7. november 2017

Patient Safety and the media – room for improvement

Is it safe to let your child get the HPV-vaccine? The answer is evidently yes if you ask the Danish Health Authority and healthcare services in general. The media give a different answer. Following the media coverage thousands of young girls and their parents are afraid of the vaccine. Because of stories in credible mainstream media, girls favor the risk of cancer over the risk of side effects.

The media isn’t made to work as a communications agency for the Danish Health Authority or other parts of Danish healthcare. The responsibility for clear and unambiguous communications of core information belongs to the healthcare services. Media in Denmark are independent and are obligated to pose critical questions. But even if you recognize this relation, we have a very real problem: the way the media covers healthcare has serious consequences for patient safety. Not just in the case of the HPV vaccine. There are plenty of other examples.

Is it dangerous to take anti-depressant? A lot of people get that impression from the media. And many stop taking their medicine because of it. Once in a while with fatal consequences.

Is medically prescribed cannabis a good idea? the Danish Medical Association says no. A famous Danish actress says something else. The media portray those two views as equal.

Can you be sure, that a patient, who, apparently, is close to brain dead will really end up brain dead? Healthcare says yes – there is no hope for miracles! A documentary on national tv shows something else – with the melodramatic headline »The girl who wouldn’t die«. A girl who seemed close to brain dead wakes up. Very much alive. The parents and everyone else are bewildered. In coarse language, the hospital accuses the Danish Broadcasting Corporation of manipulation. And the Danish Broadcasting Corporation accuses the hospital of manipulation. Viewers are not sure if it is safe to take organs from patients who are declared brain dead.

Can you cure autism by changing your diet? Healthcare experts say no. Famous Danish journalist and author Ninka-Bernadette Mauritson writes and says yes in every media outlet she can.

Consequences for patient safety

In recent years there has been – and continue to be – many examples of how media coverage of health and healthcare directly effects patient safety.

Within healthcare some accuse the media of being irresponsible in their coverage. Others believe that the media prioritizes sensation over human lives. On the other hand, journalist experience the Danish Healthcare as dismissive, unwilling to take responsibility and alternating between aggressive and passive-aggressive, when the critical stories emerge.

In between is the public. Citizens. Patients and family. Often trapped in the crossfire between two of societies’ most powerful institutions – the media and healthcare.

A report was published this year by a Danish think tank. 30 percent of respondens reply, that they agree with the statement »Doctors and scientists actually know very little about what is and isn’t healthy living«. This number is an increase of 11 percentage points compared to 2011. Does the media coverage of health and healthcare play a part in undermining doctors and scientists authority? Yes. Without a question. But healthcare occasionally has an old fashioned “chief physician”-attitude: they get annoyed and offended, if the patient doesn’t listen and obey.

They see each other as opponents

The media has certain duties, which are crucial to a democratic society. Healthcare has another and, easy to say, just as vital function. The question is if we can find constructive alternatives to the current situation, in which the two power houses increasingly view each other as opponents.

I’ve heard suggestions of a form of advisory board with representatives from both the media and healthcare. Together they would decide, in this body for the highest health information, which issues were the most important within health and healthcare, and how they should be handled. It seems unrealistic. The media would feel like they deposited their free will and independence. Generally speaking there probably won’t be one solution to the dangerous and ever changing media landscape, which healthcare has to navigate in. But it might be an advantage if media and healthcare alike gains a higher understanding of their different functions and responsibilities.

Quite a lot of healthcare staff seem to be of the opinion, that good health journalism should act as a form of general education. They feel, that the media should actively contribute to bring forth the agendas and news, which the health authorities deem important. It’s debatable, whether or not they are right, but the fact of the matter is, that’s not the view of journalists and editors. The public service network the Danish Broadcasting Corporation is, under special circumstances, obligated to convey the authorities’ announcements, e.g. during catastrophic situations. But neither the Danish Broadcasting Corporation or other media consider it their general responsibility to act as a mouthpiece for Healthcare. The typical and traditional self-understanding is closer to a guard dog, which latches om and sticks to power and lies of the authorities.

Communication responsibility

Patients, citizens would be better off, if Healthcare to a higher extent took it upon itself to communicate, what needs to be told. Just as treatment often takes place under far from ideal circumstances, the authorities’ official communication will be unfolded in, mildly speaking, difficult terms: buckets of questions from hungry reporters. Patients who tell emotionally of effects and side effects. Fake news and misinformation on social media, which for many people is the primary news source. But there’s no way around entering that battlefield, even if the court is dirty. It’s a condition which modern healthcare has to get used to.

At the same time it would be an advantage for readers, listeners and viewers if the media to a higher extent considered their stories’ validity and possible consequences, before firing headlines with little nuance which create fear. The use of powerful case stories is a great and formidable journalistic tool. But the individual stories should be able to illustrate a broader experience and more general point, if you’re sending off suspicions and accusations during prime time. It’s also problematic if the editor uncritically throws it on the cover, when a chief physician or scientist shows up, with views that go against consensus. It’s always possible to find someone who seriously believes, that the Earth is flat as a pancake. But among scientists the common and recognized position is that the Earth is round.

With influence comes responsibility

The media perceives itself to be the fourth branch of power. Journalists like the power and influence, that comes when you’re a filter between authorities and the public. Then they also must show the responsibility that comes with the part.

Healthcare is a cornerstone of the Danish welfare system. It’s one of the top priorities for a majority of the Danes, when taxes are distributed. Going into the 21st century a modern Healthcare is about so much more than diagnoses and treatment. It’s also about good communication. Towards the individual as well as the public.

There are plenty of examples of good health communication and good health journalism. But there is clearly room for improvement as well. On both sides.


A version of this column was originally published on October 2. in the Danish newspaper Berlingske.

It takes part in an ongoing debate on healtcare coverage in the media, fake news and transparency.