The Power of the Pen: Medical Journalism and Public Awareness

With approximately 4000 journals indexed on MEDLINE, containing more than 9 million abstracts, the sheer mass of emerging biomedical knowledge is overwhelming.¹ Unfortunately, there is a gap between the wealth of expanding information and the quality of public health, partly because of the difficulty of dispensing this information to the lay public. The editors of the New England Journal of Medicine noted recently that "the problem of [communicating health] is not in the research itself but in the way it is interpreted for the public."² To facilitate the flow of pertinent medical research to the public at large, we rely on the skills of medical journalists.

Reflecting the public's voracious appetite for medical news, health stories are now regularly found as page 1 newspaper stories and as daily segments on prime-time television newscasts. In addition, the need for reliable sources of medical news has produced the Journal of Health Communication, a Division of Health Communication at the Centers for Disease Control and Prevention, health communication graduate programs offered at 6 universities, and other resources. Thus, medical journalists are facing expanding job opportunities, greater visibility, and the potential to have a more powerful impact.

Among the media available to reach American health information consumers are newspapers, magazines, medical journals, billboards, radio, pamphlets, and mailings. Two of the most influential and extensive are television and the Internet. The potency of television can be illustrated by a recent survey of regular viewers of the NBC medical drama "ER"³; 32% indicated that information they receive from the show helps them make choices about their family's health care. Remarkably, 12% of viewers have contacted their physicians because of something they saw on the show. Another widely used system, the Internet, provides around-the-clock access and, unlike many other resources, is capable of accommodating personal health inquiries. This ever-growing collection of information continues to influence the "wired" groups of society—the educated, wealthy, Generation X, and Baby Boomers—and has great potential for countless others.

While every practicing physician is a health communicator, some choose to make it a career. When the American Medical Writers Association (AMWA) was founded in 1940, its membership consisted almost entirely of those with MD degrees. Over the next 50 years, however, physician membership in AMWA steadily declined. In 1955, 76% of members possessed an MD degree, yet in 1991 this figure dropped to only 9%.⁴ Betty Cohen, former president of AMWA, explains that "As AMWA evolved, other [nonphysician] writers entered, bringing different expertise. Physicians may have felt it was no longer their organization." Since 1991 this trend has begun to reverse itself and as AMWA membership has increased by 20% to 4000 members, physicians now comprise 12.5% of all members. There are few data available to assess the total number of physician-writers without ties to professional organizations.

Defining the job of a medical journalist is difficult. They specialize in fields as varied as marketing, public relations, policy planning, advertising, speechwriting, producing, and computer programming. They work in newsrooms, corporations, hospitals, nonprofit organizations, entertainment industries, schools, government agencies, health maintenance organizations, and pharmaceutical firms.

While the range of occupational opportunities for a medical journalist is extensive, it is difficult to gauge employment supply and demand. Compensation for medical journalists varies widely. Freelance writers are paid per word or per project, while a full-time metropolitan newspaper reporter earns about $80000 per year. Some writers' incomes are dependent on subscriptions or syndication. Becoming a medical writer can be as easy as distributing a newsletter. However, landing a full-time position in a major media market typically requires considerable experience.

"If physicians have the same attributes as a really good journalist, they help reflect a better rendition of reality," says Stephen J. Bloom, associate professor of journalism at the University of Iowa. The model doctor and journalist share similar qualities: the ability to conduct a focused and fact-oriented interview, perform a relevant (physical) examination, assemble reliable and reproducible data, analyze quickly and accurately, and describe results in a clear, concise, and unbiased manner.

While physicians offer the advantages of understanding medical terminology and having had clinical experience to guide them in fairly relaying health information, they generally lack the benefits of a formal education in journalism. "Don't think you can waltz into a newsroom and suddenly become a star," warns Mr Bloom. "The MD degree won't do anything for you, unless you've already proven yourself a first-rate journalist with a track record of superbly written and well-researched medical stories."

As long as a discrepancy exists between medical wisdom and the health of the population, there will be a valued role for the medical journalist. According to David Satcher, MD, recently confirmed as US Surgeon General, "We've come to a point where, unless we can communicate to people outside of medicine, we can't achieve a lot of our goals."⁵