What does that look like? A one-star story, for example, is The Guardian’s “Virtual reality to help detect early risk of Alzheimer’s.” “That is misleading. The researchers haven’t even recruited study participants yet, much less conducted the study or analyzed the results,” wrote a trio of reviewers, including a university’s public information officer/freelance science writer, medical director of a Medicaid Health plan (yes, with a medical degree), and HealthNewsReview’s own deputy managing editor, each of whom signed an industry disclosure agreement. “We can understand that a research institution may want to raise awareness of a forthcoming study in order to recruit study participants. We are less clear on why a major news outlet would write about the research — which hasn’t even taken place yet — as if it is already newsworthy and generating data that clinical decisions can be based upon.”
That was the last review that HealthNewsReview published. Battling funding loss as a nonprofit and an impasse of how to most constructively criticize news outlets, HealthNewsReview ceased operations in December 2018, amid an environment where YouTube’s recommendations coaxvaccine-searching users to anti-vax videos. The 13-year-old site’s archives are still available, but probably only for the next three years or so, according to Gary Schwitzer, HealthNewsReview’s founder and publisher.
Schwitzer used this metaphor, talking with me from a Las Vegas-area Costco parking lot on an RV trip with his wife: “I’m looking at the snow-capped mountains. They’re beautiful and wonderful, but the peaks of excellence are far too occasional and the valleys are the drumbeat of dreck [that] may overcome the good…The dreck is conflicted single-source stories that should not be called journalism but should be PR and advertising drivel, because it is simply taking spoon-feeding in an unquestioning way and fawning over it and not showing any connection with the needs of a desperate healthcare population that we could be helping,” he said. “My heart soared with some of the things from ProPublica, Kaiser Health News, and Stat, but Stat is among the ones we also have criticized. Once again, today I get their morning newsletter and today it was sponsored by the biotech industry.”For most of HealthNewsReview’s existence, Schwitzer led the crusade to critique health reporting as a one-man band funded by foundations. He focused on conflicts of interest in health journalism and the impact of misleading media reports on patients, accruing 2,870 blog posts, 50 podcast episodes, more than 50 editorial contributors (most with a MD, PhD, or MPH after their name), and six-ish full-time staffers. Its weekly email had 6,000 subscribers. HealthNewsReview arose from his frustrations working in local TV in Milwaukee and Dallas and then heading the medical news unit at CNN. He was inspired by a project called Media Doctor Australia, which used a standardized tool to evaluate stories. Here’s how Schwitzer described the situation for Boing Boing three years after launch, back in 2009:
It was mostly the CNN experience that frustrated me. In the early days of CNN, we had this tremendous, exciting opportunity. The channel could be the place to go in-depth with background and be analytical and contextual. But then the management side swung the other way and preferred to be the wire service of the air — take anything happening anywhere and report it with a quick turnaround. That’s the continued recipe for disaster in my eyes. Into that was thrown the maelstrom of artificial heart experiments in the early 1980s. I saw how all of the incentives were to just have the information everyone else had, but more often. It got to be hourly briefings on patient urine output and stuff like that, rather than reporting on evidence and tech assessment, and cost, and access and all the things that now become our criteria on HealthNewsReview.
And HealthNewsReview did establish a rigorous system for guiding reporters in healthcare news and scoring the pieces that came through. The site shares its 10 must-have elements for an article or press release to be acceptable (reporters, take note):
But of course, rating a story post-publication doesn’t always translate to a better story the next time around. The site also struggled to straddle the line of constructive criticism in a way that rank-and-file journalists and editorial leadership accepted. (Yes, we are critiquing a critiquer. We are meta.) The low honey-to-vinegar ratio didn’t endear the site to some journalists. Undark described some of the site’s pitfalls in a feature:
Both in his quotes in that Undark piece and in our parking-lot interview, Schwitzer stuck to his guns. He said he knows he “probably did sign our death sentence” by insisting the site not cut back on its resource-intensive three-reviewer system. The site also relied heavily on philanthropic dollars that ultimately ran dry. The Foundation for Informed Medical Decision Making supplied Schwitzer with grants, but that organization eventually became the Informed Medical Decisions Foundation and then merged with a nonprofit patient content company called Healthwise — which then pulled the funding in 2013. A private foundation came through with a $1.3 million grant in 2014, but that also eventually came to an end.
Schwitzer pushed for foundations to support HealthNewsReview but kept hitting the gap between healthcare foundations and journalism foundations in an era of emerging journalism philanthropy. He also had little faith in crowdfunding to hit the kind of level the grants provided to keep the site’s system afloat. And industry advertising or corporate contributions are a no-go: “I always said and stood by this: I would rather shut it down than take industry money, for all the same reasons that run so deep in me,” he said.
So which news organizations did the best job reporting on health issues? The overall winner by a healthy margin was Vox, which earned an average of 4.46 stars over 26 reviews. (Notably, Vox has no qualms about going long on health stories, and it has none of the constraints of print space or broadcast time.) Here’s what reviewers said about a Vox story by German Lopez last year about an analysis of alternatives to 12-step programs in addiction treatment:
Next up in the site’s final rankings were Stat (3.91 stars over 44 reviews), The Philadelphia Inquirer (3.69 stars over 75 reviews), and The Associated Press (3.66 stars over 336 reviews).
And the worst? The major broadcast TV networks all fared poorly. (though the site was evaluating their online stories, not actual on-air segments). A few recent reviews illustrate what the site regularly dinged stories for; here’s ABC News:
The Guardian — the source of that story about the results of a VR study that hasn’t even been done yet — doesn’t look good in HealthNewsReview’s analysis, with a meager 2.29 stars over 42 reviews. It was regularly knocked for “rehashed” press releases and “spoon-fed” stories.
And the worst of all? Fox News, with just 2.13 stars across 40 stories. (“Fox News regurgitates a hot mess from the UK Sun”; “Classic disease-mongering”; “Yet another single-source Fox News story that reads like sponsored content”; “No original reporting: Fox News rehashes news release”; “news via lone anecdote.”)
Schwitzer still holds out hope for non-industry subsidized health news reviewing: “The $1.6 million I had over two years is a drop in the hat when you look at the healthcare advertising and marketing budgets of any of the single players in the industry. That money is out there. Maybe somebody else can make the pitch better than I did.”