It’s no secret that medicine and journalism are often at odds.
Coverage of research findings sometimes lead patients to request a new treatment, or to question an established one, prompting physicians to grumble about sensationalism and the long and rocky road from single study to clinical guideline.
Stories about misdiagnosis or perceived maltreatment are inherently one-sided since written and unwritten codes around doctor-patient confidentiality prevent physicians from sharing details from the clinic. Social media and comment sections on news sites, while important barometers on a wide range of opinions, promote largely unmediated discussion around sensitive issues related to personal and systemic health issues. Doctors must tread carefully there.
On the other hand, it’s the duty of journalists to write history as it happens and to hold authorities to account. Medical research and clinical practice can be opaque to the uninitiated; so can navigating the sometimes cluttered and twisty halls of the health-care system that can be frustrating, frightening and damaging, and require massive change. Journalists often lead the charge for change.
Perhaps at no time have these tensions been more apparent than during the COVID-19 pandemic, when untested treatments enjoyed social media endorsement, and when public opinion often spoke louder than science.
So, what happens when the doctor is a journalist?
In the past year, Anthony Fong and Monica Kidd took a deep dive into the case of Medicine v. Journalism. Fong, a Vancouver emergency physician who does rural GP locums, and Kidd, a family physician in Calgary with a practice in low-risk obstetrics who is a former staff reporter with CBC Radio, took part in 2021-2022 in the University of Toronto Dalla Lana Global Journalism Fellowship, filing stories for Healthy Debate, CBC Radio, Earth Island Journal, The National Post, The Sprawl, The Toronto Star and Think Global Health on issues of health, sustainability and culture.
The two physicians discuss navigating the tensions between medicine and journalism.
Monica Kidd: I was a reporter before I went to medical school, but I have largely stayed away from medical journalism until this year – largely due to an identity crisis. People would often tell me I was in the perfect position to do medical journalism because of my dual citizenship, as it were.
I didn’t know how to be trusted by patients as a journalist.
In fact, the prospect of doing medical journalism made me feel like more of a turncoat. I didn’t know how to be trusted by patients as a journalist (“Is she going to keep my secrets?” and “I don’t want a doctor who moonlights.”) or trusted by journalists as a doctor (“She’s biased in favour of doctors,” and “Back off sister, stick to your lane.”). So, I just gave it all a wide berth.
Anthony, what was your take on the tensions between medicine and journalism when you came into the program?
Anthony Fong: I agree that individual patient confidentiality is a point where journalism and medicine are diametrically opposed – journalism wants to expose the story while medicine demands it be kept private.
I think the source of this tension is what you say: Journalism wants accountability through honesty and transparency. Medicine aims to preserve its ego; that is, to achieve better patient outcomes through analysis behind closed doors. The two worlds of knowledge-gathering have historically been kept separate, although they have much to learn from one another.
Medicine is entrenched in historical institutions that evolve slowly and are rarely torn down. I mean, it took 15 years for the evidence of aspirin’s mortality benefit in heart attack to become a strong recommendation.
We are just starting to expose and address the archaic practices and attitudes of our institutions, including gender-based pay inequities, systemic racism and marginalization of Indigenous people and the LGBTQ community. Journalism seems years ahead in this respect.
Monica, if you used to be nervous about blending the two, what brought you back to journalism?
MK: The pandemic disrupted many things, including my practice environment and my sense of urgency around doing the things that are deeply meaningful to me. Recording and reflecting on human experience is one of those deeply meaningful things.
While medicine is not the only thing I’m interested in writing about, it also doesn’t make sense to avoid it just because I’m a physician. Maybe as physician-writers, we even have a responsibility to look at medicine.
As physician-writers, we have a responsibility to look at medicine.
For instance, I’m very interested at the moment in how medicine pats the environment on the head as a social determinant of health, while we largely ignore climate change as a real force in our patients’ lives.
Anthony, how does your role as an MD influence the way you approach the stories you’re writing?
AF: In our program, I first confronted the tensions between medicine and journalism when I tried to report on the return of respiratory syncytial virus in Nunavut after two years of its absence.
It was difficult to report on health in the North because of many factors – baseline mistrust of the media, complacency due to the myriad chronic social problems in the North, tight communications policies of northern governments and confidentiality. The barriers frustrated me, and I felt inadequate as a reporter covering a topic I actually knew something about.
Journalists have the power to leverage someone’s story to make a point. I did this a few times in the program, especially with a series of stories I wrote about refugees fleeing the war in Ukraine. Treating a young man with a seizure at the Ukrainian border can be a journey that illustrates the conditions of his context – a terrible, needless war – while in the medical world, it may not even warrant a case report.
Another core difference between journalism and medicine is speed. Medicine has inertia. It demands scientific consensus, building upon the work of others to publish peer-reviewed results. As a result, it takes months to years to publish a paper in a medical journal. While journalists have much to learn from the scientific method in an era of ever-increasing scientific literacy among the public, we rarely have the luxury of months or even weeks to produce a news story that often can affect the public in real time.
Monica, have you had any blowback from colleagues or patients from the stories you’ve written?
MK: Not yet. I once had a listener call in to my prenatal clinic to ask to speak to me about a story I’d written on agriculture, for which I apologized profusely to our busy and confused assistant. While I hope it never leads to self-censorship, I do think that knowing I have to defend my words to a colleague or patient will remain a touchstone for me: unless I hand in my stethoscope, I can’t expect to use my access as a physician to find and report on stories if I’m not also willing to have my writing scrutinized against the behaviours we expect of the medical profession.
AF: Agreed. Yet, if we continue to inhabit both worlds, I’m sure we’ll find a navigable path – after all, the world needs medical journalism, and who better to do it than people with knowledge from the inside?