The Media Doctor Is In

When Alan Cassels reads the newspaper, he often shakes his head at the way medical issues are misreported. Whether the reason is simple human error or the need to sell papers with sensationalistic headlines, the result, too often, is a news story that raises hopes, or fears, without the substance to back it up.

Take one example. While some major newspapers crowed about the potential of an osteoporosis drug called Evista to significantly reduce the risk of breast cancer, Cassels, a Victoria-based health policy researcher, tracked down the published clinical trial data. Missing in many reports was the fact that Evista has a high rate of potential serious side effects like stroke, blood clots, and so on.

That day, the idea for Media Doctor was born, though it would take a few years before he could launch the site in late 2005 with a $20,000 grant from Industry Canada. "The goal was to create a sort of audit for medical journalists. We all need feedback and fair evaluation if we're going to improve," says Cassels, who has researched medical reporting for the past 15 years and is affiliated with University of Victoria's School of Health Information Science.

The Media Doctor panel of professors and researchers rate mainstream news articles on a number of factors, including "evidence," "harm of treatment" and "disease mongering." They also provide a report card-style media comparison chart. The Globe currently has the highest score at 57 per cent while most mainstream media sources are lagging at medical coverage, with the Victoria Times-Colonist last, earing a 34.

"Top notch medical journalists are in many cases getting the big issues completely wrong and make exaggerations and bombastically misleading comments about treatments when the [medical] studies didn't make such claims at all," says Cassels. "It's been reined in a bit and I think journalists have also been embarrassed by recent drug disasters. When a drug is unceremoniously yanked from the market, like Vioxx, which was responsible for harming or killing 50,000 people in the U.S., journalists should be thinking, 'Are we contributing to this?'"

Viral misinformation

The misinformation has continued through 2007, particularly around viruses. "There's been a lot of disease-mongering around the flu virus," says Cassels who just released his second book The ABCs of Disease Mongering. "You read stuff put out by media and public health agencies that a vaccine will prevent 70 to 90 per cent of the flu. But the real benefits are less than five per cent," For Cassels, the most "troubling" media bolstering has happened around the HPV vaccine, with the recent continued media assertion that it has a 90 per cent efficacy at preventing cervical pre-cancers, while the trial data actually notes only a 17 per cent reduction in these pre-cancerous lesions. "The vaccine is fraught with all kinds of problems," Cassels declares. "This is where mainstream journalism is failing us."

The patient will see you now

Of course, Cassels isn't placing the blame solely on the media. He's heard too many lamentations from doctors about patients requesting the latest magic bullet advertised on TV. Canadians now fill 400 million scripts yearly at a cost of over $20 billion.

Spending on drugs doubled between 1998 and 2004 and while the public seems enamoured by quick-fix cures hawked through aggressive pharmacorp advertising, The Health Council of Canada recently called for an outright ban of direct-to-consumer drug ads in a report titled Safe and Sound: Optimizing Prescribing Behaviours.

The report also raises concerns that doctors aren't always educated about new drugs, so they're often inappropriately prescribed and harmful.

A sick system?

The medical field is plagued with quality control problems according to researchers like Cassels. "Health care is a highly political game these days and 50 per cent of clinical trials are funded by [the pharmaceutical] industry," he points out. "It's problematic that there isn't often a level of independence in clinical trials. Pharmaceutical companies play by the same rules as businesses that make cars or computers: produce a product that sells. They've always been profit-driven.

"What has changed though is the extent to which Health Canada and CIHR are partnering with pharmacorps to do research, taking 'fees.' More and more, they're concerned with a commercial bent. The client is no longer the public, it's the company paying the fees. It's now pretty clear that influences decision-making and ultimately public health. You get drug disasters like Vioxx. That probably wouldn't have happened with an independently funded health agency. And strong public activism."

Yet the media underreports these governmental biases and conflicts of interest, according to Cassels. Meanwhile health researchers are increasingly donning the PR hat before a drug or device has been thoroughly tested and peer-reviewed, "pushing for media coverage because their next grant depends on the importance of their work," says Cassels.

For reporters and their editors, he issues this warning. "I wouldn't trust a doctor with a PR agent sending out press releases. Newspapers probably get stacks of these faxes. Good journalists shouldn't take that stuff at face value. But there's the sense you have to feed the beast every day."

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