Healthcare makes for great media stories. We have a range of archetypes about doctors and nurses especially that stories can tap into, and medical science can sometimes do things which are truly extraordinary, giving a sense of wonder.
However, there are also example of irresponsibility in media coverage. I’m not going to pick out specific pieces, but if you have any interest in healthcare you’ll recognise the kind of thing that I’m talking about.
Irresponsible story type one might be the account of the patient denied treatment by the evil bureaucrats. This can take a number of forms from surgery not being funded (often associated with obesity) or drugs not being paid for (especially true in newer treatments).
Let me be clear, these stories often involve personal tragedies – it’s obvious why the individuals want to let the press come and see them to cover their case, and it presents an opportunity for journalists to show how compassionate and outraged they can be. However, these stories are also irresponsible in that they completely decontextualise the decision not to fund care, and present that decision in a manner which makes healthcare managers out to be monsters.
Decontextualising funding decisions means that these stories appear to be personal attacks on vulnerable individuals. They ignore the fact that healthcare budgets are limited, and so funding one treatment often means not funding another. We’d all like to treat every person with the operation or drug that they want, but we can’t. That means that we have to try and come up with principles by which we decide who gets funding and who doesn’t. Ignoring the principles in reporting, not bothering to find out what they are or why they have been chosen, is lazy and irresponsible. Not explaining that treatment decisions have consequences is too. We are left with evil health managers refusing to pay for care – and the situation is simply not that straightforward.
Irresponsible story type two is the evil doctor. This has got a lot worse in recent years, but follows a similar path to that of the patient denied treatment.
An individual who has had surgery that has gone wrong, or drugs that have reacted badly, discusses their pain or ongoing problems, and the doctor who treated them is portrayed as being careless or uncaring or incompetent. Now a small number of doctors are those things I’m sure, but the problem is that media coverage simply doesn’t deal with that – it is as if suddenly the whole of the professions are engaged in a cover-up. Raymond Tallis’s wonderful book ‘Hippocratic oaths’ has a range of cases where trial by media occurred, and it doesn’t make for uplifting reading.
Of course doctors who have made mistakes need to be held responsible for them, and to learn from them, but the way we increasingly pillory every error, even from those with otherwise blameless records, isn’t constructive, and isn’t responsible. If I have a bad day in the office the worst that can happen is students don’t get taught as well as they might have. For clinicians the stakes are far, far higher. I’m frankly in awe of people who can operate at the high level most clinicians manage the vast majority of the time.
However, the overwhelmingly high performance of most clinicians gets missed out of accounts of accidents – it’s much better it seems to report things entirely from the patient’s perspective. A voice about pain and suffering deserves to be heard, but in a context where a clinician’s good as well as bad appears as well.
It is little wonder that it is so hard for us to have a rich public debate about health and healthcare reform when we are fed stories from the media of such poverty. We all need to do better – the media in trying to portray healthcare stories in a more balanced and careful way, readers in not accepting bias and carelessness in reporting, and those of us who are trying to take a public interest in healthcare to call media, clinical and patient irresponsibility when we see it. We desperately need a higher level of debate around healthcare – it is all of our responsibility to achieve it.