israeli field hospital.

The Gupta story begins with CNN’s chief medical correspondent walking down a street in Port-au-Prince following an unidentified young woman with a spiral notebook tucked into her hip pocket. That woman, presumably Gupta’s producer, leads him to a 15-day-old baby who, he says, has “some sort of head injury. They’re begging for a doctor.” After a short run Gupta finds a man, presumably the father, holding a baby whose mother has died in the quake.

Gupta does a standard neurologic exam and determines that the baby doesn’t have a skull fracture, but simply a cut on her scalp. With Gupta holding the baby and providing direction, his assistant rebandages the baby’s head wound. Gupta tells the father that the baby will need antibiotics. There’s no indication where or how the father is going to get the antibiotics, but Gupta assures him that the baby will be “OK.”

In contrast to the Besser piece, Gupta focuses on the patient rather than himself, and he does provide a neurologic exam and first aid. But four minutes of air time devoted to providing simple first aid? The story is overblown and sensationalized. It’s admirable that Gupta is providing medical care while on assignment, but does he need to report on the care he provides?

In “The Today Show” report featuring Dr. Nancy Snyderman, NBC’s chief medical editor, we meet Haitians needing amputations to remove crushed and infected limbs. In this story Snyderman wears two hats –- surgeon and reporter. She never makes clear what her actual medical duties are. Is she directing care of amputees? Is she assisting others? Or is she dropping in for short-term medical visits? We simply don’t know. We do know that Snyderman’s heart is in the right place, but the report sheds little light on the broader problems of medical care in a disaster zone.

In contrast, to see how a reporter who isn’t the focus of the story can report on the same problem of amputations in a much clearer and more comprehensive way, check out this story, also featured on MSNBC:

http://www.msnbc.msn.com/id/21134540/vp/34934435#34977592

The final piece featuring Katie Couric stands in contrast to those of the physician reporters. Rather than making herself the focus, Couric lends comfort to a young boy with a broken limb and a broken heart, having lost his mother and father in the quake. Couric takes a back seat to the story.

Physician reporters would do well to watch how a veteran news anchor recognizes that the story isn’t about the reporter. It’s about the people whose lives have been changed by the quake.

If you’re a physician reporter, what do you do if you find yourself in a disaster zone? First, if you’re a doctor, you help the sick and injured. As the situation permits, you report on the story being careful to not exploit those whom you treat. To be sure, it’s a tough balancing act. But judging from the examples above, there appears to be little effort on the part of physician reporters or network news management to keep professional boundaries intact.”

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